London Borough of Southwark

by Admin on June 22, 2016

The London Borough of Southwark has been running its Exercise Referral scheme for over a decade.  Throughout this time, as an industry innovator, the local authority has constantly sought to find ways to develop and improve its service.

In 2010, the council realised it needed to find a new way to manage its patient records. Exercise Referral & Cardiac Rehabilitation Programme Manager, Agata Roszczynska, explained: “We needed a system where we could keep patient information in one secure place.  This was crucial so that we could track and monitor patient activities easily and also eliminate any errors or duplicate records.  Our paper based system also created lots of inappropriate referrals.  This meant we struggled to filter all the referrals coming in before the end of the three month programme and couldn’t always reach people in time for follow ups and final assessments.  This, in turn, meant we couldn’t always meet our targets.  All the information from the paper forms had to be manually inputted into an Excel spreadsheet, which was hugely time consuming and overloaded our administrator. With a paper system, referrals were being handed to anyone at a leisure centre or being faxed to machines that weren’t located in our office.  This led to concerns about data protection.”


”A colleague, who was already working with ReferAll recommended them.  Crucial in our decision making process were our concerns about data protection, as well as meeting targets and budget.  We knew ReferAll had a back up system so our data would be safe.”


ReferAll specialises in software solutions to enhance the efficiency of exercise referrals from GPs to leisure providers.   The company offers a fast and efficient referral pathway for Exercise on Referral schemes from GPs via an online form. The referral from the GP appears instantly on the Exercise on Referral administrator’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 administrator with information about where the referrals come from. 


The council decided to test ReferAll’s software solution for one year.  Five years on, it has continued to use ReferAll’s specialist system expanding it to a variety of services including Exercise Referral, Cardiac Rehab and Healthy Lifestyle Motivators, which are run on the council’s behalf by Fusion Lifestyle, the Health Improvement Hub and Walk Away from Diabetes.  The services are run from Peckham Pulse Health Living Centre but can be accessed at a variety of centres throughout the borough including Camberwell, Dulwich, Seven Islands and Docks Watersports Centre.


Roszczynska said: “By having all the records and data in one place we save so much time.  We can enrol patients on the exercise referral programme more quickly, book initial and final assessments as well as tracking patients who haven’t attended for fourteen days, so that we can follow this up, and arrange three and nine month follow up.  We also save time as we no longer receive inappropriate referrals because the criteria in the system have to be met when the data is entered.”


“Accessing and creating reports is straightforward because all the data is in one place and is up to date, so we can easily ‘create’ a snapshot of our key criteria at any time. Another benefit is that we can see if patients have been on the programme before, as the database includes all referrals since the scheme began.  As we receive many referrals each year, it is important to make sure individuals aren’t repeating the programme so our resources are put to best use.”


“The online system has also benefited instructors who can access patient data at any site and at any time.  This simply wasn’t possible with a spreadsheet.  It is also possible to leave notes for different members of the team. This creates a seamless service for our programme participants.  Double booking simply isn’t possible anymore and we can use tasks to create reminders for other members of staff, all of which enhances the service we offer.”


Commenting on ReferAll, Roszczynska said: “ReferAll has worked as a true partner with us.  A clear example of this was ReferAll’s focus to create a solution for Public Health and us so that we could get EMIS forms, which GPs use, to work with our ReferAll system.  After a great deal of consultation and research, ReferAll managed to find a solution whereby the EMIS form could be uploaded so that all the data appears in our database.  This was a very welcome and time saving solution for both the GPs and us.” 


Throughout the exercise referral scheme, the Public Health Department has been well aware of the challenges involved.  Rosie Dalton-Lucas, Health Improvement Partnership Manager at Southwark Public Health Department said: “One of the biggest challenges is the size of our budget in relation to the needs of the local population.  To run the scheme well and make the biggest impact, we need to understand the health of our local population.  In theory, this would mean focusing on areas of higher deprivation but in these areas GP engagement might be patchy. This creates a challenge in getting engagement right throughout the referral process.  It is also crucial to see how exercise referral sits within our wider leisure service portfolio and how we can make our services more integrated as a whole.”


“Data collection is crucial as it indicates whether the scheme is having an impact.  It is important to get good quality information and to review it regularly, to monitor adherence to the programme and the completion rate.  This is where ReferAll comes into its own.  There are many variables which affect the scheme.  It’s all about fine tuning, and by using a software solution it is possible to see how any changes or adjustments to the scheme impact on patients.”


In 2015, Southwark decided to expand its exercise referral scheme to create a three-tier system.  New referral forms will be piloted at three GP surgeries and eventually accessible to all.  The new tiered system is divided into a low risk programme (for people who can exercise independently after their initial assessment), a medium risk service (which includes the current exercise referral scheme) and a high-risk programme (which focuses on cardiac rehabilitation). 


In the last twelve-months, the borough received around 1,400 exercise referrals and 200 cardiac rehabilitation referrals. They have received nearly 6,000 referrals since using the software.

Topics: Exercise Referral