Rubicon report

Why the MECC training was not cascaded

Question What stopped attenders of the MECC Train the Trainer session from going on to deliver (cascade) the training in their own organisations, and what helped the ones who did?

Read across all 13 attender interviews, comparing those the document list records as having cascaded with those it records as not having cascaded, and including what interviewees report about other attenders they trained, managed or met.

What stopped MECC Train the Trainer attenders from cascading, and what helped those who did

13 interviews in 2 groups · 477 passages coded · 10 October 2026

  • Verification in this report:
  • 51 numbers, every one computed directly from the coded passages rather than written by the AI. Click any number to see who it counts.
  • 477 quotations, every one found word for word in its interview. Click an interview's ID beside a quotation to read it in place.
  • 99 findings and 4 high-level findings, every one checked against the interviews after they were coded a second time.

In short. The attenders who did not cascade do not all tell the same story. Every one of them (: , , , , , ) said time or workload held delivery back. Every one () also had trouble reaching learners. Beyond that, their reasons differ:

  • was held up waiting for slides to be signed off;
  • and were interrupted by illness or personal events soon after the course;
  • and left the session unsure how to start;
  • for , and , delivering sat outside their job.

and had backing and a plan, and have sessions booked but not yet run. Those who did cascade met many of the same difficulties, so the barriers alone do not separate the two groups. Two things the cascaders had in place do separate them clearly in these interviews:

  • delivering was part of their job, or their organisation was commissioned or paid to do it;
  • they had a ready route to learners, such as a CPD slot, an induction programme or a contract.

Cascaders also more often had someone to deliver with or to turn to, but with this few interviews that difference is unclear. The MECC leads among the interviewees give the same reasons, role and time, for the attenders they trained who did not deliver.

What this rests on. This rests on all attender interviews in the corpus. Each was read in full and coded against a fixed list of themes. Every passage where the interviewee says something stopped, delayed or helped delivery was coded with a theme. Each passage was also coded for whether it concerns their own delivery or other attenders they trained, managed or met. A second coder coded the same interviews independently, and each difference was ruled on against the documents. Counts are of interviews, split by the document list's record of whether the person cascaded, and the interviews behind each count are named. These are interviews chosen for the evaluation, not a sample of all attenders. So a count shows how widely a factor came up among them, not how common it is among attenders generally. A difference between the groups is called clear only where it would still hold if any one interview were read the other way; otherwise it is called unclear. Most themes were raised in some form by nearly everyone. The useful contrasts are the themes where the two groups differ.

Who went on to deliver

Of those the list records as having cascaded:

  • deliver MECC training routinely (, , , ) (, );
  • have delivered only once or twice, or a limited version (, , ). For example, one co-delivered a single finance module: "So, I did the finance module, so we had 17 people on that one." () Another said: "I delivered my first training the other day." ()

Of those recorded as not having cascaded:

  • have delivered nothing and have nothing arranged (, , ) (, , );
  • have sessions planned or booked but not yet run (, ) (, ).

One person the list records as not having cascaded (: ) now delivers an induction-level version of MECC. They do this only since moving into a public health job (). The list's "No" holds for their original post, not for their current one.

What stopped them

Time and workload. Every interviewee who had not cascaded (: , , , , , ) said time or workload held them back, against of those who had (, , , , ). The difference is unclear. Typical accounts:

  • "time has been a huge factor because we’ve had loads of sickness in our team so we’ve been really short staffed." ()
  • "it’s just in the real world that extra sometimes is just the extra bit you haven’t got time for." ()
  • "I came back to work and actually had a backlog of probably more pressing things" ()

For , time came second to waiting for sign-off. For , the time went on organising sessions that are now booked ().

Delivery was not part of the job, and the backing was thin. of those who had not cascaded (, , ) said delivering fell outside their job:

  • "Because this isn’t a core part of my job, it’s something that I’ve chosen to do because it feels like it’s the right thing." ()
  • "that’s out with either two things, my pay grade and my remit because this is proper public health." ()

also counts it as part of their own health inequalities role ().

(, , ) said their manager or organisation set no expectation or plan, showed no interest, or held up sign-off. 's manager asked them by email: "we need to tick a box, yes, I’ll do it." () After that, their manager did not expect them to deliver: "from my manager there was no expectation and when we discussed it at appraisal, she just said oh that’s fine." () The trust did expect it, as had been told at the training. They add: "there was certainly no plan put in place from my department." () For , two things held up delivery. The first was waiting for a busy line manager to sign off the slides: "Getting signed off from the line management was the main issue" (). The second was that bespoke slides being prepared by a partner organisation "just took forever." () Against this, and describe managers who backed their delivery (, ).

Left the session unsure how to start, and short of support afterwards. of those who had not cascaded (, , ) faulted how the session prepared them to deliver. and left not knowing how to start:

  • "There was a void where I would say right, I’m ready to do what." ()
  • "I’d like to deliver it, but I don’t know how." ()

wanted practice at delivering, but still left feeling able to deliver (). Against this, , and praised the session, and said: "Oh, I was really confident. I would have done it the next week." ()

(, , , ) described missing or unusable support afterwards:

  • "there hasn’t been any positive communication to go on from, from the end of the course" ()
  • "I didn’t know who to ask as well." ()

could not join the forums while ill. felt unable to take part while still waiting for slides (, ). Against this, said the regional coordinator had "always been on hand quite quickly" (). said the regional team "would signpost us a hundred per cent in the right direction." () Some were followed up: was emailed to ask when they planned their sessions ().

Confidence. of those who had not cascaded (, , ) spoke of nerves or fading confidence. For , the doubt was about teaching experienced colleagues what they already do: "it’s like teaching your granny how to suck eggs, like this doesn’t feel right, it’s what they’re doing day in and day out. So, I think confidence dropped off quite quickly." () , and describe themselves as confident trainers (, , ).

Reaching learners. All of those who had not cascaded () described difficulty reaching learners:

  • learners not being released: "It’s hard enough for them to get the mandatory training done" ()
  • venues: "Trying to book training venues is very hard" ()
  • staff on shifts across several centres ()
  • for , colleagues who already do what MECC teaches ()

Platforms and materials. of those who had not cascaded (, , , ) raised problems here, for example "I do find the Futures platform really clunky." () found the resources good ().

Interruptions. of those who had not cascaded (, , ) were interrupted. and had illness or personal events soon after the course (, ). In 's team, colleagues moved on, and themselves left while still waiting for sign-off (). COVID had earlier stopped the first attempts of and : "I did the training, COVID kicked in and I never got around to delivering any" (, ).

The cascaders faced most of the same barriers. Among those who did cascade, the counts were:

  • for reaching learners;
  • for platforms and materials;
  • for confidence;
  • for support after the session.

So these barriers were raised by both groups and do not by themselves separate them.

What cascaders report of other attenders. Several cascaders reported on other attenders: people they trained or manage, or met on the course. , , and lead MECC in their organisations. spoke of fellow attenders on their course. These are their readings of why others did not deliver, not those attenders' own accounts. Among the cascaders:

  • said delivery was not in those attenders' roles (, , , , );
  • said those attenders lacked time (, , , ).

In their words:

  • "I just haven’t got the capacity to deliver this at the moment or it’s not…it’s not my role" ()
  • "they’re not necessarily trainers in their roles, so that’s probably a big issue as well." ()

named those attenders' confidence (, , , , ) (, , ). Those who did not cascade say similar things of fellow attenders. and spoke of time (), and and of confidence ().

Across all interviews, said the session itself left other attenders struggling (, , , , , , , ). Of these, , and said some attenders did not realise they were expected to deliver (, , ). said some attended for the course itself, a qualification or their CV (, , , ) (, , ). suspected the course looks good on a CV because "nobody is going to really ask you whether you actually delivered any sessions or not." () put the result plainly: "I suppose of a lot of people are doing the train the trainer they’re not doing anything with it afterwards" ().

What helped those who did

Delivery built into the job or a contract. This is the clearest difference, and it would still hold if any one interview were read the other way. All of those who cascaded () described delivery as part of their job or remit, or their organisation's paid contract. This compares with of those who did not (, , ):

  • "It was part of my job description as well" ()
  • "it’s my job to deliver that training, so I have time set aside to do that" ()
  • a council contract won to deliver core MECC ()
  • an organisation that commissioned a charity to deliver it for two years ()

Against this finding, , and also saw delivery as within their role, yet had not cascaded. now delivers at induction level. Among the cascaders, and said delivering sits at the edge of their job (, ). and saw the same pattern in others (): "it's probably the ones where there's opportunities within their job already to deliver education" (, ).

Time set aside. of those who cascaded (, , ) said they had time or staff for delivery. This compares with of those who did not (, ), so the difference is unclear. said: "I have the time to set up the app, I have the time to evaluate and go and look at the sessions." ()

A ready route to learners. All of those who cascaded () had one, against of those who did not (, , ). This difference is clear, though those who delivered were bound to describe the route they used. The routes included:

  • a standing CPD hour: "had we not had that slot already kind of pencilled in and had (name) not sort of given me the support she was, it would have been a lot more difficult." ()
  • induction programmes with "a bit of a captive audience" ()
  • requests from teams ()
  • a contracted number of sessions a year ()

Against this finding, and had a route but had not delivered. has sessions set during site closures (). had "all the infrastructure there on actually booking it and arranging to go out" ().

Backing that expects delivery, not only attendance. Manager support was reported by of those who cascaded and by of those who did not (, , , , ). Support as such does not separate the groups. What the backing covered differs between people more than between groups. For , it was support to attend: "initially my boss asked us because I’m the health and wellbeing champion" (). No expectation followed (). and , by contrast, had backing to deliver and have sessions booked (, ). Among cascaders, managers asked them to lead and to arrange sessions (), or MECC was written into strategy (). , and said the same of others (): "if you’ve got a manager who’s saying come on" (, )

Someone to turn to and someone to deliver with. of those who cascaded (, , , , , ) described help after the session. This compares with of those who did not (, , , ); the difference is unclear. The help included:

  • a quick regional coordinator: "And if I’m struggling, I just get in touch with (name of regional MECC at scale coordinator)." (, )
  • a local MECC lead who coached them ()
  • a former manager they could call on as a mentor ()

of those who cascaded (, , , , ) delivered with a colleague or a team. This compares with of those who did not (, , ), and the difference is unclear. For those who did not cascade, co-delivery was planned or proposed rather than done:

  • "We double teamed to do it" ()
  • "my colleague sometimes will deliver with me" ()

's team also offers to co-facilitate with trainers who lack confidence: "we'll always offer to co-facilitate if people aren't feeling massively confident." () A new trainer asked to co-deliver "without feeling like I’m thrown into the deep end." () , a routine deliverer working alone, said "it definitely would have, I think helped to have a buddy to deliver it." ()

Ready-made slides that may be adapted. All of those who cascaded () valued the materials, mostly because they could tailor them: "you can adapt it slightly if you need to add a few slides or take a few slides out" (). of those who did not cascade (, , , ) valued them too (). The difference is unclear.

What did not separate the groups. Several themes were raised about equally by both groups:

  • prior training experience or a health background ( of those who cascaded, of those who did not);
  • personal motivation (, );
  • a good session (, ).

, and left the session keen and confident, and left it keen; did not. was stopped by sign-off. lacked follow-up, and had no expectation from their manager. and have sessions booked.

Limitations

The cascade split comes from the document list. One interviewee it records as not cascading now delivers in a new post (). and , who had not delivered, have sessions planned (, ). Accounts of other attenders come mostly from MECC leads, and are their reading of why others did not deliver. A theme that came up in an interview counts as raised whether it was mentioned once or many times. Silence on a theme means the interviewee did not raise it, not that it was absent.

Annexes

How this report was written

What was read. Rubicon read all 13 documents in full. The counts below are of attenders, one document each.

Coding. It then read each document as a whole and coded delivery (how far the interviewee has delivered MECC training to others since attending Train the Trainer, by the time of the interview, on their own account). It also marked every passage that bears on the question and coded theme (what the factor is about) and direction (whether the passage describes a barrier or an enabler, and whether it concerns the interviewee's own delivery or other attenders').

Second coding and check. The same documents were coded again to the same definitions; the run does not record whether a separate coder did it, so it is not called independent here. The two codings differed in 8 places. A reader ruled on each against the text, taking them as 7 disagreements: 3 for the first coding, 3 for the second, and 1 that the definitions as written did not settle. It also checked every sentence and quotation of the answer against the documents, so the coding and the answer in this report are the corrected ones, counted again after the check.

Counting. Attenders were then counted in 3 tables: by delivery and “cascaded”; by theme and direction; by theme, direction and “cascaded”.

Writing and checks. Rubicon wrote the answer from these counts, citing for each finding the passages it rests on. Every number in the answer, 51 in all, was computed directly from the coded passages rather than written by the AI, and all 477 quotations were found word for word in their documents.

Revisions. The report was revised twice after it was first drawn, and counted and checked again each time; the changes are listed at the end of this annex.

The workflow x-ray beside Step by step, below, draws the same procedure, a box for each stage and what it made.

