The Public Health Commissioner's view

by Rachel Stokes on February 16, 2021

Phil Lown is Partnership Programme Manager at Public Health Suffolk. In his commissioning and monitoring role he’s been working with ReferAll to introduce an online solution for the county, enabling Public Health to assess the efficacy of Exercise on Referral (EOR) schemes across all of Suffolk.

Lown explains: ‘We were looking for a solution that allowed us to gather consistent data across a wide variety of sites/inputs, so we could dependably evaluate outputs. We have 15 sites run by a mix of trusts, leisure operators and schools, so we needed a customised solution to understand the effectiveness of EOR in the county and how to bring it closer to primary care.’

In October 2019, ReferAll created the final piece of the puzzle – a bespoke online software solution for sites operators offering EOR in Suffolk, enabling them to adopt a standardised, consistent approach to EOR data collection for the first time. The tool formed the final part of Public Health Suffolk’s EOR quality standards scheme – a county-wide quality standard that was the first of its kind in the UK. 

‘The pilot consisted of 13 sites across three leisure operators in the county,’ says Lown. ‘We use ReferAll’s solution on two levels. Firstly, to monitor and evaluate EOR programme efficacy and, secondly, to manage, organise and track EOR programmes in a more efficient way. Our overarching aim in Public Health is to prove efficacy particularly to primary care deliverers – which would also hopefully enable us to access funding to maintain and improve the counties EOR offer. We couldn’t do this without tangible data to show how our current schemes save the NHS time and money. A key part of the evaluation is around retention of referred participants – where they are 12 months on – something previously not measured at all. This is key to evaluating programme efficacy from a Public Health point of view.’  

The programme was intended as a two-year pilot – with implementation and sites gaining the Quality Standard in the first year and continued data gathering and evaluation in the second. ‘Sadly, due to COVID-19, that second year has been all but wiped out,’ explains Lown. 

‘Measuring behaviour change is key for us. Some initial data was beginning to come through, showing increases in physical activity (IPAQ score) levels – improved from 1.68 (low) to 2.32 (moderate) – which shows at the start of the programme participants’ were not very physically active and at the end of the 12 weeks they became moderately active. 

‘The programme also measures the impact on participants' mental wellbeing (SWEMWBS scale). At the start of the programme participants had an average score of 23.9 compared to an improvement to the average score of 28.1 at the end of the programme. The SWEMWBS scale is useful at an individual level and some instructors are using the scale to help participants think about ways in which their mental health is changing. With this information to hand, whenever I login to my ReferAll Commissioners Account I simply run a report which gives me up-to-date statistics. We’re now looking to commit to a third year (April 2021-2022) to deliver this crucial part of the project.

‘Once pandemic lockdown restrictions are lifted, ReferAll’s bespoke solution will, we hope, give us consistent data-driven proof, through more than just customer feedback, that the EOR schemes that are running in the county are effective and potentially worth more investment. For me, this is the key driver – proof of efficacy, with the added incentive of assistance in managing schemes.’ 

At the end of the evaluation year, ReferAll will provide Public Health Suffolk with an evaluation report to show the efficacy of its schemes, measured in three ways, with physical activity scores, mental wellbeing and a third behaviour element, BREQ-3, which is a new scale implemented in ReferAll for first time. 

Stu Stokes, ReferAll’s MD, highlights the value of scheme configuration. ‘During on-boarding meetings with Phil and the team, we were delighted to introduce the BREQ-3 measurement (which looks at a person’s motivation for exercise) and be able to ensure Suffolk CC can meet their reporting requirements.’

Topics: Public Health, Funding, Commissioner