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Regional Mapping Exercise Referral Schemes in the West Midlands Suzanne Gardner Regional Physical Activity Co-ordinator West Midlands

Regional Mapping Exercise Referral Schemes in the West Midlands

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Regional Mapping Exercise Referral Schemes in the West Midlands. Suzanne Gardner Regional Physical Activity Co-ordinator West Midlands. Background. NICE Guidance Identify schemes, good practice and challenges How can schemes be supported? Improved networking and sharing best practice - PowerPoint PPT Presentation

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Page 1: Regional Mapping Exercise Referral Schemes in the West Midlands

Regional MappingExercise Referral Schemes in the

West MidlandsSuzanne Gardner

Regional Physical Activity Co-ordinator

West Midlands

Page 2: Regional Mapping Exercise Referral Schemes in the West Midlands

Background

• NICE Guidance• Identify schemes, good practice and challenges• How can schemes be supported?• Improved networking and sharing best practice• Inform decision making on potential national

research programme into Exercise Referral• Undertaken August 2006 via questionnaire

Page 3: Regional Mapping Exercise Referral Schemes in the West Midlands

Location and Duration of Schemes

• 14 PCT/LA led schemes

• 5 smaller scale schemes run by Private providers

Page 4: Regional Mapping Exercise Referral Schemes in the West Midlands

Lead Agency

Acute Trust0%

Private Leisure0%

Voluntary Sector0% Other

21.5%

Local Authority35.7%

PCT42.8%

Page 5: Regional Mapping Exercise Referral Schemes in the West Midlands

Partners in Schemes

100% 100%

21.5%

7.1%

21.5%21.5%14.2%14.2%

7.1%

0%

20%

40%

60%

80%

100%

120%

Partners in schemes

% o

f S

chem

es

Partner ResourcesLocal Authority Co-ordination staff,

instructors, funding, discounted/concessionary rates, evaluation, training, development, management and admin

PCT Co-ordination, staff, funding, referrals, expertise, publicity, training

Private sector fitness Concessionary rates

Acute Health Trust Expertise and referrals

Voluntary Sector Instructors and venues

Leisure Trusts Venues, instructors, concessionary rates

Colleges/universities/Schools Venues, instructors, training and equipment

Page 6: Regional Mapping Exercise Referral Schemes in the West Midlands

The Aims of Schemes

Similarities• 11 schemes aim to

promote and increase physical activity levels

• 10 schemes aim to increase the recognition of the benefits of physical activity on health and well being

Differences• 4 schemes target specific

health conditions within the aims of the scheme

• 3 schemes cite long term behaviour change as a direct aim

• 2 schemes specifically target the sedentary population within the schemes aims.

Page 7: Regional Mapping Exercise Referral Schemes in the West Midlands

Specific Target Groups for Schemes

78.5%

64.3%

92.9% 92.9% 92.9% 92.9%

57.1%

21.5%

85.7%78.5%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%P

eopl

e w

ho a

rese

dent

ary

Peo

ple

with

CH

D

Peo

ple

at r

isk

ofC

HD

Peo

ple

who

are

over

wei

ght

orob

ese

Peo

ple

with

Dia

bete

s

Peo

ple

with

Mus

culo

skel

etal

cond

ition

s

Peo

ple

with

Chr

onic

fatig

ue/M

E

Peo

ple

at r

isk

offa

lling

Peo

ple

with

Men

tal H

ealth

Con

ditio

ns

Oth

er

Health conditions targetted by schemes

% o

f sc

hem

es

Page 8: Regional Mapping Exercise Referral Schemes in the West Midlands

Referral Routes

100.0%

85.7%

28.5%28.5%

46.1%53.8%

23.0%15.4%

53.8%46.1%

28.5%

46.1%

7.7%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Health Professionals able to refer to schemes

% o

f sch

em

es

Most frequent referrer’s

• 64.3% GPs• 42.7%

Practice Nurses

• 7.1% Physio’s

Page 9: Regional Mapping Exercise Referral Schemes in the West Midlands

Length of Referral

7.1%

14.2%

71.4%

7.1%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

4 weeks 6 weeks 8 weeks 10weeks

12weeks

14weeks

Other

No of weks participants spend on scheme

% o

f sch

em

es

Page 10: Regional Mapping Exercise Referral Schemes in the West Midlands

Facilities and settings used by schemes

100.0%

21.5%

0.0%

78.5%

50.0%

21.5%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Facilities and Settings used by schemes

% o

f sc

hem

es

• Total number of settings 144+ across the region

• Range of settings per scheme 3 – 19+

• Other settings included schools, GP Surgery, YMCA, Action Heart

Page 11: Regional Mapping Exercise Referral Schemes in the West Midlands

Activities on offer to participants

100.0%

14.2%

71.4%78.5%

28.5%

57.1%

21.5%14.2%

21.5%

7.1%14.2%

21.5%14.2%

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

120.0%

Activities available

% o

f sch

em

es o

fferi

ng

acti

vit

ies

Page 12: Regional Mapping Exercise Referral Schemes in the West Midlands

Charges• Half of the schemes in the region do not charge for assessments• 1 scheme does not charge for assessments or sessions meaning it

is fully subsidised for participants• 1 scheme utilises an all in fee of £10 for accessing the scheme.• 5 of the schemes use a leisure card system to provide discounts for

participants • 9 of the schemes offer free sessions as part of the exercise referral

activities, this ranges from free walks to free swimming sessions and Action Heart sessions.

