Camden Sport and Physical Activity Service has a goal to reduce health inequalities and support more vulnerable people in the community. As part of Camden Council they were also tasked with becoming more efficient so as to free up resources to invest in activity programmes.
Steve Berman, Exercise Referral Lead at Camden Sport and Physical Activity Service, explained: “Our previous exercise on referral service was both costly and time consuming. It was a ‘paper heavy’ solution which needed to computerised. Referrals were submitted via fax and post and this led to difficulties. We have over a thousand referrals each year and dozen of copies of these documents were required. This meant our offices had wall-to-wall files and finding the correct files, let alone the actual document, was hugely time-consuming.”
“Each week the process was to ‘move’ more patients documents forward in the process. Week one participants would move to week two and so on. Even though the exercise on referral scheme is relatively small in relation to other departments in Camden, we had huge storage issues. We knew we had to focus on cost-effectiveness and that we needed an IT solution to achieve this.”
Camden Sport and Physical Activity Service was keen to find an appropriate IT solution that was not only cost-effective but also tailored to their needs so they could enhance the efficiency of the team.
Steve Berman commented: “ReferAll had a significant background in exercise on referral and physical activity provision. This meant they had a clear understanding of what was needed and where any problems might lie. They were, and are, progressive thinkers who think outside the box and continually develop their system.”
The team adopted ReferAll’s software solution in 2009. Due to the online nature of the system, the team has the capability to use it across all nine facilities in the borough, enabling huge flexibility around where activities take place. These include gentle exercise classes at The Armoury as well as cardiac rehabilitation and GP referral programmes in Hampstead. Initial contact meetings and activities are also held at other venues in Camden including community and day centres.
Steve Berman said: “ReferAll has completely changed the way that we work. Previously we had leads for different conditions, such as diabetes or obesity, housed in different files. With ReferAll it is all in one database. This means that, as a team, we now work collectively so we are all aware of each referral and the need to manage them all in the same way. The systems and procedures on the system have focused the way we have developed the service.”
“We know there is a need for evidence based outcomes for exercise on referral. ReferAll has given us the ability to measure outcomes, patient changes in status, as well as monitoring when we contact patients and even how long it takes us to contact them. We can set up protocols on the system so we are better able to manage our patient services. By generating tasks, ReferAll’s system enhances our efficiency across the board. This has meant we could de-clutter the office and focus on the provision of our exercise on referral service and classes. Furthermore, anyone can manage any call coming in as everything is on a single system with a clear history of activity. This gives the team the ability to manage the service more quickly and more efficiently. We don’t need to leave messages for colleagues as the call can be resolved then and there.”
Communication with patients is crucial and this was one challenge the Camden Sport and Physical Activity Service team faced when receiving referrals in a paper format.
“We can now communicate with our patients from outset as we no longer receive incomplete or illegible data,” said Steve Berman. “These are simple things that we take for granted now but at the time they really affected the way we worked. Previously referrals bounced back and forth but now the system is clear and simple because it is all online. The process is also faster as the referral is in front of us immediately and then communicated to our team straight away. It was long-winded before.”
Efficiency was always the driving force behind changes to the exercise on referral system.
Steve Berman said: “We are now able to deliver a better service to our patients. We can monitor attendance figures within the class timetables and identify which classes are popular and which aren’t. We are then able to respond to this information quickly by viewing the numbers and analysing them. Using this data we can also look at staffing and rotas to ensure the team are readily available where they are most needed.”
Cost effectiveness was another goal, particularly as a Key Performance Indicator (KPI) from the Camden Council.
“We have used ReferAll to improve our KPIs and to provide a more cost effective service. As a tool it allows us to respond to these requirements, to pull out the relevant data, ask why and respond.”
Ultimately Camden Sport and Physical Activity Service is committed to providing the best possible service to patients in the exercise on referral programme.
Steve Berman said: “The whole process is smoother and communication is quicker. It drives referrals to us and we can then use all the tools it provides to continually improve the quality of our service. One example is lifestyle questionnaires. These are bolted onto the IT system so can be used at any time. We tend to use these at the beginning and the end of the programme. From our patients’ point of view they feel they are getting a better quality of service and so feel more engaged. In addition, the ReferAll system is set up so that it obliges us, as a team, to complete the questionnaires in a uniform way. This leads to the quality assurance which we want to maintain. Inclusion of ‘flags’ so we can see if someone hasn’t attended two sessions are also beneficial. The instructor is then obliged to call them via a system reminder. In this way our patients feel better supported to try and change their behaviour and are more likely to complete the programme.”
Over the five years since ReferAll’s online system was introduced, Camden Sport and Physical Activity Service has received nearly 6,000 referrals. By using the online system, the team has also been able to share performance information with senior management and public health including the number of referrals received, how quickly they are contacted, how many start the programme, when they begin exercising, how long it takes them to complete the programme and whether they are being contacted if they aren’t attending. Follow up is also completed to see how many patients are continuing to exercise, and how often, following completion of the programme.
As part of their commitment to patient care, Camden Sport and Physical Activity Service recently introduced SMS prompts. Generated by ReferAll’s system, these remind patients to attend initial meetings and are also used if they haven’t been attending exercise sessions. In addition, instructors are notified via this method to encourage them to contact non-attendees.
Steve Berman commented: “We have only been using the SMS service for a matter of months but, anecdotally, it has made a huge impact on attendance numbers at our welcome meetings. The SMS is sent to the patient the day before they are due to attend. It has led to significant improvements in attendance figures.”
Following this successful introduction, further expansion of this SMS system, which also provides motivational texts to patients participating in the scheme, is being considered by Camden Sport and Physical Activity Service.
Commenting on his experience of ReferAll, Steve Berman said: “As a company they are always responsive, personable and highly knowledgeable. They have a genuine willingness and desire to respond to us, as a team, and our needs. Their ‘lateral’ approach to our system, the way that we work and to finding appropriate solutions is applaudable. I wholeheartedly recommend them.”