1. Exploring the potential for working in partnership Carol Wilson – Franchisee Maidstone and Medway Towns

2. Introduction Weight management within the NHS. Introducing the Rosemary Conley organisation. The Rosemary Conley organisation in Medway Towns. Options for partnership and how the Rosemary Conley organisation can help. Potential service options. The next steps.

3. Weight management within the NHS  Reducing levels of obesity can play a vital role in achieving the targets for specific clinical priorities:  Coronary Heart Disease.  Diabetes  Hypertension.  …. and help GP Practices achieve the HbA1c, blood pressure and cholesterol targets contained in the new GP GMS Contract Quality and Outcomes Framework.  However, managing large numbers of patients presents a significant challenges.  The number of overweight and obese patients is increasing.  One-to-one weight management is time intensive.  Increasing pressures on Health Professionals time, and  Limited resources.

4. The Rosemary Conley organisation  30 years’ experience of helping people lose weight.  Diet and Fitness Clubs were launched in 1993 to provide community based, face-to-face, help, support and motivation to people wanting to lose weight and improve their fitness.  Every Rosemary Conley class is run by one of 190 professionally qualified exercise teachers.  In addition, each instructor undergoes a nutritional training programme, focused specifically on weight management. This was developed under the guidance of Dr Susan Jebb and is now accredited by Chester College, University of Liverpool.  More than 2,000 weekly classes across the UK every week.  The average stay at our classes is 23 weeks.  11 classes within the boundaries of this PCO.

5. Rosemary Conley classes  Rosemary Conley instructors are trained to adapt the level of activity to suit all abilities; no matter what age, size, or fitness level.  Very obese patients who have been inactive will initially do gentle, low intensity movements and walking on the spot, resting whenever necessary.  Other commercial slimming organisations concentrate almost entirely on dietary advice and do not have an exercise component to their classes.  The Rosemary Conley approach is unique amongst commercial slimming organisations in the way that it addresses both sides of the energy balance equation in every class.

6. Rosemary Conley classes  Classes tackle the fundamental causes of overweight and obesity:  Excessive consumption of high calorie foods.  Low levels of activity.  Advice is based on sensible, healthy eating and an increase in activity levels.  Each class involves:  A private weigh-in with a chance to talk on a one-to-one basis with the instructor.  A presentation on motivation or nutrition.  45 minutes of activity to music designed to meet the needs of overweight and obese individuals of all fitness levels.

7. The local Rosemary Conley organisation  There is one franchisee in the Medway Towns area. This is:  Carol Wilson  There are 8 classes run in 3 locations. These are:  Gillingham – Woodlands Primary School and RAD Halls  Rainham – St Margarets Primary School  Park Wood – Deanwood Primary School and Parkwood Community Hall

8. How can we help?  The Rosemary Conley organisation can cost-effectively manage overweight and obese patients.  Expand weight management capacity within the local area, whilst ensuring patients are seen by highly trained, professionally qualified fitness instructors who have undergone accredited nutritional training.  A healthy low fat diet combined with an increase in activity.  A strong brand name, trusted by patients.  Services that are accessible to people from all socio-economic backgrounds. Continued…

9. How can we help?  The Rosemary Conley organisation can cost-effectively manage overweight and obese patients.  Giving local GPs the option of a referral for weight management, possibly avoiding the need for additional prescribing.  Taking away the time pressures of delivering weight management within busy GP surgeries. These pressures become even more acute with the need to achieve 48 hour access targets and implement the new GMS contract.  Rapid implementation that isn’t constrained by recruitment shortages.  Flexibility to tailor the service to the needs of the area.

10. Partnership appears a reality “John Reid (The Health Secretary) has told primary care trusts they are free to use private diet clubs after a series of pilot trials proved successful in helping patients to lose weight.” Times Online – 5/9/04

11. Full funding patients to attend all NHS classes. Full funding patients to attend existing classes. Part funding patients to attend existing classes. Agree a discount for referred patients. Service options  There are a range of options for working in partnership: No NHS funding Part NHS funding Total NHS funding Raise awareness of existing classes

12. General Public costs for attending classes  For the membership fee of £7.50 members have their individual daily calorie allowance calculated and receive their starter pack containing:  A 14-day Quick Start Diet (For some people a quick start is essential for building motivation).  A 160-page 5 Star Diet book.  A motivational CD.  Each subsequent class costs £4.95  A 12 week course would cost £66.90

13. The potential - working in partnership  Rosemary Conley Diet and Fitness Clubs has recently teamed up with Sutton and Merton Primary Care Trust and local doctors surgeries.  The choice of organisation to work with was very important to the PCT: “Rosemary Conley classes are approved by a well-recognised nutritional expert and give the same good advice about healthy eating that we would provide at the PCT. They also include an exercise component, which is something that we highly recommend. We had to make sure that any organisation we asked doctors to refer patients to was giving the same messages that we would give to patients.” Deborah Norman (State Registered Dietitian) Health Improvement Manager, Sutton and Merton PCT

14. Simple logistics for the GP and the health professional team 1 An appropriate patient is identified. 3 Patient attends Rosemary Conley class. 4 Doctor receives feedback on patient progress. 2 Patient is given a Rosemary Conley “prescription” 5 Using the data collected the effectiveness of the initiative can be assessed.

15. Working in partnership: No NHS Funding Example: £6 for 6 weeks “kick start” programme.  We will provide places for ? patients referred in the first 12 months.  All patients referred will receive a 6 week course, including their membership pack, for just £6 (£1 per week).  This represents a saving of £31.20 over 6 weeks.  Payment of the £6 at the first appointment will build commitment to the course.  Patients who wish to continue beyond 6 weeks will pay the standard price of £4.95 per class.  There is no cost to the PCT.  We will provide weekly feedback on progress via email.

16. Working in partnership: No NHS Funding Example: ½ price for 12 weeks  We will provide places for ? patients referred in the first 12 months.  All patients referred will receive a 12 week course, at ½ price (including starter pack).  This represents a saving over the 12 weeks of £33.45.  Patients who wish to continue beyond 12 weeks will pay the standard price of £4.95 per class.  There is no cost to the PCT.  We will provide feedback on each patients progress via a weekly email.

17. Working in partnership: Part NHS Funding  Sutton and Merton PCT is providing part funding for 160 patients to attend local Rosemary Conley classes for 12 weeks.  Selected practices each have 20 places for their patients.  Patients must have BMI > 30kg/m 2.  The PCT is funding the joining fee (£7.50) and 50% of all class fees for 12 weeks.  The patient pays half of the £4.95 class fee.  The cost to the PCT per patient for a 12 week course is £37.20.  The Rosemary Conley instructor provides feedback to the PCT via a weekly email.

18. Working in partnership: Full NHS Funding  Especially suitable for patients from areas of higher socio-economic deprivation.  The PCT would fully fund the half price 12 week course.  We will offer a 20% discount, saving £13.40 per patient.  The cost per patient for a 12 week course to the PCT is £53.50 (includes the joining fee and pack).  Weekly feedback will be provided via a weekly email.

19. The next steps We would be delighted to discuss a way of working together that meets your needs. For more information please contact: Carol Wilson Tel. 01622 677766 carolwilsonrcdfc@msn.com