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Self care

Self care in the community

Farmers' mental health

Men's health - Anne & Steven

What: A health education programme that encourages local patients and staff to take responsibility for their health and well-being

Who: Anne Thomas – Staff Nurse

Background: Anne is a band 6 Staff Nurse, with a BSc in Health Studies and qualifications in Health Education and counselling. 

Location: Betsi Cadwaladr University Health Board, Outpatient Department, Dolgellau Hospital, NHS Wales
Specialty: Community nursing and health promotion

What initiative or project are you involved in?

A health promotion hub that encourages local patients, staff and the community to make healthy lifestyle choices, and signposts to other available forms of help and support.

Working in a small hospital at the heart of a rural community, the outpatient team at Dolgellau Hospital provides an effective, patient-centred health education programme.
Since 2012, the team have developed several initiatives, including:

Healthy Hearts: a programme of 6 individual sessions to support chronically ill patients who are at risk of cardiovascular disease or who would benefit from making positive lifestyle changes. An expansion of the Healthy Hearts programme to include rheumatoid patients; a study of these patients resulted in a research study of the effectiveness of the Healthy Hearts programme.

Working for a Healthy Heart: an initiative developed for Dolgellau Hospital staff to provide support for lifestyle changes. This includes initiatives such as the walking and hydration challenge to improve ealth in an enjoyable way.

Prostate Symptom support Sessions: Men are able to drop in or be referred for education and tests for prostate symptoms. Providing services locally has been the key to successful health promotion.

Testicular Awareness: Visits to colleges and schools to give presentations to raise awareness of testicular cancer.

Sun Awareness and Skin Cancer Recognition: Health education is taken to where it is needed most. Staff visit farmers markets and target other outdoor workers such as postmen, giving health education literature and sun screen samples. 

Farmers mental health support: (See video above)

Carers Health and Well-being: Carers Outreach Service is available for carers within the department.

Macmillan Health and Well-being: Drop in sessions to provide support for patients and carers following treatment.

What prompted the work?

Self care is a key theme in the Welsh Government’s Delivering Local Health care plan (2013). The focus is on providing support for people to adopt and maintain healthy lifestyles, as well as empowering them to manage and minimise the impact of long-term conditions on their day-to-day life.

Self care is part of a continuum of care, starting with the responsibility individuals have in making daily choices about their lifestyle, right through to major trauma where responsibility for care is entirely in the hands of the health care professionals, until the start of recovery when self care can begin again. The outpatient team at Dolgellau Hospital support people to self care at all points along the continuum.

The Rural Health Plan (Welsh Government 2013) and own research identified barriers to accessing health education in rural areas. The development of the Out Patient Department as a Health Promotion Hub aims to encourage the rural community to see it as a resource for good health as well as ill health.

What difference has the project or initiative made?

The change in focus to preventative health care has had a positive impact on patients, staff and community at no extra cost to the NHS.

What are the long-term objectives?

  • To reduce inequalities in health in rural areas with a particular focus on men’s health.
  • To make health education more accessible to the community by taking ‘Out Patients Out’. Including young people; learning disability groups; patients with chronic illness at home. 
  • To take the model of Health Promotion Hubs to other rural community hospitals.

Patient Testimonials

'The help, advice and support was beneficial in pointing out to me things I already knew but was not implementing in my lifestyle’ (68 year old female)

This approach for me is helpful as sometimes I think more about work than my own well-being’ (55 year old male)

The programme has helped me to address my health and weight issues without being made to feel guilty’ (45 year old female)
'I have found that students are more willing to discuss their health since you have been coming to the construction department” (College Tutor)

'I wouldn’t have bothered to come (for a flow rate test) if I had to travel' (male, 64)

'I like it that I can drop in for advice without an appointment' (male,56)

'Carers Outreach have arranged a sitter for my wife so I can meet my friends. It has made such a difference, thank you'


  • BCUHB 2012 Achievement Awards: Evidence into Practice: Healthy Hearts Programme
  • BCUHB 2013 Achievement Awards: Evidence into Practice: Healthy Hearts Programme/Rheumatology department collaboration
  • Shortlisted for 2014 Nursing Times Awards: ‘Working for a Healthy Heart: Promoting Rural Workplace Health and Wellbeing’
  • Nursing and Midwifery Awards 2014
  • BCUHB 2014 Achievement Awards Winner: Contribution to Improving the Health and Wellbeing of Staff in the Workplace
  • BCUHB 2015 Achievement Awards: ‘Working in Partnership’
  • RCN Nurse of the Year Award 2015, runner-up in ‘Improving Individual and Population Health’
  • BCUHB Achievement Awards 2016 Winner
  • RCN Health Care assistant of the Year Award 2016
  • RCN Wales Health Care Support Worker of the Year Award 2017
  • RCN Nurse of the Year Community Nursing Award 2017 for ’Addressing Inequalities in Men’s Health in a Rural Community’
Nurses 4 public health

Nurses 4 public health

The RCN has been working with members on a series of case studies which help showcase the variety of ways nurses are currently working to improve public health. 

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