A pioneering men’s health project in central Scotland has proven so effective it has been adopted as the model for a £4m pilot to be rolled out across the country by the Scottish Executive. 

Sessions run by the Camelon Centre for Men’s Health have garnered much local support and will form a template for a series of pilot men’s health schemes, to be chosen through a bidding process.

Each clinic scheme is designed to be a partnership initiative involving health boards, local authorities and voluntary organisations, such as the Men’s Health Forum Scotland. The first £2.3m allocation, shared across seven areas, was announced by deputy health minister Tom McCabe during Men’s Health Week.

The Camelon centre clinics were first established in 2001 by Forth Valley Primary Care and NHS Trust district nurse Jim Leishman and health visitor Alison Dalziel. More than just an out-of-hours drop-in service, the clinic deals with all facets of men’s health. Its success, according to Mr Leishman and Ms Dalziel, was the result of detailed research and careful planning, following on from some hard thinking. ‘We had lots of ideas in our heads,’ says Ms Dalziel. ‘Everyone who works in primary care for any time knows that we don’t engage with men.’

To develop the clinic, Ms Dalziel and Mr Leishman secured an initial budget from the trust, which included salaries for the receptionist and sessions run by nurses. Traditionally, payment for out-of-hours services in the NHS are based on time off in lieu, but Mr Leishman and Ms Dalziel insisted from the beginning that their staff were paid and paid properly.

They also chose an ‘appointments only’ system and rejected the drop-in model that has been favoured by many other well man initiatives. During each appointment, patients are offered a long consultation and undergo a full general health check, which is carried out in the context of a conversation. This gives the men an opportunity to discuss every aspect of their health in a relaxed manner.

The clinics are held weekly and begin at 6pm. When men arrive, they are welcomed, then prompted to think about some key health matters – such as stress, depression or exercise – which they may wish to raise with the nurse. Since the sessions were established, this format has provided men with consistent access to health professionals, with a significant number of them attending the centre for their first health check-up in many years.

Those early decisions have generated sustained success. Just by identifying illness and referring people for treatment, the clinics have proved remarkably effective. In a sample of attendees from the first year, more than half were diagnosed with a condition that they were previously unaware of. These ranged from infections to type 2 diabetes and cancer. A large number of patients suffered from hypertension.

The positive response to the clinics, according to Ms Dalziel, developed from a working partnership with local GPs and other community organisations. In the early stages of the project, Ms Dalziel and Mr Leishman spent many hours talking to local GPs. They also arranged for the GPs to send out letters to their male patients. Targeted at men aged between 18 and 74, the letters addressed the subject of men’s health generally and invited the recipients to make an appointment if they wished.

‘We also advertised in the local free newspapers, emphasising that these were free health checks and that they were available in the evenings,’ Ms Dalziel adds. ‘We placed the ads for three weeks and then repeated them at quarterly intervals. It was also made clear to people that the sessions were nurse-led.

‘We knew that, with a bit of imagination and psychology, we could attract men to seek services. We had set up the referral pathways before we began. Every GP knew we might refer the patient back and we had direct referral arrangements with the urology department at Falkirk District Royal Infirmary.’

It worked. Men called and made appointments and kept them. Ms Dalziel cites a 95 per cent attendance rate in the first year. After three years, that rate has fallen only slightly, down to 92 per cent. While men’s health in general was the focal point of the clinics, it was not long before Ms Dalziel and Mr Leishman realised that obesity was a core issue.

‘After three months, we audited the assessments,’ Mr Leishman explains, ‘and it showed that 77 per cent of the men were overweight. Of these, 31 per cent were obese and 21 per cent had a waist measurement above 102cms.’


In direct response to these figures, Ms Dalziel and Mr Leishman began to develop weight management interventions. With help from the trust’s dietetic department, they researched and attended courses on weight management and then used their new knowledge to revamp literature to address obesity using male-specific language.

Since 2002, they have been running a weight management course alongside the clinics and the success rate has, again, been impressive.
‘The men who have been through the programme have mostly lost weight and retained their low weight, and a lot of them say their new diet is having a healthy impact on their families as well,’ says Ms Dalziel.

When the team saw the men from the first weight management course for a consultation six months on, their audit found most of them speaking of lifestyle change. ‘All but one had maintained their lower weight and some had continued to lose weight,’ Mr Leishman says. ‘Among the first two groups to complete the programme, the average waist size reduction was 10cms and average weight loss was 8.1kg.’

Ten men attend each course, which lasts for 12 weeks. The programme, which is group work oriented, was designed by Forth Valley dieticians and adapted by the team to better meet the needs of men. As part of the programme, passes are obtained for the local leisure centre, which is happily just 100m from the centre.

So great is demand for the weight management course that they have had to restrict access to it. Only those who are clinically obese and have a waist measurement of at least 102cms can attend. However, advice on weight reduction and exercise is offered to all others concerned about their weight.

‘We found that, if men had a weight issue, they were desperate to do something about it,’ says Mr Leishman. ‘When the weight management course began 18 months ago, a waiting list of more than 100 built up just from those men who had been to the clinic.’

Although the majority of men who come to the Camelon centre are in their 40s and 50s, the team has seen people as young as 17 and as old as 85. Most are in steady employment. Stress management courses are also now available. A satellite clinic is being held at nearby Grangemouth and prostate and erectile dysfunction assessment and guidance have been added to the health package.

Further training for staff for the pilot projects across Scotland is likely to be organised through the Men’s Health Forum Scotland. In the meantime, health professionals are beating a constant path to the Camelon centre to shadow the team. ‘They tend to be from a broad spectrum of health work,’ notes Ms Dalziel.

Initially, the project was approved with use of some leftover funding by the former NHS trust, which morphed in April this year into the primary care operating division of NHS Forth Valley. The second phase of the work at the Camelon centre has used money from the primary health development fund.

The trust also funded one-day-a-week cover for the full-time district nurse and health visitor caseloads of Mr Leishman and Ms Dalziel so that they could continue to develop and improve the pioneering service. In the current phase, they are engaging two nurses who specialise in working with people with learning disabilities. ‘We think they can help us to get those men through the door,’ says Ms Dalziel.

Although their efforts have drawn so many to learn and have impressed the executive enough to strongly influence the pilot scheme guidance, Mr Leishman insists there is still a long way to go. ‘We are only at the beginning,’ he says. ‘Men are still badly served by the health care system.’