Sandwell Physical Activity Sandwell Physical Activity Referral ProgrammeReferral Programme

Helen BrockHelen Brock

Sandwell Primary Care TrustSandwell Primary Care Trust

BackgroundBackground

Sandwell has 6 townsSandwell has 6 towns Funded by PCT Funded by PCT Been running for 4 yearsBeen running for 4 years Gradually grown in size and reputation across Gradually grown in size and reputation across

SandwellSandwell Aim is to encourage participants to be more Aim is to encourage participants to be more

physically active in their day-day lifephysically active in their day-day life Successful scheme but now struggling with new Successful scheme but now struggling with new

challenges (e.g. NICE) and large numberschallenges (e.g. NICE) and large numbers

Where and who runs the scheme?Where and who runs the scheme?

13 health and fitness assessment centres13 health and fitness assessment centres– 2 Leisure Centres, 2 schools, 8 community 2 Leisure Centres, 2 schools, 8 community

centres, 1 GP practicecentres, 1 GP practice– Covers the whole of SandwellCovers the whole of Sandwell

20 staff trained to GP referral standard.20 staff trained to GP referral standard.– Also have in-house training sessionsAlso have in-house training sessions

1 full time coordinator (but this programme is 1 full time coordinator (but this programme is not the only part of role)not the only part of role)

Health ProfessionalsHealth Professionals

All have a briefing sessionAll have a briefing session At least one person per GP surgery in At least one person per GP surgery in

Sandwell is registered to refer patientsSandwell is registered to refer patients Secondary Care ServicesSecondary Care Services

– Physiotherapy, diabetes specialist nurses, Physiotherapy, diabetes specialist nurses, respiratory nurses, respiratory nurses,

CVD Risk ProjectCVD Risk Project

Referral ProcessReferral Process

Referral by health professionalReferral by health professional Appointment made at one of the centresAppointment made at one of the centres

1-1 assessment1-1 assessment PAR-Q, various health and fitness checks, lifestyle questions, physical activity advicePAR-Q, various health and fitness checks, lifestyle questions, physical activity advice

10 week exercise period10 week exercise period Support through 10 weeksSupport through 10 weeks

10 week re-assessment10 week re-assessment Further advice, other lifestyle referralsFurther advice, other lifestyle referrals

6 and 12 month follow ups6 and 12 month follow ups

Inclusion / ExclusionInclusion / Exclusion

Inclusion:Inclusion:– Patients who are aged16+ Patients who are aged16+ – suffer a medical condition suffer a medical condition – sedentarysedentary

Exclusion:Exclusion:– Symptomatic CHD or asymptomatic post MISymptomatic CHD or asymptomatic post MI who have not who have not

undergone coronary rehabundergone coronary rehab programme.programme.– Uncontrolled hypertension >160/100mmHgUncontrolled hypertension >160/100mmHg– Unstable diabetics (can’t exercise below 5 or above17 mmols/l)Unstable diabetics (can’t exercise below 5 or above17 mmols/l)– Uncontrolled or acute heart failureUncontrolled or acute heart failure– Ventricular or aortic aneurysmVentricular or aortic aneurysm– Uncontrolled tachycardia (>100bpm at rest) Uncontrolled tachycardia (>100bpm at rest) – Unstable or recently diagnosed angina (last 3 months)Unstable or recently diagnosed angina (last 3 months)

Physical Activity OptionsPhysical Activity Options

10 week exercise programme – FREE10 week exercise programme – FREE Leisure Centre ActivitiesLeisure Centre Activities EXTENDEXTEND Home based exercise Home based exercise Walking – independent and health walksWalking – independent and health walks Green GymGreen Gym GardeningGardening Daily routine changesDaily routine changes CyclingCycling

Self-referralsSelf-referrals

Scheme also takes self-referralsScheme also takes self-referrals Same process but no free exerciseSame process but no free exercise Also target this work with whole community Also target this work with whole community

groups / workplacesgroups / workplaces

Results from last yearResults from last year

Quarterly monitored but annually reportedQuarterly monitored but annually reported April 2005 – March 2006April 2005 – March 2006

– 1529 patients (66% female, 41% aged 30-50 years old and 46% 1529 patients (66% female, 41% aged 30-50 years old and 46% over 50)over 50)

– 58% white British, 42% BME58% white British, 42% BME– 60% health professional referrals, 40 % self-referrals60% health professional referrals, 40 % self-referrals– Most popular medical conditions suffered – hypertension, obesity, Most popular medical conditions suffered – hypertension, obesity,

diabetes, arthritis and other (general stress and anxiety)diabetes, arthritis and other (general stress and anxiety)

Results ContinuedResults Continued

55% returned for re-assessment55% returned for re-assessment 73% of those had increased their activity levels73% of those had increased their activity levels Most had increased their activity by 2-3 daysMost had increased their activity by 2-3 days The main activities adhered to after 10 weeks The main activities adhered to after 10 weeks

were home based programmes, walking and then were home based programmes, walking and then exercise classes and the gymexercise classes and the gym

Total of 2038 health improvements were recorded Total of 2038 health improvements were recorded the main one being overall fitness.the main one being overall fitness.

ChallengesChallenges

NICE guidance and being part of a research NICE guidance and being part of a research programmeprogramme

Large numbers of referrals – emphasis on quality Large numbers of referrals – emphasis on quality rather than quantity rather than quantity

Ensuring right type of patient comes through on Ensuring right type of patient comes through on schemescheme

Free Exercise – long term sustainabilityFree Exercise – long term sustainability Looking to revamp scheme 1Looking to revamp scheme 1stst April 2007 April 2007

– Meeting tomorrow to get the process startedMeeting tomorrow to get the process started

Thanks for listeningThanks for listening

Questions?Questions?