Step by step

The analysis was written down as a workflow before it was counted: what to look for, how to code it, what to count. It was then counted directly from the coded passages rather than by the AI, so anyone can check a number, and another coder can follow the same definitions and code the interviews afresh.

What was read

All 13 documents, read in full: 6 no, 7 yes.

Coding: Delivery

one row for each document, read whole; 13 rows.

The instruction a second coder would follow
This is an interview with someone who attended a MECC (Making Every Contact Count) Train the Trainer session. Read the whole interview and give one row saying how far the interviewee has gone on to deliver MECC training to others since attending, using the definitions of the column. The quote is the interviewee's own words that best show it, copied exactly.
Delivery

How far the interviewee has delivered MECC training to others since attending Train the Trainer, by the time of the interview, on their own account.

CodeMeansCountsDoes not count
Delivers routinelyDelivers MECC training (core MECC or a MECC module) repeatedly or on a regular schedule.Several sessions delivered, or a monthly or similar schedule they personally deliver to.A single session so far (delivered_once_or_limited).
Delivered once or limitedHas delivered MECC training, but only once or twice, or only a cut-down version, or only alongside a colleague who led.One session so far; delivers only an induction-level MECC slot; co-delivered one module.Sessions booked or planned but not yet run (not_yet_planned).
Not yet plannedHas not delivered any MECC training yet, but has sessions booked or a concrete plan to deliver.Dates booked, sessions scheduled, a team plan with dates.A vague wish to deliver some day with nothing arranged (not_delivered).
Not deliveredHas not delivered any MECC training and has nothing concrete arranged.Never delivered; plans abandoned or on hold; a wish with no arrangement.Anything booked (not_yet_planned).
The coded passages 13 rows
Delivers routinely 4 passages
  • And we always still do a monthly core MECC session for anybody to drop into.
  • So, and then obviously I delivered, I’ve delivered that training now for well I’m going to say somewhere between 22 and 26 times.
  • The training that I deliver tends to be online but then I’ve got colleagues who do deliver face to face and deliver more bespoke, so we approach it as a bit of team.
  • we applied for the bid from (name of location) Council to actually go and deliver the training and we won the bid so we’re delivering it. We seem to be doing one or two a month, so it’s going quite well.
Delivered once or limited 4 passages
  • So, I’ve done a couple of sessions already, so it is in my job role.
  • We have a link worker, and I delivered my first training the other day.
  • So, I did the finance module, so we had 17 people on that one.
  • Then coming into public health, there was an expectation that you delivered some type, so once I saw it delivered at care certificate level and what we’re delivering, I embraced that. I’ve offered to be the main care certificate deliverer because there’s a lot of people that don’t like to have that conversation with people.
Not yet planned 2 passages
  • We haven’t. The problem we’ve got is we’ve got such a wide net to cast over our sites and also, it’s getting the people at the same time.
  • My personal circumstances meant that I had an illness not long after I went on it and was off sick for a period of time, hence I have got two courses booked but they haven’t been delivered yet.
Not delivered 3 passages
  • I did the MECC training about I think it would have been November 2022, and I left the (public sector service) about a month ago and the slides still hadn’t been prepared.
  • People say to you well I’m doing this and I’m doing that, or you’ve got me saying well I’m sorry but I haven’t really done anything in that respect.
  • I’ve never asked the question and said look guys, I did this training in November, would you like me to present, you know, cascade the training to youse guys.

Coding: Factors

one row for each passage that fits; 464 rows.

The instruction a second coder would follow
This is an interview with someone who attended a MECC (Making Every Contact Count) Train the Trainer session, which prepares people to deliver (cascade) MECC training in their own organisations. Find every passage where the interviewee says that something stopped, delayed, limited or discouraged delivery of MECC training (a barrier), or that something helped, enabled or encouraged it (an enabler) - either for their own delivery (including their own organisation's delivery that they take part in or lead) or for other Train the Trainer attenders they know of, such as people they trained, manage or met on the course. Code only what the interviewee reports as having happened or as being the case; do not code wishes or suggestions for improvement ("it would help if...") unless the same passage says the lack of that thing held delivery back. Code the interviewee's words only, never the interviewer's. Give one row per passage and theme; a passage that raises two themes gives two rows. Copy the quote exactly: the shortest span, usually one to three sentences, that shows both the factor and its bearing on delivering the training.
Theme

What the factor is about.

CodeMeansCountsDoes not count
Time capacityThe time, workload or staffing capacity of the would-be trainer (or their team) to prepare and deliver sessions.Too busy; delivery is extra on top of the day job; staff shortages and sickness; competing priorities in the would-be trainer's own workload pushed it down their list; having protected time set aside to deliver.Whether learners can be released to attend, or learners not making MECC a priority (audience_access); an organisation or its leaders not treating MECC as a priority (management_backing); illness of the trainer (disruption).
Role fitWhether delivering MECC training is part of the person's job, contract or remit.Delivery written into the job description or training plan; paid or commissioned to deliver; a public health or training post; or, as a barrier, delivery not being part of the role, being out of remit, not being a trainer by job.A manager's expectation or permission to deliver (management_backing); personal experience as a trainer (confidence_skills).
Management backingSupport, expectation, permission, sign-off or a plan from the person's manager, leadership or organisation for delivering MECC training.A manager asking or expecting them to deliver; leadership on board; an organisational target or implementation plan; or, as a barrier, no expectation or plan, managers uninterested, sign-off held up, no authority over trained staff, the organisation or its leaders not treating MECC as a priority.Support from the regional MECC team or peers (after_support); being given a meeting slot to reach staff (audience_access); the would-be trainer's own competing workload (time_capacity).
Confidence skillsThe would-be trainer's own confidence, nerves, knowledge or prior experience of training or of health topics.Prior teaching or presenting experience; a health or public health background; nervousness about presenting; fear of questions they cannot answer; knowledge fading; not from a training background.Confidence that comes from what the Train the Trainer session did (tt_session) or from a co-trainer (co_delivery).
Tt sessionHow the Train the Trainer session itself prepared the person to deliver, including whether it made the expectation to deliver clear.The trainer's encouragement; practice or role play in the session; the session's content, level or length; unclear or unexplained expectation to deliver; a session that left them not knowing how to deliver.Support received after the session (after_support); the slides and resources as materials to deliver from (materials_platform).
After supportSupport, follow-up or contact after the session from the regional MECC team, peer networks or forums, a local MECC lead, mentor or champion.A responsive regional coordinator or principal trainer; peer support groups or forums; a local MECC lead coaching them; or, as a barrier, no follow-up, not knowing whom to ask, being unable to attend forums.A colleague delivering alongside them (co_delivery); the online platform as a store of materials (materials_platform).
Materials platformThe slides, resources, online platforms (Future NHS, MECC Gateway), booking and certificate systems, and the freedom or effort to adapt the slides.Ready-made slides; resources easy or hard to find; a clunky platform; registration or certificate problems; freedom to tailor slides; waiting for bespoke slides to be signed off; work needed to adapt the deck.Session content as taught on the day (tt_session).
Co deliveryDelivering alongside a colleague, a pair or a team, or the lack of anyone to deliver with.Co-delivering; a team sharing delivery; a new trainer shadowing or co-facilitating; delivering alone without a buddy as a difficulty.Advice from a lead or regional team without delivering together (after_support).
Audience accessAccess to learners: getting staff released to attend, a slot, venue or channel to deliver through, logistics, demand, take-up, or whether audiences see a need for the training.An existing CPD slot, induction day or team meeting; venues hard to book; staff on shifts across sites; managers unable to release staff; low take-up; requests from teams; colleagues who 'already do it' so training them seems pointless; staff too pressed to make MECC training a priority.The trainer's own time (time_capacity).
DisruptionEvents that interrupted delivery: the trainer's illness or personal circumstances, COVID, a job move, people leaving, restructuring.Off sick after the course; COVID stopping delivery; trained staff moving jobs; leaving the organisation.Ongoing workload or staffing pressure (time_capacity).
Motivation beliefThe person's own motivation, enthusiasm or belief in MECC, or their reasons for attending.Passion for health promotion; believing in MECC; enjoying training; attending only to network, for a CV or a qualification, or to learn MECC rather than to train others.A manager's expectation (management_backing); nerves (confidence_skills).
Direction

Whether the passage describes a barrier or an enabler, and whether it concerns the interviewee's own delivery or other attenders'.

