Take the A Team Challenge and make every contact count

Public Health England has identified smoking, poor diet, physical inactivity, and high alcohol consumption as the four main behavioural risks to people’s health in England in their 2020-25 strategy document. This, in conjunction with the APAGBI Best Practice Guidance for Paediatric Pre-assessment 2022 and recent GIRFT – Closing the gap document, brought health screening and behavioural change whilst waiting for surgery into the domain of pre-assessment services.

Making every contact count is an approach to behaviour change that uses our day-to-day interactions with patients to support them in making positive changes in their physical and mental health.  It enables the opportunistic delivery of healthy lifestyle information and is as important for children and young people as it is for adults. For example, the PEACHY study showed 1 in 4 children presenting for anaesthesia were clinically overweight or obese and the national prevalence of dental decay is quoted as 29%!  With approximately 500,000 paediatric operations performed each year in the UK…. that’s a lot of teachable moments at pre-assessment to make a difference!

At the RCoA and APAGBI we wanted to help start conversations about behavioural change in pre-assessment clinics and help families to ‘wait well’ for their operations.  Building on the success of our  ‘Dennis has an Anaesthetic’ collaboration with the Beano we developed the A-team challenges. These are a series of health promotion activities to help children and families take active steps to improve their lifestyle ahead of surgery – rewarded with health improvements as well as a very special sticker!


Dr Samantha Black, Consultant Anaesthetist, Medway NHS Foundation Trust

Dr Amy Norrington, Consultant Anaesthetist, The James Cook University Hospital