In 1992 Life Leisure established one of the first Exercise on Referral (EOR) schemes in the country. Called PARiS (Physical Activity Referral in Stockport), it is a joint partnership between the trust and NHS Stockport. Following a conversation with a commissioner early in 2014, the trust realised that more needed to be done to improve the evidence base and to ensure long-term continuity of the service. Life Leisure took strategic action, adopting ReferAll’s software solution in October 2014 in a bid to gather meaningful data from its EOR scheme and assert the success of its programmes.
Michelle Childs, Senior Physical Activity Development Officer at Life Leisure, explained: “When it came to evaluating a patient’s improvements against baseline, our previous referrals database made this difficult and time consuming. We wanted a system that could collect and analyse more information as well as providing additional monitoring tools. This information would provide Commissioners, and patients, with a better understanding of the positive impact the service was having on their health over the length of the scheme and beyond.”
Using ReferAll Life Leisure has clearly demonstrated the success of PARiS.
“Typically we receive around 1,500 referrals over a twelve-month period. In the last year, 100% of those who accessed PARiS completed the initial evaluation and 68% completed their three-month evaluation. Out of all our referrals to the central hub we know that after six months nearly 500 are still active with 60% now achieving at least 150 minutes of moderate intensity physical activity per week.”
As a result in June 2016 the trust was awarded a further contract by Public Health Stockport Metropolitan Borough Council. The three-year agreement, which could potentially run for five years subject to outcomes, was worth over £170,000 and tasked Life Leisure to additionally provide falls prevention and cardiac rehab phase 4 programmes alongside its specialist physical activity and EOR service.
“For any EOR programme provider successfully bidding for new contracts is always challenging. We have benefitted greatly from using ReferAll as the quality of our data and reporting was essential to gain this additional funding. Previously we couldn’t show how many patients went from doing no activity to completing thirty minutes of exercise five times a week. This is what public health teams want to see: the impact of the EOR programme. Over an eighteen-month period we received over 2,200 referrals and 1,990 of these started the programme. 92% of these increased their physical activity levels from baseline and there was an average decrease in BMI of 1.5 as well as an average reduction in waist circumference of 7 cm. 64% of our PARiS participants reduced their daily sitting time by an average of 105 minutes per day.
“We used ReferAll to showcase our evidence, from tangible improvements in best imaginable health scores over three and six months to the number of people doing moderate or vigorous activity for thirty minutes or sixty minutes and the number of times per week this was occurring.”
Life Leisure uses ReferAll’s software to provide a central hub, so all the data can be fed back into one overall framework, not only from their PARiS scheme but also from other related programmes, such as weight management and COPD (Chronic Obstructive Pulmonary Disease) classes. ReferAll also provided Life Leisure with an integrated and automated text service, which sends SMS messages to patients to remind them about assessments during the programme.
“EOR schemes are a great first step for many people. I truly believe they provide excellent social value. By supporting participants from their first consultation to overcome any barriers to physical activity and then throughout their experience we can inspire individuals to become and stay more physically active. Some of our patients see their PARiS officer every week during the six-month period, while others respond well to questionnaires and motivational text messages. ReferAll’s software provides us with a broad set of data which showcases these successful patient outcomes, not only for physical activity but also for enhancing health and wellbeing.
“Our standard programme is six months but provides subsidised activity for up to eighteen months post referral. One of our strengths is that our service is patient-led rather than prescriptive so, subject to their capabilities, participants have open access to our facilities. They can choose to swim, go the gym, or, depending on the reason for their referral, participate in group exercise. These include everything from mainstream classes to falls prevention, COPD and cardiac rehab as well as team sports such as football and netball.
“The range of activities presents a challenge in terms of monitoring long-term activity. Before we began working with ReferAll we knew that people were still being active but struggled to know who they were and how to track them. Additionally, for individuals who are physically inactive, they may not understand what being physically active is as it can be hard for people to judge so self-reported data can be difficult to evaluate. The questionnaires we use on ReferAll standardise this data, making it more meaningful. Even more than that we can show how being physically active enhances other domains such as sitting less, improving health and wellbeing by a specific score over three or six months, reducing BMI and waist circumference as well as losing weight.”
ReferAll offers a fast and efficient referral pathway for the leisure trust’s EOR schemes from healthcare providers, such as Primary Care, Mental Health teams, Cardiac Rehab teams, hospitals and GPs, via an online form. The referral from the healthcare provider appears instantly on the leisure provider’s dashboard, from where they can use ReferAll’s software solution to move the patient through their service, setting target dates and recording actions completed against the referral, such as contacting the patient and booking appointments via a task bar. The integrated system also provides the leisure provider with information about where the referrals come from.
Life Leisure provides EOR services at nine of their fifteen sites in the Stockport area including PARiS and falls prevention, COPD and Cardiac Rehabilitation classes.