CodeMeansCountsDoes not count
Barrier ownSomething that stopped, delayed, limited or discouraged the interviewee's own delivery (or their organisation's delivery that they take part in or lead)."I haven't delivered because..."; a difficulty they met in delivering.A difficulty they say other attenders have (barrier_others).
Enabler ownSomething that helped or made possible the interviewee's own delivery, or would plainly make their planned delivery possible."Because it's my job I have time set aside"; "my colleague delivers with me".Something that helped other attenders (enabler_others); a suggestion for improvement.
Barrier othersSomething the interviewee says stopped or held back other Train the Trainer attenders from delivering.A MECC lead explaining why the staff they trained have not delivered; observations of fellow attenders on the course.Barriers to staff having MECC conversations with patients rather than to delivering training.
Enabler othersSomething the interviewee says helped other Train the Trainer attenders who did deliver.A MECC lead naming what the attenders who went on to deliver had in common.The interviewee's own delivery (enabler_own).
The coded passages 464 rows
Time capacity 35 passages
  • So, we’ve had quite a few sessions together already to go through the presentations, the core training and we’ve got time booked in to practice the delivery.
  • In terms of sitting down with team leads and trying to sell it to them and sitting down with managers and trying to organise which staff are doing what, than sitting down with the team that’s delivering and getting them confident and comfortable to be able to deliver. So, it’s been massively time consuming.
  • Getting signed off from the line management was the main issue of just I think because both the teams are so busy, my line manager had a massive workload, she’s just been promoted so she was doing like two job roles at the same time
  • getting the time to go out and see them is a barrier and because I’ve left there’s now even more of a staff shortage than there was
  • the new process at (name of organisation) is cost saving, every job has to be reapproved before you can hire for it.
  • I mean the person who did it before me was like it’s a massive amount of work that. I don’t think it is.
  • I mean we’re ridiculously stretched like most of the NHS at the moment. It’s just like you haven’t got time to do anything else, basically.
  • I’m in a fortunate pot at the moment where because I’ve just moved over in roles, I’m still having an eight week induction, so I’ve got a little bit more time at the moment so I can do things like this
  • So, obviously if I’d got a full caseload then trying to fit anything in would be really, really difficult.
  • So, in the future there may be other things that I want to do but it’s time. At the end of the day, I’m paid to look after patients and that’s the important bit, you know.
  • I don't have the capacity when I get back into my team, either the managers not supportive of the extra time it's going to take
  • So yeah, we just haven't got that level of capacity in the system.
  • I mean in terms of the capacity within our team there is also a clinical educator who’s supporting this piece of work.
  • Again, it’s a very busy environment and it’s liaising with the project manager (name), who’s very busy.
  • it’s the first time I’ve been involved as the election agent and it was, what can I say, it was difficult, but it was an extremely good learning exercise.
  • Well, it’s a mixture of both but also then the trustee here is it’s not, I wouldn’t say it’s hugely time consuming, but I do like to be obviously involved in lots of aspects of it. You know, there’s a lot to it, particular in finance we generate a one income and that in itself is daunting.
  • Like I said at the beginning, I didn’t have the capacity to do it once a month, so they’ve got a two-year contract.
  • So, I think I would have got to it quicker had it not been for I came back to work and actually had a backlog of probably more pressing things that I have to attend to first.
  • a lot of them have either moved jobs or they haven’t got the capacity to do it anymore, or they don’t feel comfortable.
  • I think that’s partly to do with the fact that we’ve all been so busy we’ve probably not promoted it quite as well as we could have.
  • But because working public health it’s my job to deliver that training, so I have time set aside to do that, whereas people who are doing the core, sorry who are receiving the Train the Trainer training, weren’t necessarily in that kind of role.
  • They were practitioners, or they have a day job and so I think they found it very difficult to prioritise MECC around everything else.
  • got so many emails back from people saying I just haven’t got the capacity to deliver this at the moment or it’s not…it’s not my role – not that it’s not their role because I don’t think it ever was their role – but I’m not able to have this in my remit notes, it’s not seen as relevant to my role
  • I have the time to set up the app, I have the time to evaluate and go and look at the sessions. I mean, I spend a lot of time on MECC and that’s why I’ve been successfully delivering it
  • So, feeling more comfortable in delivering the MECC training comes from me having the time to look at the training slides, look at the other documents that come along with that
  • Oh, again, in this role absolutely because it’s part of my role.
  • Public health, but my old role not a hope, you know.
  • I think this is your problem is you’re expecting that these people to be able to book out a lot of time and it’s not just going to deliver it, it’s the preparation time sorting out.
  • I don’t have time to attend that Teams meeting that’s really nice to discuss these things because I just don’t have time to book my time out.
  • time has been a huge factor because we’ve had loads of sickness in our team so we’ve been really short staffed.
  • Oh my God, this is another thing I’ve got to do and I’ve already got a jam packed schedule and I’m already working above and beyond and now I’ve got this to do.
  • I had it on my to do list and then it just kept getting pushed because I had also just completed and audit.
  • it’s just in the real world that extra sometimes is just the extra bit you haven’t got time for.
  • I’m probably fitting it into a role that they’re already busy. It’s time for a lot of things, isn’t it, a capacity.
  • Just finding the time because I only work part time and I still find I do a lot at home for other things, so one of these days I’ll get to them, it’s just time and capacity like everybody, I think.
Role fit 37 passages
  • this was obviously not something that I foreseeing being part of my job role and I’m quite happy and motivated to do it but obviously it does add, when you say what is MECC, no, it’s not adding things to the rest of your workload, but in this sense it has added a massive amount to workload.
  • because I normally did training roll out to (the team) my line manager was asked to go on the training and she asked me to go along with her.
  • So, then I got signed up to do the train the trainer and part of my role is to do the MECC training for the public health team.
  • So, I’ve done a couple of sessions already, so it is in my job role.
  • Because of my health background and my job title lends itself to, you know, leading on training and development. Oh well, that’s (AP11)’s pot.
  • Because they think they don’t want to take that responsibility whereas I’ve said yes, I’ll come to your practice, you know.
  • It’s kind of like I become the public health link worker because the trust has a whole has a big sort of drive for physical health
  • So, yeah, I think I’m now down as a trainer so if they need some training, you know, I mean we’ve already got one trainer, one very good trainer, you know, but she says it’s just nice to have some support, you know.
  • At the end of the day, I’m paid to look after patients and that’s the important bit, you know.
  • the other part of my role was to develop or deliver the MECC program of work across the organization.
  • I don't have the capacity when I get back into my team, either the managers not supportive of the extra time it's going to take, or we didn't actually realize what we were signing up to when we came on your programme
  • That's not, that's not me, and that's not what I want to do.
  • so they have to do that and it was part of their role and they had, I would say they had more opportunities to do that in their day-to-day
  • Then we also had, we've got a public health midwife in our wider team and so then she was MECC trained and would deliver on maternity education days. So that was inbuilt.
  • it's probably the ones where there's opportunities within their job already to deliver education, and if they're part of the public health team as well, then the expectation is that they would be, they would be doing MECC routinely.
  • because we’ve got name of charity) who are commissioned to deliver it for two years.
  • I’m more after looking after the trainers that we’ve got
  • Yeah. Uh-huh. And you get paid per course so.
  • I have chosen to do that myself as part of my own health inequalities role.
  • I have to be clear that my remit is only for people working with cancer patients, so I can’t tackle this as a trust
  • Because this isn’t a core part of my job, it’s something that I’ve chosen to do because it feels like it’s the right thing.
  • But because working public health it’s my job to deliver that training, so I have time set aside to do that, whereas people who are doing the core, sorry who are receiving the Train the Trainer training, weren’t necessarily in that kind of role.
  • got so many emails back from people saying I just haven’t got the capacity to deliver this at the moment or it’s not…it’s not my role – not that it’s not their role because I don’t think it ever was their role – but I’m not able to have this in my remit notes, it’s not seen as relevant to my role
  • they’re exercise therapists or they’re specialist nurses and they might have done it once or twice so it’s not really anybody else who’s delivering it successfully is really putting a lot of work in outside of their actual role, I think.
  • we can’t ask that he goes travelling off to other sites to deliver it because that’s beyond the call of his kind of role.
  • I work for public health but I’m going that’s out with either two things, my pay grade and my remit because this is proper public health.
  • Oh, again, in this role absolutely because it’s part of my role.
  • For no extra money, so with all due respect as well, to go and deliver that again, say a Band 2 to go and deliver some sort of training, it’s a higher remit. It’s a higher pay grade. It is all of a sudden more of a bigger responsibility.
  • It was part of my job description as well, so I knew that that was this deliverable that had to kind of be delivered on.
  • Which I suppose is a bit different to maybe some other people that are attending the Train the Trainer where they might not have that kind of either written into their job description or that opportunity to kind of channel that within their existing role
  • I was going to say the only people that have really effectively cascaded it are people within sort of like the health improvement, health improvement practitioners’ team
  • the health improvement team, myself, we do deliver training, that is part of our role.
  • But I suppose thinking of maybe some of the other organisations that have done the train the trainer, they’re not necessarily trainers in their roles, so that’s probably a big issue as well.
  • we had in our group a lot of people from different organisations who hope to roll it out to their companies and it probably hasn’t happened. But one they weren’t trainers
  • if someone if they’re not, their job isn’t the trainer, I think it will be a bit difficult to suddenly go in
  • Because I’m already either a tutor in (name of organisation) in the centre, or a trainer doing outreach things.
  • we had to then apply, because (name of location) put out a call for commissioning to teach the core MECC, but I do have a good relationship with (name), so she kept saying, you know, put in for it, so we had to apply.
Management backing 54 passages
  • It was good because a lot of the team leads and the management actually they got involved as well. They came along to the core training themselves.
  • It’s always been that everyone who did the Train the Trainer was always going to have an involvement in the delivery. And I guess there’s a need to be as well because you’ve got to do so many sessions, as you know, to fit that in within a 12-month period, I think that is.
  • We have had regular meetings about progress and updates and there’s things I’ve gone back to management with and said that we’re not really comfortable with this and we’d like to think of a different approach to do with this, and they’ve kind of just said OK whatever works for you.
  • My boss was really good about making sure that we did a lot of health and wellbeing training, and we got access to all of those resources.
  • Because it was getting handled at the (name of organisation) side it was then wrapped up in all of the red tape and we just couldn’t get out and get it done.
  • Getting signed off from the line management was the main issue of just I think because both the teams are so busy, my line manager had a massive workload, she’s just been promoted so she was doing like two job roles at the same time
  • we went in with GPs and the GP was just going to distribute it to their surgery and they were the MECC champion, they were going to roll it out to their surgery, they’ve got control over that process.
  • Nothing was in place at the time when I was leaving and there’s lots going on at the moment with it coming up to (redacted for confidentiality) and they’re very busy at the moment so I don’t think anything will have happened since I left.
  • Yeah. They value MECC. They understand the value of it
  • Yeah. They would like, when I’m like well I’m pushing it as best as I can, but until people see the value of MECC they’re not going to get on board.
  • No, well not particularly. My plan is I’m looking at right where are our services.
  • I would love to make it mandatory but that’s like not happening.
  • Yeah, they were really good actually. They were really good about it.
  • the trust does have quite a good push, big push towards physical health and health promotion because the NHS, you know, it’s part of the five year plan and all that sort of thing, so it was like well yes, as long as you’re going to use it kind of thing
  • as part of signing up to the training they've got to deliver four core MECC sessions within a year.
  • people go away, back to their workplaces, and they aren't supported to deliver their training when they get there.
  • my manager, one of the public health OSMs had gone to the board and said look, this is what we said we'd do, this is what you agreed to do but actually it's not had the desired outcome.
  • they decided they want 50% of staff within the Community to be trained in MECC.
  • at least if we're working in a more targeted way with these particular teams under phase two, then we've got a bit more leverage
  • some random healthcare assistant who came on train the trainer last January, there's only a limit to how much we can get them to do anything with that. You know we can send them emails but we've got no sort of authority over them
  • I think probably what's lacking at the minute is like a, maybe a steering group around MECC, like a specific project plan
  • if your managers not going to support that, then you're not going to be able to move that forward.
  • Whereas if your manager, if you’ve got a manager who’s saying come on, there's three or four of you from the team have gone off and spent half an hour, half an hour, half a day, doing your training, we need some movement on it.
  • But I mean now we’ve got like more buy in from senior managers and they’re very keen to have MECC, so that’s where I’ve got the core MECC module.
  • And it’s part of our public health plan that we want to get, and the wellbeing strategy that we want to get everyone at (name of location) Council kind of MECC trained. It’s part of the health champions plan. The director’s on board so I know it is really important that we get the message out there.
  • we’ve got the internal task and finish group now, so they’re really keen to deliver MECC within a lot of the council staff.
  • Totally supportive of me delivering it and I can’t really say more than that, you know. It’s something that I talk about in management meetings, it’s something that I talk about in team meetings. They’re happy for me to promote it, to plug it.
  • So, when I came back into the trust (name) asked me to deliver or to take the lead on MECC, which was fine with me
  • I think the sort of senior people thought another training session that we’re going to have to, why – and I think they saw it as duplicating, although MECC I think is more general than those specific topic areas.
  • my line manager said get in touch with (name of regional MECC at scale coordinator), get in touch with (name of principal trainer), you need if you’re taking the lead on MECC, you need to organise some training sessions.
  • My line manager is absolutely definitely on board with MECC.
  • It’s not to say that it’s not…there’s not some work to do around cascading that message more broadly across senior managers.
  • she kind of just said it’s not something that we’ve got capacity to really put in place at the moment. We don’t want to bombard staff with other training when we’ve already got the smoke free, and we’ve got the alcohol training.
  • It looks really positive, and nobody is going to really ask you whether you actually delivered any sessions or not.
  • we’ve never said you have to deliver to X number. We’ve sort of said deliver one session or to ten people. And I mean I’ve never really pushed that either because people just aren’t doing it.
  • But then when I spoke to my peers about it from management down, they didn’t show any kind of interest, they weren’t really that…I mean first what does it mean, that’s what am I going to get out of it.
  • Management don’t have time, especially in a clinical setting, for you to go and say can I have four hours of your team, or three hours of your team, or even an hour of your team to talk about MECC.
  • Then coming into public health, there was an expectation that you delivered some type, so once I saw it delivered at care certificate level and what we’re delivering, I embraced that.
  • It’s like public health have got a massive implementation plan. That’s what they want to do, they want to see MECC and obviously they’ve come up with the figures, how much they want to impact it. So, from that side of things it’s massively supported.
  • But internally, in there, it is going through, don’t get us wrong, I think there’s more people talking about it now, but again it’s that senior management don’t really get it
  • Now, one of the things that we were aware of when I went on that is the managers didn’t know what it was. It might be different now a year down the line, so they were putting people forward just because they thought they were going to become aware of MECC.
  • It was almost like you weren’t allowed to even allow yourself to step out. The expectation, this is what we want from you because we paid for this training.
  • I think we’ve got lots of different strategies and policies where MECC is featured within that and the different services within the council, they’re really on board with MECC.
  • they know that they want to kind of deliver on MECC within the joint health and wellbeing strategy and they know that there’s people in the team that kind of have that, or within the staffing structure, that have that kind of role.
  • They had management who already had had experience of MECC in the trust, so I think that definitely helped. That was steered at a very kind of leadership kind of level.
  • there was an expectation there that that was what the intention was, that they needed to kind of develop their training to like rework it around the MECC framework. There was that expectation that everybody was going to do that, so it wasn’t really optional
  • And maybes it doesn’t get seen as a priority but if it was just pushed up the priority ladder it would actually really make a massive difference overall
  • so I think health and wellbeing is really high on their agenda looking after their staff.
  • initially my boss asked us because I’m the health and wellbeing champion and said (AP8) would you, I know you’ve done previous MECC training and you’ve done the public health training, so would you be the train the trainer for the team.
  • but certainly from my manager there was no expectation and when we discussed it at appraisal, she just said oh that’s fine.
  • so she quickly sends out an email, (AP8) will you do this, we need to tick a box, yes, I’ll do it. So that box is ticked.
  • And there was certainly no plan put in place from my department.
  • Oh, they were really keen. They were really keen because they knew, I think, they were forward thinking and they knew it’s something that we’re going to hear a lot of in the future
  • They’re very keen and supportive.
Confidence skills 55 passages
  • I think because of being trying to implement MECC for such a large time during the work, working environment, it just felt like a natural sort of progression. I felt quite comfortable at the idea of having to then deliver the training.
  • So, every week that I’m standing up delivering health lifestyle sessions and stuff like that and using the PowerPoints and stuff, so in that sense absolutely fine, it’s not something that’s completely new.
  • Because it’s one thing learning a presentation and remembering the slides and all the rest of it, but as somebody throws you a curve ball question that you should really know about, but you haven’t got an answer you’re going to end up looking really silly so it’s just about fine tuning everything.
  • I was fairly comfortable that I had good relationships with (the teams), and I knew sort of kind of how to present them in a way that they would get along with.
  • Oh, I was really confident. I would have done it the next week.
  • I’d already been having those conversations about how to draw this information out of people, so it felt like a familiar topic just with more resources behind me to help me out.
  • it’s sort of took longer and longer until it got to the point where I was sort of feeling like well it’s no longer fresh in my mind.
  • it makes people feel more confident if they tweak the slides a little bit or they had their own activity that they were going to do, it felt like it was their training
  • Well, when I’ve spoken to people, one girl’s really keen but she’s not delivered training before, so she’s got to come along with the couple that I’m doing, so I think that is an issue.
  • I think a lot of people aren’t – I’m from a health background so I’m really comfortable with all of the topics and all of the information – but people aren’t comfortable, and I think they’re worried about what they’re going to be asked in the training sessions.
  • if you make it too overly complicated, they’re going to go all right, yeah I’ll do the train the trainer and then they go nah, you know, I don’t feel confident because I don’t actually understand that part myself.
  • Yeah, I am probably pretty confident in doing training anyway. And then when I did the train the trainer it was stuff I knew about. I was like yeah, that’s fine right, I can do that no problem. So, I think my background really made it super easy for us to just transition.
