Sandwell Physical Activity Referral Programme Helen Brock Sandwell Primary Care Trust

Background  Sandwell has 6 towns  Funded by PCT  Been running for 4 years  Gradually grown in size and reputation across Sandwell  Aim is to encourage participants to be more physically active in their day-day life  Successful scheme but now struggling with new challenges (e.g. NICE) and large numbers

Where and who runs the scheme?  13 health and fitness assessment centres –2 Leisure Centres, 2 schools, 8 community centres, 1 GP practice –Covers the whole of Sandwell  20 staff trained to GP referral standard. –Also have in-house training sessions  1 full time coordinator (but this programme is not the only part of role)

Health Professionals  All have a briefing session  At least one person per GP surgery in Sandwell is registered to refer patients  Secondary Care Services –Physiotherapy, diabetes specialist nurses, respiratory nurses,  CVD Risk Project

Referral Process  Referral by health professional  Appointment made at one of the centres  1-1 assessment  PAR-Q, various health and fitness checks, lifestyle questions, physical activity advice  10 week exercise period  Support through 10 weeks  10 week re-assessment  Further advice, other lifestyle referrals  6 and 12 month follow ups

Inclusion / Exclusion  Inclusion: –Patients who are aged16+ –suffer a medical condition –sedentary  Exclusion: –Symptomatic CHD or asymptomatic post MI who have not undergone coronary rehab programme. –Uncontrolled hypertension >160/100mmHg –Unstable diabetics (can’t exercise below 5 or above17 mmols/l) –Uncontrolled or acute heart failure –Ventricular or aortic aneurysm –Uncontrolled tachycardia (>100bpm at rest) –Unstable or recently diagnosed angina (last 3 months)

Physical Activity Options  10 week exercise programme – FREE  Leisure Centre Activities  EXTEND  Home based exercise  Walking – independent and health walks  Green Gym  Gardening  Daily routine changes  Cycling

Self-referrals  Scheme also takes self-referrals  Same process but no free exercise  Also target this work with whole community groups / workplaces

Results from last year  Quarterly monitored but annually reported  April 2005 – March 2006 –1529 patients (66% female, 41% aged years old and 46% over 50) –58% white British, 42% BME –60% health professional referrals, 40 % self-referrals –Most popular medical conditions suffered – hypertension, obesity, diabetes, arthritis and other (general stress and anxiety)

Results Continued  55% returned for re-assessment  73% of those had increased their activity levels  Most had increased their activity by 2-3 days  The main activities adhered to after 10 weeks were home based programmes, walking and then exercise classes and the gym  Total of 2038 health improvements were recorded the main one being overall fitness.

Challenges  NICE guidance and being part of a research programme  Large numbers of referrals – emphasis on quality rather than quantity  Ensuring right type of patient comes through on scheme  Free Exercise – long term sustainability  Looking to revamp scheme 1 st April 2007 –Meeting tomorrow to get the process started

Thanks for listening Questions?