• 6 of the schemes offer subsidy’s to participants over and above the leisure card systems offered. These subsidies are as much as 50% discount in some areas although discounts may be restricted to off peak times.

• 2 schemes utilise voucher schemes for sessions as part of the subsidy system.

Page 13: Regional Mapping Exercise Referral Schemes in the West Midlands

NQAF

• 92.9% schemes reported adherence to NQAF

• 78.5% of schemes provide feedback to the referrer

• 1/14 schemes is aware of the referrer holding a follow up appointment with participant after the referral period

Page 14: Regional Mapping Exercise Referral Schemes in the West Midlands

Staff

• 134+ people identified as working on schemes across the West Midlands

• Range of people working on schemes: 2 – 47 people• Includes; Schemes co-ordinators, physical activity leads,

instructors/assessors, outreach consultants, leisure managers and health professionals

• Range of hours spent on schemes ranges from 7+ - 340 – 600 hours

• Number of hours spent on exercise referral = 1297.75 – 156.75+ hours per week across the region

Page 15: Regional Mapping Exercise Referral Schemes in the West Midlands

Staff QualificationsOther Courses;

Future Fit GP referral, YMCA, Premier Fitness Exercise Referral, L3 Disabled persons, BA hons degrees, Advanced Gym Instructor, YMCA Level 3 Fitness Knowledge, 1 day training WSHPS benefits if activity and behaviour change, day 2 training - BACR, medical conditions , referral conditions and medication.

The exercise referral qualifications recognised by the Register of Exercise professionals are currently;

• CYQ Exercise Referral qualification• Wright Foundation Exercise Referral

qualification• Future Fit Exercise Referral qualification• Envisage Exercise Referral Systems

qualification

14.2%

92.9%

78.5%

28.5%35.7%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

90.0%

100.0%

CYQ ExerciseReferral

WrightFoundationExerciseReferral

Cardiac RehabPhase IV

Gayton GroupExerciseReferral

Other

Courses utilised to train exercise referral staff

% o

f sc

hem

es

Page 16: Regional Mapping Exercise Referral Schemes in the West Midlands

REP’s and CPDAre staff accredited to REP’s? CPD

• 64.3% of schemes provide in house training for staff

• Examples include; CHD,mental health, physiotherapy, diabetes, nutrition ,rowing techniques, medication training, Specialist population groups, obesity management, facilitating change and smoking cessation, chronic back pain management

• provided by locality health professionals/leads, specialists and external companies.

Yes, 78.5%

No,

Unsure, 14.2%

Page 17: Regional Mapping Exercise Referral Schemes in the West Midlands

Core Costs • 5/14 schemes were unable to attribute core costs to their scheme, in

part this is due to instructor time being incorporated within full time roles within centres, venues etc being given free of charge through partnerships etc.

• Total costs identified by schemes was £323,763 - £328,763 across the region.

• 12,128 people participated in schemes during the last year of evaluation – based on the figures given by the schemes this would equate to a cost of £26.70 - £27.11 for each person accessing the scheme.

• If the participant figures for the schemes unable to identify costs at this point are removed from the equation the average cost per person accessing schemes is £57.94 - £58.83 (based on 5588).

• This is likely to be a conservative estimate on costs.

Page 18: Regional Mapping Exercise Referral Schemes in the West Midlands

Evaluation and monitoring

• 92.9% schemes evaluated, majority of which is internally

• 85.7% of schemes have specific targets set to work to.

• Ranges from LPSA, SLA, local and scheme based targets

• 21.5% have reviewed cost effectiveness• No schemes currently part of research

programme

Page 19: Regional Mapping Exercise Referral Schemes in the West Midlands

What is being monitored92.9%

42.8%

71.4%

42.8%

71.4%

57.1%50.0%

21.5%

7.1%7.1%

42.8%

14.2%

35.7%

0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%90.0%

100.0%

Monitoring

No

. o

f sc

hem

es

Page 20: Regional Mapping Exercise Referral Schemes in the West Midlands

Monitoring Information

• Throughputs range from 20 – 3,500• 12,243 people have accessed scheme in last

monitoring year, equates to 0.02% of regions popultation

• Adherence rates range from unknown – 63%• Half schemes could not provide adherence data• 1 scheme monitored longer term adherence to 6

months (54%)

Page 21: Regional Mapping Exercise Referral Schemes in the West Midlands

Successes

7.1%

42.8%

21.5%

28.5%

21.5%

14.2%

28.5%

7.1%

7.1%

14.2%

7.1%

14.2%

7.1%

21.5%

7.1%

7.1%

0.0% 5.0% 10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

Increasing participants activity levels

Range and commitment of referrers

Range of activity options

Commitment and skill of staff

Evaluation and monitoring

Geographical coverage

Commitment of partners

Supporting resources

Targeting of key groups

Size of scheme

Improving participants physiological well being

Funding

Follow up of participants

Quality of service

Standardisation of processes

Subsidy to participants

Page 22: Regional Mapping Exercise Referral Schemes in the West Midlands

Challenges and Future Development

• Development• Monitoring, Evaluation & benchmarking• Adherence to NICE guidance• Training costs and staff retention• Capacity of schemes• Long term funding • LEAP Findings?• Flow diagrams of referral processes• What makes up an effective assessment/consultation?