  • I’m a person that can stand up and talk to people. I’m quite outgoing and stuff and I’ve always liked that idea
  • sometimes it’s like I obviously don’t know enough sort of thing, you know, it can sort of be a bit like that but then you have to think well this is their job.
  • I mean, it was a bit nerve wracking because as I say, I’ve never done it before.
  • I am confident, that’s the word, isn’t it? And it’s like if I want to do something I’ll kind of find a way of doing it generally both in work life and private life.
  • I came into post, I knew what MECC was, I've worked in public health for years.
  • or actually, I've really enjoyed it, but I don't feel confident or comfortable delivering the MECC training.
  • I know I should be doing this and I do want to do it, but I need some additional support, so we offer that.
  • I do think it can be hard for them to know how to deliver the information on, say the wider determinants
  • Again, I looked at my background as well and I used to do a lot of training and such, you know, so it hasn’t left us entirely.
  • When you’ve got a teaching session your experience sort of gets you through. You settle down and you get people interacting hopefully.
  • I mean I’ve got an advantage just because I know about health inequalities and like I’ve seen the Public Health England Fingertips charts, like I didn’t need to figure out what it was.
  • again it’s I’m not from a training background so it might just be my insecurity of being a trainer.
  • Like she’s very kind of open and confident and she is a trainer so I think she obviously wouldn’t struggle as much as I would.
  • But I’m quite introverted and even university presentations were quite overwhelming at first.
  • Well, I hadn’t looked at the slides like in a few months and like the panic that set over us because I was hosting the event and then just like it was a bit like I didn’t have any resources on us either
  • I suppose I’ve got the advantage that I have read the slides quite a lot, so I am familiar with them.
  • I’m a trainer or was. I haven’t done it for a long time but for me I maybe have an advantage because I’ve got a post graduate certificate in adult education so I’m a little bit more confident in delivering and I present, I do a lot of presentations in my current work
  • Maybe for other people that might be a little bit of a barrier, it might feel a bit scary, but I think with a clear step-by-step guide that could be overcome.
  • I know the point is to deliver it at scale. It’s that cascade but I do think not everybody would want or feel confident to do that.
  • So, I’ve had the training about five or six times now.
  • I was quite nervous about delivering the MECC training because before I started doing it, it wasn’t something that I’d done for long, like for quite a while.
  • But I used to deliver other training. I used to do brief advice or the IBA, alcohol, identification and brief advice for alcohol while I was at Northumbria Healthcare.
  • a lot of them have either moved jobs or they haven’t got the capacity to do it anymore, or they don’t feel comfortable.
  • Some people that are trained haven’t done any training and feel really lacking in confidence or just intimidated at the thought of presenting to a group of people.
  • I think I’d probably now feel more secure delivering it online just because I’ve done that more often, the sort of doing a face-to-face session now feels a little bit intimidating.
  • That didn’t faze me, I’m a…well, I’m a personal trainer, I’m also a group exercise instructor. I’ve done a lot of training delivery.
  • I don’t, you know, if anybody asked me a question like so I think it was it’s too heavy on the stats.
  • Whereas now I understand what I’m trying to deliver.
  • I froze because I looked at the slides and went, I don’t understand them. I don’t get them.
  • they almost felt a little bit I mean very unconfident in kind of delivering it even though, like it’s you’ve run through the training, you’ve got the slide deck, things like that, but it’s not your own kind of slide deck
  • I think confidence is a lot of the problem. Possibly because I think if they’re thinking well, I’ve got to deliver that just how (name of principal trainer)’s delivered it, then that is going to be kind of a confidence issue.
  • once I start then I actually quite enjoy it and I think it would be same if I presented the MECC training.
  • I think I would be apprehensive, one will my technology work, will this PowerPoint work and stuff, and two will my presentation skills be OK.
  • as time goes on your confidence does fade, it wanes away the less you have to do with it.
  • it’s like teaching your granny how to suck eggs, like this doesn’t feel right, it’s what they’re doing day in and day out. So, I think confidence dropped off quite quickly.
  • still do feel a little nervous beforehand, delivering the training
  • they were really a bit nervous on the course like oh but what if I can’t answer the questions, you know.
  • if they only need to do it once or twice a year they’ll probably get quite nervous about it.
  • I did feel I haven’t got (name of principal trainer)’s knowledge, but I think because he’s done it loads of times and it will come with time, yeah.
  • And once you’ve done it a few times, like everything it does get easier.
  • I think having the background sort of in that area in public health, in health promotion.
  • Yeah, they’re worried they haven’t got the knowledge. They’re worried they’re going to get asked questions that they don’t know
  • A little bit because usually you get very positive comments, but I think one of the comments there was I wasn’t very enthusiastic, which I’ve never had that before
Tt session 51 passages
  • it just bamboozled a few people, I think, and it lost a few people quite early on.
  • there was some good work around some good support and like sort of advice around how to be an effective trainer, how to deliver in an effective way.
  • I just thought if you’re being trained to do something you need to practice doing it, so I thought that might have been involved in the session.
  • And I just think that was too much for them on that day. I think they probably could have done with a little bit of time to reflect and digest and come away from the core MECC
  • I think they had some good ideas about activities and stuff that you could do.
  • if you make it too overly complicated, they’re going to go all right, yeah I’ll do the train the trainer and then they go nah, you know, I don’t feel confident because I don’t actually understand that part myself.
  • And I think that’s what the training is like, whereas my colleague who did the training with me is then coming with me to do further, you know, to observe the training that I do, and I wonder if that’s because she’s not that kind of see one, do on, off you go kind of learner.
  • I think it just reinforced all of the things that I already knew and gave us the backup of that there’s a gateway there.
  • No. Probably not. There wasn’t. So, it was basically me having an [35.33 unclear] round Future NHS because some of the emails you get are really, really long.
  • I liked the idea that it gave you like sentence starters and stuff like that, because I think a lot of the time people are like well yeah, how do I do it
  • I kind of came away from the training with like oh let’s do this, you know
  • So, yeah it did give me the impetus and the enthusiasm I suppose to go out and do something, I think, because yeah, I think it’s so relevant to what we do.
  • there wasn't the opportunity to do any skills practice.
  • So we developed our own case studies or scenarios that we gave out in the training and just ask people to, you know, go into pairs and then practice using the three-A approach
  • But then it felt like we were all sat in the training for a good hour or so before MECC was even mentioned.
  • we didn't actually realize what we were signing up to when we came on your programme, even though the clue is kind of in the title a bit
  • I think the feedback I get from staff around the content is that it can be quite overwhelming
  • And getting the confidence as well, because obviously when you’re doing sort of teaching sessions it can be quite daunting at times, but I think that helped as well.
  • I was motivated certainly when I done the MECC course in that and I was looking forward to it, but the thing what I found was, was this gap. There was a void where I would say right, I’m ready to do what.
  • Because it just it was really well right OK, I’ve done that, now how am I going to get my message across. What structure, you know, can be in place to actually try and achieve your objectives and there didn’t seem to be any support in that respect there.
  • Not, you know, some aspects of it was a little bit vague.
  • There was a relaxed atmosphere, you know, and you were encouraged to be involved.
  • Then how do you actually practice what you’ve learnt.
  • So, it might have just been that one session, but again I didn’t feel like equipped to then go away and deliver it.
  • So, I know a couple of people just went straight to the Train the Trainer so they might have struggled a little bit more with not having that prior knowledge.
  • Like until I’d done the session with (name of principal trainer), I would have been very nervous doing it.
  • We also did an exercise that was different, like a role play, and I think the one we got was we’re in a GP surgery and a lady had came in with issues so you were kind of practicing having a conversation, so I think that was quite useful.
  • Again, just not being from a training background I think there could have been a little bit extra at the end rather than just what qualities should you have.
  • I suppose the one thing that’s probably came up is some people will do it and maybe not realise that they have to deliver training.
  • But yeah, I mean (name of principal trainer) made it clear.
  • It was good. It was really good. So, thoroughly enjoyed it. Did feel motivated afterwards.
  • I think that could be a bit scary to some people. Because one of the exercises that was done in that is a case study of how the COM-B fit in with this, and I think you’re actually asking people to understand a quite trickly concept and then apply it.
  • But then the additional bit that supports you to be the trainer as well was a good approach.
  • In order for me to deliver it I was there to really observe and shadow and that’s why I wanted to go to every session he delivered because it helped me to kind of ingrain that into my mind as to what I would say.
  • after the first time I could never remember how (name of principal trainer) had kind of woven that into the training and I just never, I’ve never included it in mine because I feel like it’s very random
  • I think the Train the Trainer bit on the end was really useful because I think people aren’t necessarily natural trainers.
  • You know, the practicalities of delivering a session, promoting it, bookings, registers, IT facilities and kind of it’s a bit more of a full package rather than just leaving people to it
  • I don’t remember all that much content in the Train the Trainer sessions about organising your sessions via the app.
  • They didn’t have a clue what they were trying to deliver and then they were told the expectation was they needed to deliver that four sessions in a year and nobody had a clue about it.
  • So, that’s in all honestly why you lost or why our trust, lost a whole people because they weren’t prepared to do the training because they didn’t understand they had to deliver training.
  • I’d like to deliver it, but I don’t know how. Haven’t got a clue how I’m going to do it.
  • Because it was train the trainer, they were wanting that, there were stats is that impact why are we doing it, rather than how are we going to do it.
  • we pull people in with no expectation or understanding what the expectation is, and even my colleagues who went through the last sort of Train the Trainer they didn’t understand their expectations.
  • I think my overall experience was at the end of it I thought right, how do I take this forward, and I did have to do a lot of work adapting it and making it comfortable for me to deliver, making it (name of location) specific.
  • But sometimes that doesn’t translate to I don’t know if you’ve got somebody from a VCSE organisation it might not feel like it translates to them.
  • but then when a person leaves that session there’s still quite a lot of work to do to adapt it for them and I don’t know if that’s something that can be done in the training.
  • I think it’s the barrier’s maybe well how do I then deliver that within my team.
  • they made that very clear that you don’t have to be an expert. We’re giving you the tools to then signpost people.
  • He kind of gave us tips so said don’t just go in cold turkey, you need to practice with family or whatever. You need to time yourself. You need to practice with the technology.
  • It was very clear, and it was really encouraging telling us to, you know, you will be all right, you will be able to do it.
  • I think they covered how to train really well. I mean I enjoyed it and I took a lot from it
After support 46 passages
  • He’s always been on hand quite quickly if there’s been any questions that I’ve had or any concerns.
  • It was just a bit embarrassing for me being in these meetings and everyone else is talking about what they’re doing and I’m like yeah, I’ve not done anything yet, I’ve got a big project to do.
  • what’s kind of the point in interacting when everyone else was sort of taking the slides and tweaking them for them self and I’m just waiting on someone else to sign off on it.
  • it was I sitting in the forums and finding them interesting, but I felt like I couldn’t really participate.
  • Yeah, I mean I’ll just email them and ask if I need anything. So, I do go to the regional forum so it’s there if I need it.
  • That is way too long. I mean they’re not very often, but it is really long and it’s a bit of a showcasey this is what I’ve done, this is how I’ve done it.
  • You do need that because if you’re trained in it and then there’s no champion there going well can we do this, can we do that, I sometimes think it just gets well right we’ve done that and it’s in a folder with everyone’s name on and nothing happens.
  • lady who gave me a lot of support, her sort of thing was the more you do it the more familiar you are with everything the more it becomes like a talk rather than I am reading off a piece of paper.
  • No. No. Just timing, you know. It’s just crazy.
  • So, it was good to have (name), who’s our sort of link worker for that, because she gave me loads of tips and everything because I would have just delivered the training from the website but like she’s sort of like adapted it a bit more to us
  • you’re going to take the patient every time and we’re just so, I mean you know, it’s like everywhere, we’ve got staff sickness, staff illness etc. etc. etc. We’re just too busy really.
  • But again, the problem we have is people don't attend them. They're not mandatory, so they get sent out to everybody on our training list.
  • It was financial well-being but, it was delivered by the money and pension service but there was only three people came and I was really disappointed
  • I felt a bit odd but on the other hand I was made very welcome, and we got on very well, but I came out of the end of it and I says where do I go from here, you know.
  • To a certain extent, but I haven’t really done anything in that respect. I think that might be down to me personally, but again I think there should have been more help there and pushing you and saying yeah, you know, get on the app and—
  • I couldn’t get online for some reason. It was keep getting blocked and what have you.
  • Well, there hasn’t been any positive communication to go on from, from the end of the course so to speak.
  • I haven’t been encouraged to use them or there hasn’t been—
  • I wasn’t at the webinar so I couldn’t even ask questions. I was only watch the recording.
  • It’s like normally within the day that he gets back to us.
  • I’ve only been to a few of the trainer ones to be honest, and I think one was talking about behavioural insights and there’s normally a clash with something.
  • So, I just feel having support of the regional team which perhaps wasn’t as good before
  • I’m going to a MECC trainer’s brunch which I think is a great idea on Tuesday next week with (name of location) Council, so I think was part of their plan to ensure that it’s rolled out.
  • There has been the opportunity to take part in the trainer’s forum. As I’ve mentioned I was unwell for a period of time, so I haven’t been able to join in with that yet.
  • so people might not feel confident to maybe email (name of regional MECC at scale coordinator) and say oh I can’t find this or I can’t do that, so they just don’t.
  • I happen to be honest that it’s one of those things if my work load’s really high it’s a thing that I can feel I can pass off.
  • (name of principal trainer) from the regional team, the regional trainer, he delivered some for our staff and I sat in on that first session and did the MECC Train the Trainer there and then sat in on several sessions.
  • And out of the 80 odd staff I think I only got about 10 that came along to that, and even then, I don’t think many of those are delivering now at all.
  • so we decided to join together and do that as a partnership so that it took a little bit of pressure off actually coming up with a monthly topic because we’ve got four different organisations that we could tap into.
  • I feel like if’s if I need a sort of role model or an ally or a mentor or something I could call her because she knows about it as well.
  • she contacted me and asked me if I would be happy to kind of spend some time with her going through the training stuff, which obviously I am so we met up yesterday and she kind of I suppose was a bit nervous about setting up her first session and she wanted to familiarise herself with the slides and wanted to know how I did it
  • I don’t have time to attend that Teams meeting that’s really nice to discuss these things because I just don’t have time to book my time out.
  • I think I’m lucky enough at the moment I’ve got like my support for MECC is very verbal because it’s part of my team.
  • I didn’t know who to ask as well. I got a bit confused because you’ve got your trainer that was training but he wasn’t really in the go-to then you had somebody else that was the kind of go-to, but he was regional and not really realising who to go to in the hospital
  • Who might not get back to you or if they get back to you, they might not get quick at the question, or you might not feel comfortable speaking to them so you avoid them.
  • back then when I did it you did the Train the Trainer and then you kind of like were expected to kind of cascade it.
  • are very accessible for any support or advice on anything.
  • I think the stuff that happens after the training, like (name of regional MECC at scale coordinator)’s regional steering group, like (name of regional MECC at scale coordinator)’s regional trainer forum, I think some of the conversations that come from that afterwards are really valuable
  • And I think then I suppose that’s the issue that comes back to kind of who is going to help that person with the support.
  • I suppose of a lot of people are doing the train the trainer they’re not doing anything with it afterwards
  • It helps me when I’m kind of linking with other local authority MECC leads, or MECC leads in different organisations.
  • so I know that if I was going to deliver it, if I’d got in touch with (name of regional MECC at scale coordinator), (name of principal trainer) that they would signpost us a hundred per cent in the right direction.
  • our health and wellbeing team network are great so if ever I’ve got any doubt I just reach out to them
  • again I’d love to go to the meetings for the train the trainer, but I don’t often have the time.
  • And if I’m struggling, I just get in touch with (name of regional MECC at scale coordinator).
  • Just finding the time because I only work part time and I still find I do a lot at home for other things, so one of these days I’ll get to them, it’s just time and capacity like everybody, I think.
Materials platform 54 passages
  • I think it’s more motivating for people when they know that actually the work’s been done. We’ve provided everything for you, all we’re asking you to do is go out and deliver it.
  • So, we’ve kind of reshuffled some of the slides, if you like, and moved some things further up the presentation and moved some things further down and took a couple of the legal bits, if you like, out of it in terms of policy and so on.
  • As much as we might have tweaked them a little bit it’s just it was a massive relief to then come away knowing that actually I don’t have to go away and do all of this myself.
  • there’s been a bit more of a workload involved in that because we’re going to have to manage potentially 200 paper copies on the first day of training.
  • they’ve decided that (name of organisation)’s going to help create bespoke slides, so they were going to adjust the slides that were available on MECC instead of us doing it ourselves, and they were going to make them more focused around what we were concerned about our risk factors, that sort of thing. And it just took forever.
  • the process of them wanting their stamp on it meant it never actually got done because there was so much focus on making it perfect rather than just getting out and doing it.
  • I think I would have had everything I needed, and I would have been happy to go out and deliver it based on what was accessible online
  • I was always getting the emails refreshing them as well, so things were quite up to date which was quite nice too.
  • I don’t think I would have been allowed to change a slide, but we often didn’t have any management going out with us
  • Really long. The first time I did it I was like, my God, I’m doing the training and even I’m a bit like bored.
  • So, I’ve popped that in as, so if it’s on Teams I pop them in breakout rooms, if it’s face to face I’ll just go right, that table, look at that one
  • It was a bit…it’s a bit more complicated for train the trainer because they have to sign up with us on Eventbrite and then have to sign up with the MECC Gateway.
  • I think that was really good to go well actually, you haven’t got to worry about giving that advice because the stuff’s there for you to access.
  • so I had a little look on the Future NHS and there was low and behold the lovely new templates that had came out for the PowerPoint so we’re going to use them as an [34.58 unclear] to them to say well actually we’ll train you in MECC.
  • No. Probably not. There wasn’t. So, it was basically me having an [35.33 unclear] round Future NHS because some of the emails you get are really, really long.
  • the website it just great, you know. It really is. And that does give you all the information so even if you literally start the training and say go to the website, stop the training after you’ve done your bit
  • it was virtually the same core but there was just a few bits that weren’t relevant or, you know, and obviously we don’t always have as much time so some of the bits that were slightly less relevant, you know, we hid the slides and stuff like that
  • I think the regional content had covered two of them, but then had the other three as sort of bolt on sessions
