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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  • Regional MappingExercise Referral Schemes in the West Midlands

    Suzanne GardnerRegional Physical Activity Co-ordinatorWest Midlands

  • BackgroundNICE GuidanceIdentify schemes, good practice and challengesHow can schemes be supported?Improved networking and sharing best practiceInform decision making on potential national research programme into Exercise ReferralUndertaken August 2006 via questionnaire

  • Location and Duration of Schemes14 PCT/LA led schemes5 smaller scale schemes run by Private providers

  • Lead Agency

  • Partners in Schemes

  • The Aims of SchemesSimilarities11 schemes aim to promote and increase physical activity levels10 schemes aim to increase the recognition of the benefits of physical activity on health and well beingDifferences4 schemes target specific health conditions within the aims of the scheme3 schemes cite long term behaviour change as a direct aim2 schemes specifically target the sedentary population within the schemes aims.

  • Specific Target Groups for Schemes

  • Referral RoutesMost frequent referrers64.3% GPs42.7% Practice Nurses7.1% Physios

  • Length of Referral

  • Facilities and settings used by schemesTotal number of settings 144+ across the regionRange of settings per scheme 3 19+Other settings included schools, GP Surgery, YMCA, Action Heart

  • Activities on offer to participants

  • ChargesHalf of the schemes in the region do not charge for assessments1 scheme does not charge for assessments or sessions meaning it is fully subsidised for participants1 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 subsidys 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.

  • NQAF92.9% schemes reported adherence to NQAF78.5% of schemes provide feedback to the referrer1/14 schemes is aware of the referrer holding a follow up appointment with participant after the referral period

  • Staff134+ people identified as working on schemes across the West MidlandsRange of people working on schemes: 2 47 peopleIncludes; Schemes co-ordinators, physical activity leads, instructors/assessors, outreach consultants, leisure managers and health professionalsRange of hours spent on schemes ranges from 7+ - 340 600 hoursNumber of hours spent on exercise referral = 1297.75 156.75+ hours per week across the region

  • 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 qualificationWright Foundation Exercise Referral qualificationFuture Fit Exercise Referral qualificationEnvisage Exercise Referral Systems qualification

  • REPs and CPDAre staff accredited to REPs?CPD64.3% of schemes provide in house training for staffExamples 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.

  • 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.

  • Evaluation and monitoring92.9% schemes evaluated, majority of which is internally85.7% of schemes have specific targets set to work to.Ranges from LPSA, SLA, local and scheme based targets21.5% have reviewed cost effectivenessNo schemes currently part of research programme

  • What is being monitored

    Chart1

    0.929

    0.428

    0.714

    0.428

    0.714

    0.571

    0.5

    0.215

    0.071

    0.071

    0.428

    0.142

    0.357

    Monitoring

    No. of schemes

    Sheet1

    Local Authority Leisure facility

    Private leisure facility

    Sports Club

    Outdoor settings

    Community Settings

    Other

    Local Authority Leisure Facility100.0%

    Private Leisure facility21.5%

    Sports Clubs0.0%

    Outdoor Settings78.5%

    Community Settings50.0%

    Other settings21.5%

    Gym100.0%

    BACR Sessions14.2%

    Exercise Classes71.4%

    Swim78.5%

    Hydrotherapy28.5%

    Walking57.1%

    Older Peoples sessions21.5%

    Green Activity14.2%

    Racquet Sports21.5%

    Bowls7.1%

    Yoga/Tai Chi14.2%

    Leisure/Sports Activities21.5%

    Dance14.2%

    4 weeks7.1%

    6 weeks

    8 weeks

    10 weeks14.2%

    12 weeks71.4%

    14 weeks

    Other7.1%

    GP100.0%

    Practice Nurse85.7%

    Community Healthcare28.5%

    Dieticians28.5%

    Cardiac rehab professionals46.1%

    Physiotherapists53.8%

    Occupational Therapists23.0%

    Private Health professionals15.4%

    Specialist nurses53.8%

    Hospital department consultant46.1%

    Community Psychiatric Nurses28.5%

    Mental Health professionals46.1%

    Other7.7%

    who refers most frequently

    GP64.3%

    Practice Nurse42.7%

    Community Healthcare

    Dieticians

    Cardiac rehab professionals

    Physiotherapists7.1%

    Occupational Therapists

    Private Health professionals

    Specialist nurses

    Hospital department consultant14.2%

    Community Psychiatric Nurses

    Mental Health professionals

    Other

    NQAF

    Yes92.9%

    No

    Partly7.1%

    Unsure

    Feedback given

    Yes78.5%

    No14.2%

    Unsure7.1%

    Follow up appointment with referrer

    Yes7.1%

    No57.1%

    Don't know35.7%

    CYQ Exercise Referral14.2%

    Wright Foundation Exercise Referral92.9%

    Cardiac Rehab Phase IV78.5%

    Gayton Group Exercise Referral28.5%

    Other35.7%

    REPS?

    Yes78.5%

    No

    Unsure14.2%

    CPD?

    Yes64.3%

    No28.5%

    Unsure7.1%

    Steering group?

    Yes71.4%

    No7.1%

    Unsure21.5%

    Partners in schemes

    Local Authority100%

    PCT100%

    Actute Trust21.5%

    Voluntary Sector7.1%

    Private Sector21.5%

    Leisure Trust21.5%

    Local College14.2%

    Local Schools14.2%

    University7.1%

    scheme monitored?

    Yes92.9%

    No7.1%

    Unsure0.0%

    how monitored

    Internally85.7%

    Externally0.0%

    Internally & Externally7.1%

    Scheme not evaluated7.1%

    throughputs92.9%

    Personal details42.8%

    adherence71.4%

    satisfaction ratings42.8%

    physiological measures71.4%

    psychological measures57.1%

    levels of activity50.0%

    stage of behaviour change21.5%

    perceptions of physical activity7.1%

    Confidence7.1%

    Health conditions referred42.8%

    DNAs14.2%

    Referral routes35.7%

    Successful elementsNumber of schemes citing

    Increasing participants activity levels7.1%

    Range and commitment of referrers42.8%

    Range of activity options21.5%

    Commitment and skill of staff28.5%(quality, commitment and training)

    Evaluation and monitoring21.5%

    Geographical coverage14.2%

    Commitment of partners28.5%

    Supporting resources7.1%

    Targeting of key groups7.1%

    Size of scheme14.2%

    Improving participants physiological well being7.1%

    Funding14.2%

    Follow up of participants7.1%

    Quality of service21.5%

    Standardisation of processes7.1%

    Subsidy to participants7.1%

    Sheet1

    0

    0

    0

    0

    0

    0

    Facilities and Settings used by schemes

    % of schemes

    Sheet2

    0

    0

    0

    0

    0

    0

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    0

    0

    0

    0

    0

    0

    Activities available

    % of schemes offering activities

    Sheet3

    0

    0

    0

    0

    0

    0

    0

    No of weks participants spend on scheme

    % of schemes

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    Health Professionals able to refer to schemes

    % of schemes

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    Most frequent referrers to schemes

    % if schemes

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    Courses utilised to train exercise referral staff

    % of schemes

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0

    0