Ann has asked me to blog about my experience of trying to bring physical activity into the heart of my general practice community. After the Olympics I was inspired to help get my patients more active to improve their health and wellbeing. Via @Twitter I quickly found @exerciseworks and Ann kindly spent a good deal of time bringing me up to speed on all the research and evidence behind the benefits of physical activity for all patients. She signposted me, and the practice, to a range of national and international ‘movers and shakers’ in the area of exercise as a medicine.
My 'work in progress' has taken into account all the things I have learned and can be summarised into the following strands.
1. Workforce wellbeing
Encouraging my colleagues and staff to find ways in the working day to sit less, stand more, and walk more. To support and encourage physical activity amongst the staff and celebrate their achievements.
2. Exercise IS a medicine
I've started to talk to my patients about physical activity as a matter of routine. I have developed a way to record in Emis-Web current levels of PA as a significant active problem and code my brief interventions. I can export this template to any Emis-Web users who are interested. Please contact me @jowallis100 for further details!
3. Patient information literature
I have collected a variety of written information leaflets on physical activity covering a full range of ages and health burden. I code the electronic patient record when I back up my brief intervention with an appropriate educational support leaflet.
4. Local Community Stakeholders
I have introduced myself to local people and businesses with an interest in physical activity. This includes some local Registered Exercise Professionals (REP's) and gym owners in order to work on a joint venture to improve physical activity in our community and break down any barriers which exist between health and the exercise/fitness industry.
I am also creating a bank of local volunteers who will become our walk leaders, Nordic waking leaders and Otago class instructors for the future. We have had one stakeholder’s meeting where we brought everyone together to share ideas and aims.
5. Local professional stakeholders in Physical Activity
I have made contact with local health workers who are involved in physical activity with patients, in order to work out where the gaps in provision are. We are now working together to develop small projects which 'fill the gaps' and plan to apply jointly for funding.
Unfortunately my all encompassing bid to the local trust was unsuccessful, so 'Plan B' is to work up smaller bids with other stakeholders. For example...
‘More Life’ for children's weight management; we are improving signposting and referral within the practice to get more children to take up the excellent weight management service at an earlier stage.
Cardiac rehabilitation programmes; working with Secondary Care Trust's Lead Cardiac nurse and leisure facilities to increase the cardiac rehabilitation provision in the early days post event and to support and encourage ongoing exercise for the rest of the patients life. We are working together to encourage and support physical activity in the community for patients with heart failure.
Working with Local Authorities' Sport & Physical Activity Development Team on lots of projects; Otago in surgery, supporting the links with local gyms and REP's, bringing the 'Active Always' programme into the South of the borough where I practice, training up Otago class leaders, training up walking for health leaders, working to find some funding to support a co-ordinator who will 'case find' and match patients with locally available physical activity (eg on discharge from pulmonary rehabilitation, cardiac rehabilitation, weight management services, Falls service etc)
Preliminary discussions with the local pulmonary rehabilitation team to bring the course into our community and ensure patients have easy access to ongoing physical activity after discharge.
We have a Health Trainer in the surgery once a week and we are working together to increase the physical activity part of her role. She is going to train to be a 'walking for health' leader and thereafter plans to take her cohort of patients out for a walk, perhaps once a month!
6. Set up Otago classes to run from surgery for our frailer older patients
All clinicians are referring into Otago classes which run in our surgery. We have now filled three classes and are trying to work out how to accommodate the next cohort of enthusiastic patients. The classes are funded by public health and one of our patient volunteers to help.
We have sent two representatives from the practice to be trained up to be Otago instructors (funded via public health).
7. Walking for Health
Walking is so easy and suitable for vast majority of people. So I am developing a group of patient volunteers to train as walk leaders (who will be trained and insured by public health). My aim is to get a walking group leaving the surgery every weekday. I am going to train up too, and offer 'walk with the doc' sessions from time to time!
I am working with Catherine Hughes (Director of British Nordic Walking) to find funding to train up some Nordic Walking leaders, who would then lead Nordic Walking groups from the surgery.
9. Work with Patient Participation Group (PPG)
We have an active PPG who have become involved with the idea of improving opportunities for physical activity in our community. They have taken a special interest in the BHFNC information on physical activity for older adults and are helping to raise the profile of the project.
10. Create a physical activity suite within the surgery
This will be the area where patients can browse information on the UK Chief Medical Officer guidelines, watch exercise DVD's and be signposted to local opportunities for physical activity. We have invested in some audiovisual equipment which will allow presentations and web access for groups. It is the area where the Otago classes take place and will be the place where walks from the surgery start and finish.
There are tea & coffee making facilities!
11. Emis-web templates
I have amended all the Qof templates where physical activity has been proven to have benefits (which is most of them!!). I have bolted on my physical activity template as a 'new page' on each existing Qof template.
Lobbying public health and CCG to put more resources into PA (ongoing), talking to anyone, who will listen, about physical activity for health and wellbeing, writing about physical activity in my letters to consultants, seeking support from other local GP's to add weight to the lobbying.
13. Case studies
I am collecting a series of case studies where my physical activity advice has been the cornerstone of my management.
14. Working on an official launch for the physical activity project
The PPG are taking a strong role in the official launch for the Physical Activity project which will be on:
Wednesday 17th July 2013
at Kiveton Park Medical Practice S26 6QU.
3-6pm; Local stakeholders stands & activities in the surgery and 'Walk with the Doc' sessions. Official opening at 6.15pm.
All twitter friends welcome!