Sandwell Physical Activity Referral Programme

1. Sandwell Physical Activity Referral Programme Helen Brock Sandwell Primary Care Trust

2. 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

3. 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)

4. 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

5. 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

6. Inclusion / Exclusion • Inclusion: • Patients who are aged16+ • suffer a medical condition • sedentary • Exclusion: • Symptomatic CHD or asymptomatic post MIwho have not undergone coronary rehabprogramme. • 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)

7. 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

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

9. Results from last year • Quarterly monitored but annually reported • April 2005 – March 2006 • 1529 patients (66% female, 41% aged 30-50 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)

10. 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.

11. 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 1st April 2007 • Meeting tomorrow to get the process started

12. Thanks for listening Questions?