  • But we knew that there was a quality ensurance checklist, so we made sure that we adhered to that, we didn't take anything significant out of the training
  • created a document, trust specific signposting that everybody gets.
  • you kind of go on and you’re like oh my god I cant get anything to work, I can't find anything on there and you know, there's always updates of slides and you know, this video, that video. So I do think people find it overwhelming
  • I think there were lots of glitches in the system at the time. And then it just felt like we were asking them too much.
  • we would just ask them to arrange it in house and then just send us the registers and evaluations and then we update them onto the staff’s record automatically.
  • I could get into it as a lead trainer but then a few people weren’t able to register and it’s just a bit of a pain in the bum where you’re having to get back to them
  • Yeah, it’s really useful and I like the way there’s like a pick of videos.
  • So, I’d kind of got a few queries and I know they’ve rectified it now, so I had to backtrack and send all the certificates out
  • we’ve added a few localisms
  • I do find the Futures platform really clunky.
  • It isn’t easy, and I’m not totally hopeless with IT. I’m not the best either. Some of the younger and more switched on might be better, but I’m certainly not bad with it and I was really struggling to find everything that I needed.
  • So, the resources are plentiful. You can’t say there’s anything missing because there isn’t, it’s just a bit all over the place.
  • So, I will make them about cancer, so I’ll make them relevant to my organisation
  • I had to really dig around to find it again after I came back after being off.
  • So, yeah, I will make sure that that is a resource that I suggest everybody uses when they come to the MECC training because I think it’s the evidence base credible, reliable, valid information in there
  • I mean we have obviously tweaked it for our own organisation but at least you know you’re kind of working to a bit of a template around that. So, it was very easy to access and very easy to organise sessions for our staff.
  • I think that really helps because you can signpost people to that and on it.
  • I think you’ve really got to try to make it as relevant for your staff as you can and as specific to your staff as you can. So, we’ve tried to do that a bit with the training.
  • Again, I think if the videos had just been a little bit more specific towards our staff, we might have had…it would have been easier to engage some of them a bit better.
  • So, logging on to things like training apps and the NHS, Future NHS forum, and using the passwords and having to log on, I think, becomes a bit of a barrier.
  • I think the future NHS forum is a good resource, but I think it scan be a bit daunting looking in it and there’s lots of things in different places
  • I never got it. Like I never got what they were trying to support you with.
  • The portal was very busy. All of a sudden, we’re introducing this, all of a sudden we’re introducing that, all of a sudden this is a new part of MECC, and I was like whoa this is getting a bit kind of all of a sudden you’re kind of there.
  • I haven’t been on the portal for months because I just got…I just looked at it and went this is way too confusing for me, so I just left.
  • I did have to do a lot of work adapting it and making it comfortable for me to deliver, making it (name of location) specific.
  • There’s a whole load of resources on the platform, not only just the core slides to deliver on but all the kind of different add on slides and things like that. So, it equips people more to be able to cascade it.
  • I inputted (name of location) data, so part of the sessions is looking at the fingertips profiles for (name of location)
  • they almost felt a little bit I mean very unconfident in kind of delivering it even though, like it’s you’ve run through the training, you’ve got the slide deck, things like that, but it’s not your own kind of slide deck
  • I joined the NHS is it the Future NHS forum, then it’s just whatever it is where you can log in and all the information is there.
  • I haven’t looked at the slides for months to see what resources are there now, but certainly from what we were presented I thought the resources were really good.
  • I found that hard to explain but I’ve noticed they’ve taken that out and they’ve left the one slide and the one with stool on the ladder, the COM-B one.
  • We’ve got a few extra slides we add on which link to (name of location).
  • you can adapt it slightly if you need to add a few slides or take a few slides out
  • Well, I’ve got the basic PowerPoint. That’s all I usually need.
  • sometimes we couldn’t get certificates, but I think that’s sorted now.
  • I think (name of regional MECC at scale coordinator) said you can order them from a printer but it will be another cost, so I just left it.
Co delivery 18 passages
  • So, we’ll have two people delivering each session. We’ve tried to spread them out amongst the team, so we’ll get a few sessions logged and in the bank, if you like, come the end of December.
  • So, all of us who attended the Train the Trainer will be.
  • we’d kind of swop around who went to each (team) depending on who knew that (team) better.
  • So, within the trust at one, you know, there was just her and now obviously there’s her and me so if we do need any extra
  • we'll always offer to co-facilitate if people aren't feeling massively confident.
  • she's just sort of another person on the ground, trying to sort of infiltrate more of the acute settings.
  • So that's delivered by myself and the staff health and well-being lead.
  • it was actually a lady who used to work here, and she said do you want to do the course together. Now, you know, like deliver any aspect of the MECC, and I think that’s a good thing, you know, like if there’s two of you, so you can get your message across better I think
  • I think two minds is better than one. And you can sort of work off each other, you can certainly if you have a really positive rapport with the person then I think you can bounce off each other ideas
  • So, there was me and someone from the finance team. We double teamed to do it because she had a finance background, I had the MECC background.
  • But yeah, like I said I think I could do it, but I would get nervous because it’s just me sort of the day before.
  • I feel more comfortable with someone else as well, like a co-host.
  • she looks out for that side of things, and looks out for the questions so that helps, whereas when I’m doing the MECC training by myself there is a lot of flicking between screens and kind of trying to watch out for questions.
  • I don’t think I feel too bad about having to deliver that training by myself. But it definitely would have, I think helped to have a buddy to deliver it.
  • she said can I joint deliver that with you so it gives me the opportunity to kind of have a go without feeling like I’m thrown into the deep end.
  • then I’ve got colleagues who do deliver face to face and deliver more bespoke, so we approach it as a bit of team.
  • they have delivered their training with MECC as the overarching framework so it’s all about MECC conversations around health weight, MECC conversations around mental health
  • I still have my days where I’m not confident and my colleague sometimes will deliver with me, but just again she sort of has other roles as well so it’s just occasional
Audience access 61 passages
  • I think for us it’s really, really suitable. I think because of the lot of or most of what we do is customer facing, and engaging with people within the community
  • trying to combat any resistance that we might have from staff within the centres as in do I really have to do this.
  • Because a lot of the staff that we’ll be cascading this out to work shifts, a lot of them are part time or casual staff, and that they’re based across like five different centres.
  • we actually have some site closures in December, so we’re putting on sessions at every centre during those closures where the staff are free, all of the staff are free to come along to the session.
  • So, it’s been a bit of a challenge logistically to try and find the space and the time to get everybody together.
  • the fact that I couldn’t combine them was sort of frustrating
  • a lot of our (name of building)s are built in the fifties, they’ve got terrible wi-fi and not very good IT resources so some of them I might have had a barrier with the slides.
  • once that’s approved then you’ve got the strategic issue of getting to be able to get in person and see the (number) (name of role) and booking everything in
  • I had all the infrastructure there on actually booking it and arranging to go out, it was just I needed signoff before I could send the email saying we’ve got this training to deliver to you.
  • we were already having those conversations, it just needed some sort of extra resources to make them feel a bit more confident.
  • by the time I was leaving they were getting really on board and excited about it, which I think would have helped with the MECC conversation
  • So, they’re really reluctant to then disseminate the training, which I don’t understand because in my role as a school nurse I would do asthma and anaphylaxis training
  • Yeah, so we’ve had queries from GPs, a consortium of 27 GP practices across (name of location) to do MECC training.
  • But again, they want us to go in and do the training for them and they’re not keen to sign anyone up from the practice for train the trainer.
  • We already do that, so why do we need training in it. Well, so or I’ve done drugs and alcohol training, so why do I need training in that.
  • So, they are a bit worried about the time but three sessions for an organisation like (name of service)(name of location), that is like nothing to have them all trained.
  • And with the condition that I train all the rest of the staff first. So, they’ll have seen us do it and then they’ll go onto the train the trainer, so it will be, you know, it should be easy enough.
  • So, I think some give and take on well I’ll give you this, but you have to do this back.
  • We have, we’re quite lucky with that, because we have a weekly CPD hour.
  • So, that’s because everybody’s so crazy busy. If you’ve got a case load of thirty, obviously an hour’s CPD is, or two hours whatever it is, is massive.
  • So, had we not had that slot already kind of pencilled in and had (name) not sort of given me the support she was, it would have been a lot more difficult.
  • hope that staff would drop into that because its not mandatory training.
  • we’re a really time pressured organization, obviously you’ve got staff working in wards etc, and MECC I think, it's still an issue now, but MECC is hard to get up people's agenda in terms of a priority, and you know, it's understandable.
  • So they're, they're quite good because we've got a bit of a captive audience and quite high numbers.
  • But core MECC has always been an issue, and I think that's standard across the different organizations in the region because you put on a lot of training, but your numbers are very, or relatively low, should I say.
  • because it's so ingrained, that's their job to be having a, like going into somebody’s home and having a conversation about all the holistic elements that might impact on their health and well-being, it's not about you need to be trained in MECC
  • So there's no end of requests to be MECC trained, you know, we get them from HR, we get them from the governors, we get them from a whole range of clinical teams across the organization, dietetics, physios, you name it.
  • So that's capturing, I would say, between 30 to 50 newly qualified staff every month
  • how do you get around to that, how do you organise that training because obviously you need to be involved with other people.
  • Of course, it’s always time as well, and people’s time, you know. And then you can guarantee if you say well, I’m OK for a certain day something will crop up, you know, that—
  • And there’s quite a lot of take up so.
  • I just feel if they’re in the group they’re a bit more I know this, like a bit more critical.
  • But the lowest have been like the NHS staff.
  • And we’re trying to get more council staff on it, so there has been quite a few at city hall, but now we’re trying to get like out into the community
  • Trying to book training venues is very hard because as you can imagine there’s a lot of clinical training and mandatory training that has to take place in a trust.
  • One session I think there was going to be one person who actually turned up for it.
  • But yeah, I think people just really feel a bit aggrieved at having to travel these days.
  • people were saying there’s no way we can release staff for three hours, it needs to be sort of half that
  • So, it almost feels like will somebody see this as a real waste of time if I’m telling them to have a conversation with somebody and help them and support them when actually that’s what they do.
  • But yeah, and sometimes I feel like is this just a teaching granny to suck eggs a bit because people do say oh well, we do that anyway.
  • We’ve had actually quite a few staff teams have come and said can you come and do, we want this for all our staff
  • I’m delivering to about 200 preceptees and I suppose the benefit of online training is that you can do that. Obviously, we’d never have a venue that was available to deliver to 200 people, but they come on and do their inductions
  • he sent me an email, bless him, saying I feel like I’ve done, nobody else is interested now, I’ve saturated this site
  • He just went to his team meeting and he delivered the session.
  • They didn’t see the importance of MECC at all.
  • But if I go back to when now that I’m delivery it to the care certificate people who haven’t had that experience, who aren’t embedded in the service, who are not confident speaking to patients, that’s a really good way of getting them motivated and understanding and confident and also giving them permission to have that conversation.
  • Management don’t have time, especially in a clinical setting, for you to go and say can I have four hours of your team, or three hours of your team, or even an hour of your team to talk about MECC.
  • The only way you can really impact it is if they have a team meeting and you’re invited along to.
  • It’s hard enough for them to get the mandatory training done, you know, ESR.
  • It was there was too much resistance so you just kind of hide away from it, and that would be, probably I would have said the majority of people that have tried to do the Train the Trainer.
  • I think sometimes as well they don’t see that actually what they’re doing all the time is MECC.
  • It goes onto a platform called (name of platform) so it’s quite widely promoted with people, I suppose our own staff, and so we get a lot of (name of location) Council staff come on board but broader than that as well.
  • I think it works really well in (name of location) because the travelling to different venues is a massive kind of issue for people’s time and capacity
  • for them to then cascade MECC as it is, as the standard core MECC, doesn’t fit with the (name of) programme.
  • I feel a bit like I would be teaching my colleagues what they’re doing every day, every minute of every day.
  • she very much talked about the challenges of how she was going to deliver this training, cascade it to her team.
  • she does the recruitment so she makes sure we’ve got people on the courses and then everyone who seems to come like nine times out of ten are very keen and really want to do it
  • So, people are keen to pass on a healthy message and I think that’s positive as well.
  • Yes. So many over the year. I think it was something like eight to twelve over a year.
  • if you go to venues there’s always the IT issue. That’s always worrying for any trainer.
  • I give her some dates I’m free, she’ll advertise it and then obviously we just go from there.
Disruption 13 passages
  • getting the time to go out and see them is a barrier and because I’ve left there’s now even more of a staff shortage than there was
  • It’s just a bit of a staff problem of we had a lot of people move on at the same time so there’s just little bits of that all the way throughout the team that’s just going to be a little bit of a challenge until they get the staffing done
  • But because of COVID hitting, most people disengaged and then I know (name) was the regional lead and she’d left.
  • Apart from a couple of months where (name) she’s had an operation.
  • Public health were kind of had a COVID champions programme instead. MECC was completely put on the back burner.
  • My personal circumstances meant that I had an illness not long after I went on it and was off sick for a period of time, hence I have got two courses booked but they haven’t been delivered yet.
  • I had done some training back in I think 2020 but then COVID came along so I’d kind of forgotten all about that.
  • I think about 70 or 80 staff in MECC Train the Trainer, and then it was COVID that stopped that.
  • It was kind of like panic stations in terms of wards and capacity and caseloads and stuff like that, so there was absolutely no activity whatsoever on MECC for a good couple of years really.
  • a lot of them have either moved jobs or they haven’t got the capacity to do it anymore, or they don’t feel comfortable.
  • However, the next day (circumstances) so I literally did the training and then boom was hit with a (circumstances) and everything that goes along with that. So, I had to kind of just shelve that.
  • Unfortunately, within kind of 24 hours that all vanished because this is life, isn’t it? It throws these curve balls at you that you’re not expecting.
  • I did the training, COVID kicked in and I never got around to delivering any
Motivation belief 40 passages
  • I just thought if I’m on board with it then at least I can support them with delivery as well.
  • Yeah, quite motivated to be honest. I think it was quite, for me, it was quite exciting instead of sitting doing yet another MECC training session, the prospect of actually OK well now I’m on the other side of it, now I get the chance to go and actually deliver it.
  • I was really excited to go out and do it. I was sort of ready and rearing to go straight away.
  • I think it’s a great way of guiding conversations and I like the cascading down model
  • I was interested to see what it was about. But also, I love doing training so I’m very sad.
  • And to spread, I suppose because of my public health background, I see it as a fantastic means of spreading just basic public health messages.
  • I think I’m passionate about it. I mean I’d make a good salesperson.
  • So yeah, so it’s kind of I’ve always had an interest in physical health and like I say, as a learning disability nurse fairly recently qualified, I don’t think we had enough physical health teaching
  • No. I think the motivation was already there. I think it’s again it just solidified it all
  • it’s like if I want to do something I’ll kind of find a way of doing it generally both in work life and private life.
  • a lot of them were going to do their teaching qualification at the time. So wanted to do the MECC training in order to build up the hours of teaching and learning they needed for their qualification.
  • were just really keen and invested and were just doing it. There was no need to nudge or do anything, they were just doing it.
  • I was motivated certainly when I done the MECC course in that and I was looking forward to it, but the thing what I found was, was this gap.
  • So, you’ve got to prioritise your time but again I put a high priority on if I’ve got a skill and there’s a need for it, I feel that that could be passed on and used usually by other people.
  • I mean, like I said, I’m quite sold on MECC now, so I think it is important for people to know the basics.
  • if I had to do it, I’ll be happy to do it because then on continue rolling it out as part of a public health plan.
  • Because they were happy to do it, maybe to get a qualification but not—
  • But I think it’s a bit hit-and-miss like from what other people, other local authorities have said about picking up this training and who’s just happy to come.
  • I also come from a public health background, so I am very passionate about doing things that may help to reduce health inequalities and I think MECC is an excellent way to perhaps deliver messages at scale
  • I think I already had a strong motivation to deliver it because historically I’m aware of the impact that it can have.
  • I do think that perhaps some people that have signed up to it have gone to do the MECC training rather than the Train the Trainer training.
  • I know the point is to deliver it at scale. It’s that cascade but I do think not everybody would want or feel confident to do that.
  • now that it’s got a bit more backing and I can see a lot more of the evidence around it I feel like it’s got a bit more weight to it
  • Before I came back last year I wasn’t a big fan of MECC and I did think oh it’s a bit, like I say, a bit woolly and a bit like I thought it was a bit general
  • so I think in my head when I came back I really wanted to do the MECC so I could catch up with her and I thought well because I really respect her as a professional I thought well if she’s doing it I feel quite justified that it’s the right thing to do.
  • It’s more of an approach that I think comes through in the work that, or the values of the trust and the work, so it kind of feels that it fits quite well, especially since capacity has been such an issue like throughout COVID
  • And I think, and it might have been a bit unfair or a bit sceptical, but I think possibly having a Train the Trainer course on your CV looks very good.
  • So, I think having that training element on your CV is potentially what’s luring people in.
  • maybe because I do a lot of work and a lot of kind of talk about MECC maybe people don’t see the need to be actually delivering it themselves.
  • I don’t think they need training. I think what they probably need to do is an awareness of I think this training people don’t get it because they don’t understand what you’re trying to train them in.
  • There’s not one person sat down in that first thing and went I’m here because I want to deliver the training for MECC and be an ambassador for MECC in my department. All they thought they were going to say is I’m at a course to become more aware of MECC so when I’m in my job I can be comfortable having MECC conversations.
  • So, the networking was for me to try and secure a position in public health.
  • even though I didn’t have motivation to deliver it as such, I’m now really motivated to deliver it at a certain level.
  • So, then you lose your motivation and then you get the email through saying can you let us know when you’re planning to do your four delivery sessions.
  • But that’s my own passion of always being passionate about delivering that type of thing.
  • even though it was new to me in the role, I got it straight away and I believed in it straight away.
  • So, I suppose I did have kind of high levels of motivation because I knew that this was quite a big part of my role.
  • I think at that stage my motivation was quite high and really our team morale was quite low, and I did think oh this could be a good thing to help kind of boost team morale.
  • I was keen because I thought this is going to be something quite big, because MECC seems to underpin everything at the moment
  • I also thought about keeping my organisation going as well, you know. We need this sort of steady income to keep going.

