1. Shropshire & Telford Activity Referral Scheme (S.T.A.R.S) Jenny Stretton Health Promotion Officer Exercise Referral Meeting, PAN-WM 12 th December 2006 STARS

2. History of ‘S.T.A.R.S’ Started in 1991 as a Local Authority ‘pilot’ – 1 GP Practice and 1 assessor, known as ‘Exercise on Prescription’ 1993 supported by Shropshire Health Authority, national conference, expanded to county-wide. Developed to include 28 leisure centres Working party reporting to county wide multi professional steering group Accreditation of providers Scheme currently under review STARS

3. Training Standards 2003 Telford & Wrekin PCT appointed a physical activity co-ordinator. STARS working party agree new training standards for all GP referral assessors across the scheme. 2006 Attain NVQ 3 by and maintain REPS accreditation at Level 3 For specialist conditions eg. Phase 1V Cardiac, Fitness Instructors must have specific qualification Annual registration and protocol training has been provided locally by STARS and accredited with REPS as CPD STARS

4. Training Standards continued… All fitness staff are on the REPS Register Level 2/3 6 GP referral qualified staff (Local Authority) 3 BACR trained staff 8 staff Diet and Nutrition trained – Level 3 9 staff Special populations - Kids Level 3 3 staff Advanced Instructor Adapted Physical Activity training– Level 3 STARS

5. S.T.A.R.S Organisation Telford & Wrekin CouncilTelford & Wrekin PCT ‘Lets Get Physical’ Steering Group STARS Working Party Lets Get Physical Programme Manager T&WC Leisure & Development Manager T&WC Health or Fitness Facilities ManagerGP Private LC Rep STARS Co-ordinator STARS Co-ordinator Private assessorsLocal authority assessors

6. S.T.A.R.S. Referral Process STARS GP/Consultant - Patient Signposting Appointment with qualified assessor at accredited centre 1 hour consultation (£13.60 inc re-assessment) STARS referral form 12 week personal programme Fitness suite / gym Free induction Concessionary rates Walkabout – Wrekin walking for health Fitness classes, Aquatherapy Appropriate referrals eg. ‘Why Weight’ Mental Health Team Voluntary groups 12 week re-assessment 30 mins

7. Successes Long standing, well known High profile Integrated into ‘Let’s Get Physical’ programme Support and involvement from wide range of organisations Provides local training / CPD for assessors STARS

8. Challenges Currently under review NICE Guidance – brief interventions v. support for lifestyle change NQAF – risk stratification Evaluation criteria – local, regional, national? REPs – training, accreditation, costs and retention of staff (no salary increase) Demand v. capacity + cardiac rehabilitation GP knowledge – training issues (eg BP guidelines) Funding STARS

9. S.T.A.R.S…..the way forward…… Appreciation for PAN-WM mapping exercise Awaiting results of audit Development and implementation of monitoring framework Co-ordination and communication with Primary Care Provision of on-going CPD for fitness assessors Robust evaluation Tiered referral system eg. Triage categories of referral Patient consultation forum Sustainability STARS

10. Thank you! Jenny Stretton - Health Promotion Officer STARS