Counting: Delivery

Attenders by delivery and cascaded

The table 8 cells
DeliveryCascadedAttenders
Delivers routinelyYes of 7
Delivered once or limitedYes of 7
Not deliveredNo of 6
Not yet plannedNo of 6
Delivered once or limitedNo of 6
Delivers routinelyNo of 6
Not deliveredYes of 7
Not yet plannedYes of 7

Counting: Theme direction

Attenders by theme and direction

The table 44 cells
ThemeDirectionAttenders
Audience accessBarrier own of 13
Confidence skillsEnabler own of 13
Management backingEnabler own of 13
Motivation beliefEnabler own of 13
Materials platformEnabler own of 13
Time capacityBarrier own of 13
Tt sessionEnabler own of 13
After supportBarrier own of 13
After supportEnabler own of 13
Audience accessEnabler own of 13
Materials platformBarrier own of 13
Role fitEnabler own of 13
Co deliveryEnabler own of 13
Tt sessionBarrier others of 13
Tt sessionBarrier own of 13
Confidence skillsBarrier others of 13
Confidence skillsBarrier own of 13
DisruptionBarrier own of 13
Management backingBarrier own of 13
Role fitBarrier others of 13
Time capacityBarrier others of 13
After supportBarrier others of 13
Role fitBarrier own of 13
Time capacityEnabler own of 13
Audience accessBarrier others of 13
Management backingBarrier others of 13
Motivation beliefBarrier others of 13
Management backingEnabler others of 13
Materials platformBarrier others of 13
Co deliveryBarrier own of 13
Motivation beliefBarrier own of 13
Role fitEnabler others of 13
After supportEnabler others of 13
Audience accessEnabler others of 13
Co deliveryEnabler others of 13
Confidence skillsEnabler others of 13
DisruptionBarrier others of 13
Materials platformEnabler others of 13
Motivation beliefEnabler others of 13
Co deliveryBarrier others of 13
DisruptionEnabler others of 13
DisruptionEnabler own of 13
Time capacityEnabler others of 13
Tt sessionEnabler others of 13

Counting: Theme cascaded

Attenders by theme and direction and cascaded

The table 88 cells
ThemeDirectionCascadedAttenders
Audience accessEnabler ownYes of 7
Management backingEnabler ownYes of 7
Materials platformEnabler ownYes of 7
Role fitEnabler ownYes of 7
After supportBarrier ownYes of 7
After supportEnabler ownYes of 7
Audience accessBarrier ownNo of 6
Audience accessBarrier ownYes of 7
Confidence skillsEnabler ownNo of 6
Confidence skillsEnabler ownYes of 7
Materials platformBarrier ownYes of 7
Motivation beliefEnabler ownNo of 6
Motivation beliefEnabler ownYes of 7
Time capacityBarrier ownNo of 6
Tt sessionEnabler ownYes of 7
Co deliveryEnabler ownYes of 7
Confidence skillsBarrier othersYes of 7
Management backingEnabler ownNo of 6
Role fitBarrier othersYes of 7
Time capacityBarrier ownYes of 7
Tt sessionBarrier othersYes of 7
Tt sessionBarrier ownYes of 7
Tt sessionEnabler ownNo of 6
After supportBarrier othersYes of 7
After supportBarrier ownNo of 6
After supportEnabler ownNo of 6
Confidence skillsBarrier ownYes of 7
Materials platformBarrier ownNo of 6
Materials platformEnabler ownNo of 6
Time capacityBarrier othersYes of 7
Audience accessEnabler ownNo of 6
Co deliveryEnabler ownNo of 6
Confidence skillsBarrier ownNo of 6
DisruptionBarrier ownNo of 6
DisruptionBarrier ownYes of 7
Management backingBarrier othersYes of 7
Management backingBarrier ownNo of 6
Management backingBarrier ownYes of 7
Materials platformBarrier othersYes of 7
Role fitBarrier ownNo of 6
Role fitEnabler ownNo of 6
Time capacityEnabler ownYes of 7
Tt sessionBarrier othersNo of 6
Tt sessionBarrier ownNo of 6
Audience accessBarrier othersNo of 6
Audience accessBarrier othersYes of 7
Co deliveryBarrier ownYes of 7
Confidence skillsBarrier othersNo of 6
Management backingEnabler othersYes of 7
Motivation beliefBarrier othersNo of 6
Motivation beliefBarrier othersYes of 7
Role fitBarrier ownYes of 7
Role fitEnabler othersYes of 7
Time capacityBarrier othersNo of 6
Time capacityEnabler ownNo of 6
After supportBarrier othersNo of 6
After supportEnabler othersYes of 7
Audience accessEnabler othersYes of 7
Co deliveryEnabler othersYes of 7
Confidence skillsEnabler othersYes of 7
DisruptionBarrier othersYes of 7
Management backingBarrier othersNo of 6
Management backingEnabler othersNo of 6
Materials platformEnabler othersYes of 7
Motivation beliefBarrier ownNo of 6
Motivation beliefBarrier ownYes of 7
Motivation beliefEnabler othersYes of 7
Role fitBarrier othersNo of 6
After supportEnabler othersNo of 6
Audience accessEnabler othersNo of 6
Co deliveryBarrier othersNo of 6
Co deliveryBarrier othersYes of 7
Co deliveryBarrier ownNo of 6
Co deliveryEnabler othersNo of 6
Confidence skillsEnabler othersNo of 6
DisruptionBarrier othersNo of 6
DisruptionEnabler othersNo of 6
DisruptionEnabler othersYes of 7
DisruptionEnabler ownNo of 6
DisruptionEnabler ownYes of 7
Materials platformBarrier othersNo of 6
Materials platformEnabler othersNo of 6
Motivation beliefEnabler othersNo of 6
Role fitEnabler othersNo of 6
Time capacityEnabler othersNo of 6
Time capacityEnabler othersYes of 7
Tt sessionEnabler othersNo of 6
Tt sessionEnabler othersYes of 7

Writing: Answer

The instruction the answer was written to
Answer the question in two parts: first what stopped attenders from delivering, then what helped those who did. Lead each part with the themes raised by most interviews, stating each count with its base, and say how the barriers raised by those who did not cascade compare with those raised by those who did. Keep what interviewees say about their own delivery apart from what they report of other attenders. Note where the document list's record of who cascaded differs from what the interviewee describes. Quote interviewees exactly. Say plainly that these are 13 interviews chosen for the evaluation, so counts show how widely a factor was raised among them, not how common it is among all attenders.

The checks that were run

  • 477 of 477 quotations found word for word in their document.
  • 51 numbers in the answer, every one computed directly from the coded passages rather than written by the AI; 0 written by the AI without a count behind them.
  • 0 citations to passages that do not exist; 0 quotations not in the passage they cite.

Second coding

The same documents were coded again to the same definitions; the run does not record whether a separate coder did it, so it is not called independent here.

The second coder's rows
  • Delivery: 13 rows
  • Factors: 410 rows

In the run's zip, under check/coded/.

The check

A reader ruled on every place the two codings differed, and checked every sentence and quotation of the answer against the documents, correcting the coding and the answer where they were wrong. The answer above is the corrected one, recounted after the check.

The check's record check.md
Counts
  • Disagreements between the coders: 7. recode/disagreements.md has 8 entries, but its two AP11 delivery entries are the same disagreement seen from each side.
  • Ruled for the rows: 3 (AP11 delivery; AP10 tt_session; AP11 enabler_others).
  • Ruled for the second coder: 3 (AP13, AP6 and AP7 disruption). These removed 4 rows.
  • Unsettled by the definition: 1 (AP7 time_capacity). I tightened the definition, which then settled it for the rows. Recoding every document on the new boundary changed 1 more row (AP13).
  • Rows changed in coded/c_factors.json: 26.
  • 17 deleted: 4 from the rulings and 13 from checking the report.
  • 7 recoded: 1 under the tightened definition and 6 from checking the report.
  • 2 added.
  • coded/c_delivery.json is unchanged.
  • The file went from 479 rows to 464.
  • Sentences changed in answer.md:
  • 66 of the original 137 sentences were reworded or removed.
  • The corrected report has 194 sentences, 123 of them new or reworded. Most of the new ones name the interviews behind a count or the accounts that go against a finding.
  • Cell ids were renumbered throughout, because the tables order cells by count. Each id was mapped to its new cell by its theme, direction and group, not by its number.
  • Recount: `recount.py . --answer answer.md` now reports nothing:
  • no ids naming no count;
  • no bare numbers;
  • no citations to no row;
  • no quotations missing from the documents or from what they cite.

A script compared the interviews named beside each count with the table cell. All of them match.

Rulings on the disagreements

1. c_delivery, AP11: delivered_once_or_limited (rows) or delivers_routinely (second coder). Ruled for the rows.

  • Passage: "So, I’ve done a couple of sessions already, so it is in my job role." It is the reply to "So, it’s part of your role to do that."
  • Why: "a couple" is two. The value delivered_once_or_limited covers "only once or twice", while delivers_routinely needs several sessions or a schedule they deliver to. The three sessions AP11 mentions for a housing service are booked, not run, and booked sessions do not count.

2. c_factors theme, AP10: tt_session coded by the analyst only. Ruled for the rows.

  • Passage: "I think they had some good ideas about activities and stuff that you could do." It answers whether they learnt anything new from the train-the-trainer part.
  • Why: this is how the session prepared them to deliver (its content). That is tt_session, as an enabler.

3. c_factors theme, AP13: disruption coded by the analyst only. Ruled for the second coder; row deleted.

  • Passage: "COVID had a lot to do with this, but when I came into post we had to just do an hour of MECC every week online and hope that staff would drop into that because its not mandatory training."
  • Why: COVID is given as the reason the training ran as a weekly online drop-in. Delivery went on and was not interrupted, and disruption counts COVID stopping delivery. The bearing on delivery is low drop-in, which is already coded as audience_access (row 5dfu6).

4. c_factors theme, AP6: disruption coded by the analyst only. Ruled for the second coder; both rows deleted.

  • First passage: "You’ve also got to think, that’s not the same ten thousand people that will start from today, because tomorrow you will have lost a hundred people because of turn around." AP6 is arguing that a trust target to train half its staff was unrealistic. It is a projection about a target, not an account of an attender whose delivery was interrupted.
  • Second passage: "but you see your physios, your allied health professions, they rotate, OK. They rotate through services." This is part of AP6's answer to "is there any strategies you would recommend", a suggestion that rotating staff need a plan before they attend. The prompt excludes suggestions.

5. c_factors theme, AP7: disruption coded by the analyst only. Ruled for the second coder; row deleted.

  • Passage: "COVID kind of got in the way. So, I think it inevitably did kind of make a difference."
  • Why: AP7 is explaining why their own online, COVID-era course cannot be compared with the present course. COVID changed the session, not their delivery, which they describe as ongoing.

6. c_factors theme, AP7: time_capacity coded by the second coder only. Unsettled, so the definition was tightened; then ruled for the rows.

  • Passage: "I think it comes down to priorities as well ... And maybes it doesn’t get seen as a priority".
  • Why it was unsettled: time_capacity counted "competing priorities pushed it down the list", while management_backing covered leadership not being on board. The passage concerns organisations and workforces not treating MECC as a priority, and both definitions could take it.
  • How workflow.json was tightened:
  • time_capacity now counts competing priorities "in the would-be trainer's own workload".
  • Its does_not_count sends learners not prioritising MECC to audience_access, and organisations or leaders not prioritising it to management_backing.
  • management_backing now counts "the organisation or its leaders not treating MECC as a priority".
  • audience_access now counts "staff too pressed to make MECC training a priority".
  • Under the new boundary, the analyst's management_backing barrier_others row (uzxcd) stands.
  • Recoding: I searched all 13 documents for "priorit" and recoded every interviewee passage it found.
  • AP2 (own time) stays time_capacity.
  • AP5's chief nurse passage ("seen as less of a priority back then") stays management_backing.
  • AP5's practitioners passage ("difficult to prioritise MECC around everything else") stays time_capacity.
  • AP3 ("priority area") and AP5 (what the training should prioritise) are not factors.
  • AP13 changed: "MECC is hard to get up people's agenda in terms of a priority" is about staff in a time-pressured trust not taking up the training. Row 53a52 was recoded from time_capacity to audience_access.
  • The interviewer's own uses of the word were skipped.

7. c_factors direction, AP11: enabler_others coded by the second coder only. Ruled for the rows.

  • Passage: "one girl’s really keen but she’s not delivered training before, so she’s got to come along with the couple that I’m doing, so I think that is an issue." The colleague has not delivered, and enabler_others counts only what helped attenders who did deliver. AP11 calls it "an issue", so barrier_others stands. (Its theme was corrected separately; see below.)
  • Passage: "my colleague who did the training with me is then coming with me to do further ... to observe": also not yet delivering, so tt_session barrier_others stands.
  • Passage: "And with the condition that I train all the rest of the staff first. So, they’ll have seen us do it and then they’ll go onto the train the trainer": these five people have not attended the course yet. The passage concerns AP11's own delivery to that service, so audience_access enabler_own stands.
Row changes found while checking the report

All of these are in c_factors, and every quotation is copied exactly from the document. "Report" names the claim each change bears on.

Deleted rows

  • AP7, confidence_skills and tt_session barrier_own (2 rows). Passage: "it kind of I suppose having that scenario kind of fuelled maybe the more negative things of well actually I don’t know anything about that particular topic and I might say the wrong thing and I don’t know how to signpost that person."
  • Why: this is fear in a course role-play about having MECC conversations, not about delivering training. AP7 delivers routinely.
  • Report: cascaders' confidence barriers.
  • AP4, tt_session barrier_own. Passage: "I did go into it being a little bit unclear about what the Train the Trainer involved."
  • Why: this concerns the advert. AP4 goes on to say "Obviously from the title Train the Trainer I knew there would be an expectation that I would deliver it" and "I can’t rate it highly enough". It is not given as holding delivery back.
  • Report: "faulted how the session prepared them".
  • AP8, tt_session barrier_own. Passage: "I feel a bit vague with that, but I know (name of principal trainer) kept saying about it and saying, you know, you’ll have the resources and just you must practice."
  • Why: this is a vague memory, followed by the tips the trainer gave. AP8 calls it "a really good session", and the rest of the answer is a suggestion.
  • Report: same claim.
  • AP8, after_support barrier_own. Passage: "I haven’t delivered any training, it’s just me, and I was just like oh my God what have I done to myself again."
  • Why: this is awkwardness at being first on a support call. AP8 says "I felt like if I needed support, it was there."
  • Report: "All of them ... described missing or unusable support".
  • AP1, after_support barrier_own (2 rows). Passages: "I think there was only four or five of us on that call. I was expecting something a little bit bigger." and "a lot of the time I don’t have a great deal of time to go through them in any great detail."
  • Why: a smaller forum than expected, and unread update emails. Neither is said to hold delivery back. AP1 calls the coordinator "brilliant" and "always ... on hand quite quickly".
  • Report: same claim.
  • AP2, confidence_skills barrier_own. Passage: "However, it’s still relevant but it needs updating, so to speak, or my skills need to be sort of refreshed I think would be a good answer."
  • Why: this is said of their teaching skills before the course, which they say the course refreshed ("getting the confidence as well ... I think that helped"). They later say they feel confident to deliver.
  • Report: "5 of 6 spoke of nerves or fading confidence".
  • AP2, audience_access enabler_own (2 rows).
  • "And we identify areas where the shortfalls are, ... people coming in doing job experience": these are possible audiences, with no delivery or arrangement.
  • "For instance, here I could say right, can we organise a free venue...": this offers the centre as a venue for peer support networks, in answer to a question about networks.
  • Why: neither is a route to learners for AP2's delivery.
  • Report: "A ready route to learners ... 4 of 6".
  • AP3, time_capacity barrier_others. Passage: "But it’s probably capacity issues as well."
  • Why: this is a guess at why Fire and Rescue might not take up the training. Fire and Rescue are not people who attended the course.
  • Report: "said those attenders lacked time".
  • AP13, after_support enabler_own (2 rows). Passages: "So we've built in a bit of a support package for them after they've done train the trainer," and "we would club together and try and deliver some update training to our cohort of MECC trainers across that patch".
  • Why: this is support AP13's team offers to others. AP13 reports low turnout ("people don't attend them"), not that it helped any delivery.
  • Report: cited the first as help cascaders had.

Recoded rows

  • AP13, time_capacity to audience_access. Passage: "we’re a really time pressured organization, obviously you’ve got staff working in wards etc, and MECC I think, it's still an issue now, but MECC is hard to get up people's agenda in terms of a priority".
  • Why: the tightened definition (ruling 6).
  • AP11, theme co_delivery to confidence_skills (barrier_others). Passage: "Well, when I’ve spoken to people, one girl’s really keen but she’s not delivered training before, so she’s got to come along with the couple that I’m doing, so I think that is an issue."
  • Why: the barrier named is the colleague's lack of training experience. The next line is "So, they’re not confident to go and discuss." Delivering alongside is the remedy, not the barrier.
  • AP11, time_capacity barrier_others to audience_access barrier_own. Passage: "So, they are a bit worried about the time but three sessions for an organisation like (name of service)(name of location), that is like nothing to have them all trained."
  • Why: this is the housing service's management worrying about staff time for AP11's own sessions, which is about releasing learners. It is not about other attenders.
  • AP2, materials_platform to after_support (barrier_own). Passage: "To a certain extent, but I haven’t really done anything in that respect. I think that might be down to me personally, but again I think there should have been more help there and pushing you and saying yeah, you know, get on the app and—"
  • Why: the complaint is the lack of follow-up, not the app.
  • Report: "Platforms and materials ... 5 of 6".
  • AP6, role_fit barrier_own to barrier_others. Passage: "For no extra money, so with all due respect as well, to go and deliver that again, say a Band 2 to go and deliver some sort of training, it’s a higher remit. It’s a higher pay grade."
  • Why: this is said of attenders in general ("say a Band 2"). AP6's own case is kept in "that’s out with either two things, my pay grade and my remit".
  • Report: this was quoted as AP6's own case.
  • AP6, time_capacity barrier_own to barrier_others. Passage: "I think this is your problem is you’re expecting that these people to be able to book out a lot of time".
  • Why: "these people" are attenders in general.
  • AP1, confidence_skills barrier_own to barrier_others. Passage: "Because it’s one thing learning a presentation and remembering the slides ... you’re going to end up looking really silly so it’s just about fine tuning everything."
  • Why: this is about getting the colleagues who attended with AP1 "on the same page". AP1 says they themselves felt "quite comfortable".

Added rows

  • AP6, time_capacity barrier_own. Passage: "Public health, but my old role not a hope, you know."
  • Why: this is the reply to "What about your own time and your boss giving you time to go and deliver MECC training?" It is AP6's own time barrier, and it replaces the general passage above.
  • AP6, time_capacity enabler_own. Passage: "Oh, again, in this role absolutely because it’s part of my role."
  • Why: this is the same reply, about the current role, where they have time to deliver.
Changes to the report

In short

  • The original said the non-cascaders "almost all describe the same picture", that "Nobody had built it into their role, time or plans", and that "nobody followed up". These are false:
  • AP1's organisation planned delivery and booked time.
  • AP4 counts delivery as part of their role.
  • AP10's job included training roll-out.
  • AP8 was phoned by the trust, and AP6 was emailed, to ask about delivery.
  • The rewrite lists the different reasons, with each interview named.
  • The third "what separates them" point (someone to deliver with or turn to) was moved out of the list. Help after the session is 6 of 7 against 4 of 6, and co-delivery 5 of 7 against 3 of 6. Neither would survive one interview read the other way, so both are now called unclear.

What this rests on

  • The original said "Each was read in full twice: once openly ... and once against the codebook below". There was no open-coding step, and no codebook is printed below.
  • The rewrite says the interviews were coded against a fixed list of themes and checked by a second coder. It also states the test for "clear".

Who went on to deliver

  • Interviews were named for each count. The wording is otherwise unchanged.

Time and workload

  • Interviews were named, the difference (6 of 6 against 5 of 7) is called unclear, and AP10 and AP1 are noted as qualifying it.

Role

  • The quotation "it’s a higher remit. It’s a higher pay grade." was said of a "Band 2" in general, not of AP6's own case. It was replaced with AP6's own words (8yc7q).
  • AP4's counter-statement (5exvm) was added.

Backing

  • "nobody expected them to deliver" was changed to "their manager did not expect them". AP8 says "I know there’s a trust expectation because we were told that at the training".
  • "showed no interest" was added for AP6.
  • AP1 and AP4 are named as against the finding.

Session

  • "Left the session not knowing how to start, and nobody followed up" was corrected:
  • The count fell to 3 of 6 after the AP4 and AP8 rows were removed.
  • AP1 faulted the lack of practice, but said they still felt able to deliver.
  • AP4, AP8 and AP10 praised the session and are named as against the finding.

Support

  • "All of them (6 of 6)" was changed to 4 of 6 after the AP1 and AP8 rows were removed. AP1 and AP8 are named as against the finding, and the follow-ups AP6 and AP8 received are noted.

Confidence

  • The count is now 3 of 6. AP1, AP2 and AP4 are named as confident trainers.

Reaching learners

  • "getting learners released or finding venues" did not fit AP8, whose barrier was colleagues who already do what MECC teaches. The heading claim was widened to "reaching learners", and AP8's account was added.

Platforms

  • The count is now 4 of 6, and AP8 is named as against the finding.

Interruptions

  • AP10's interruption was colleagues leaving and their own move, not "illness or personal events right after the course". The sentence now says so.
  • AP5's COVID account (k8xwc) was added beside AP9's.

"So these barriers slowed people down but did not by themselves decide who delivered"

  • Changed to "were raised by both groups and do not by themselves separate them". The documents do not show that the barriers slowed anyone down.

What leads say about others

  • AP9 is not a lead. Their account is of fellow attenders on their course, so the passage now says who reported what.
  • "Across all interviews, 8 of 13 said attenders often did not realise they were expected to deliver" was wrong. That cell counts every session-related barrier reported of others. Only AP3, AP6 and AP13 said attenders did not realise they would be expected to deliver, and "often" overstated them. The passage was corrected to say this.
  • "Nobody followed up afterwards" was stated as fact, but it came from AP5's speculation about CVs. It is now attributed to AP5, and the follow-ups are noted under support.
  • Non-cascaders' reports of others were added: AP6 and AP8 on time, AP1 and AP4 on confidence.

Role-fit enabler

  • Kept as the clearest difference: 7 of 7 against 3 of 6, which survives any one interview being read the other way.
  • The interviews against it were added: AP4, AP6 and AP10 saw delivery as within their role, and AP3 and AP12 placed delivery at the edge of their jobs.
  • The bullet "a charity commissioned to deliver it" was reworded. AP3's council commissioned a charity because AP3 lacked capacity.

Time set aside

  • The count for those who did not cascade is now 2 of 6 (AP6 added), and the difference is called unclear.

Route to learners

  • Kept as clear (7 of 7 against 3 of 6 after the AP2 rows were removed).
  • AP1, AP6 and AP10 are named as against the finding, with a note that those who delivered were bound to describe the route they used.
  • The CPD-slot quotation was cited to jjj9k, which does not hold it. It now cites the row that does (dvx6v).

Backing as enabler

  • "Among those who did not cascade, it was often support to attend" held only for AP8. AP1 and AP4 had backing to deliver, and AP4 calls their manager "Totally supportive of me delivering it". The passage was corrected.
  • "Leads said the same of others" was changed to name AP7, AP10 and AP13, because AP10 is not a lead.

Someone to turn to

  • The count for cascaders is now 6 of 7, after AP13's support-package rows were removed, and the difference is called unclear.
  • The citation of AP13's support package as help cascaders had was replaced with AP5's mentor (pndq9).

Co-delivery

  • The difference is called unclear.
  • AP13's offer to co-facilitate was described as an offer to other trainers, not as co-delivery the interviewee did.
  • The speakers of n4jxp and 74tkn (AP5) were named.

Materials

  • The difference (7 of 7 against 4 of 6) is called unclear.

Closing of "what did not separate"

  • "Most of those who did not cascade were keen and capable when they left the session. What was missing was the structure around them." This overstated both points. AP6 left lost ("I’d like to deliver it, but I don’t know how"). AP1 and AP4 had structure and have sessions booked.
  • It was replaced with what each interview says.

Limits

  • "Two who had not delivered" was changed to name AP1 and AP4, so that the count is not written as a bare number.

The record

This report was drawn directly from the run's zip, what-stopped-attenders-of-the-mecc-train-the-2026-10-10-revision-2-e9cf88da.zip. The zip's fingerprint is e9cf88dafe990f9ec75c60234ebecfa5778e1a076aa88d28592fde4b3158903b. It is the SHA-256 of the zip's SHA256SUMS file, which lists the SHA-256 of every other file in the zip, so changing any file breaks the match. To check that the zip is the one this report was drawn from, unzip it, run sha256sum -c SHA256SUMS, then sha256sum SHA256SUMS, and compare the result with the fingerprint above. Rubicon's own code, which is public, checks the rest: python verify.py <report> <zip> recounts every number from the coded passages in the zip, draws the report again from the zip and says whether it matches this one exactly.

Revisions

Changes made after the first report, each recounted and checked before this version was drawn. Earlier versions keep their own files.

  • 9 October 2026: asked for the title to read "Why the MECC training was not cascaded" in place of "Why the MECC training was not passed on". Presentation: the heading of `answer.md` is the only change; the workflow, the coding and every count, quotation and finding are as before. Recounted with `recount.py --answer`, which gave the same counts and rows. The documents in `corpus/` were also re-saved with LF line endings, their wording unchanged, so that the passage offsets in the recount point at the right text.
  • 10 October 2026: Each table now says what it counts: every count names its unit, attenders, beside the number it is out of. Workflow: every tabulate step names its unit. Coding and answer unchanged. Recounted the whole workflow; no count moved.

Every interview at a glance

Each row is one interview, each column a reason as the coding defines it. Click a mark to read the passages.

Confidence skillsTt sessionAfter supportAudience accessMotivation beliefTime capacityManagement backingMaterials platformRole fitCo deliveryDisruption
No
Yes
🔥 Carbon cost of this report: Between 0.02 and 6.8 km driven in an average UK family car

Making this report used between 26.5 and 9052 watt-hours of electricity, which is the carbon of driving an average UK family car for that distance. A ballpark only: Anthropic publishes no energy figures, and the run, made in the evaluator's own Claude, records no token counts, so the estimate is made from the run's size. The 13 documents were read in full once by each of the 2 coding steps, by the second coder and by the check, and the writer read the tables; everything the run wrote counts as output. That comes to about 731,798 tokens read and 83,731 written, at 4 characters a token. It covers the first run and its two revisions. The zip holds only the latest state, so each revision is counted at the low end as rereading the tables and writing the answer again, and at the high end as a whole run again.

  • High: 0.39 Wh per thousand tokens read and 1.95 per thousand written, with what was read counted 10 times over for the agent's own overhead. Simon P. Couch, 'Electricity use of AI coding agents', 20 January 2026, https://simonpcouch.com/blog/2026-01-20-cc-impact/: about 390 Wh per million input tokens and 1,950 per million output tokens for Claude Opus, back-solved from Epoch AI's estimate for a 100,000-token prompt with output at five times the input rate, as Anthropic's prices are. The author calls them napkin maths. Our assumption, not a measurement: an agent re-sends its instructions, earlier turns and tool output with every request, so it reads far more than the documents themselves. The low case counts only what was read and written; the high case counts what was read ten times over.
  • Low: the same rates divided by 20, what was read counted once. Oviedo et al., 'Energy use of AI inference, efficiency pathways, and test-time scaling', arXiv:2509.20241: a median 0.31 Wh per query for frontier models, and widely cited estimates overstated by 4 to 20 times. The low case takes the high case's rates divided by the top of that range.
  • 0.124 kg CO2e per kWh. DESNZ greenhouse gas reporting conversion factors, UK grid electricity, 2024.
  • 0.16601 kg CO2e per km. DESNZ greenhouse gas reporting conversion factors, average car of unknown fuel, 2024.

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