Printed Date: 26/09/2017

Health

Healthwise

We’re committed to helping people to stay fit and healthy. And if they need a little help with that – we’re on hand. We have specialist teams working in a number of our partnerships dedicated to offering a programme called Healthwise.

Over our 14 years of experience of delivering health programmes, our highly skilled team working with expert partners, including dietitians, health psychologists, have developed and refined our Healthwise Scheme.

Healthwise is a model for physical activity interventions covering a wide range of medical conditions.  Health professionals can refer patients to a low cost physical activity programme designed for individuals with existing health conditions, as well as those at risk of developing health conditions, such as diabetes and hypertension.

Healthwise offers a menu of established evidence based programme options including physical activity on referral, cardiac referral and weight management, providing supervised or independent pathways, delivered by highly trained staff. GLL will work with the council to tailor the offer to best meet local priorities.

Healthwise is a high-quality person centred model increasing an individual’s knowledge, skills and confidence – with the overall aim of improving their health and wellbeing. Our focus is on supporting people to become and remain more active, facilitating long term sustainable lifestyle changes and full integration with local health services and care pathways. All programmes are compliant with NICE guidance and deliver behaviour change support.

Today our ‘Healthwise’ scheme operates within 21 Local Authorities. Across our Healthwise programmes in the last year there have been:

  • 1875 GPs and Allied Health Professionals referring
  • 301 GP surgeries signed up
  • Over 16,500 customers referred
  • Partnership work with many extended services including:
    • 12 Acute service sector departments partners
    • 4 Dietetics Department partners
    • 5 Specialist cardiac schemes
    • 4 Pulmonary rehabilitation schemes

We undertake extensive local research and work closely with the local authority to tailor our Health programming offer to best meet local need and address health priorities. This approach includes:

  • Understanding of Key local and regional strategies (JSNA, Joint health and wellbeing strategy)
  • Undertake service user engagement events
  • Regular discussion with council lead
  • Work closely with local working groups and steering committees
  • Engage local stakeholders

Our Programmes

Details of which programmes are delivered within your Better Centre can be found within your local centre pages.

Physical Activity on Referral

GLL’s firm belief that physical activity at appropriate levels can have a beneficial effect upon the health of an individual, underpins our commitment to the provision of the Physical Activity Referral Schemes (PARS) within our Partnerships.

Health professionals can refer patients to a low cost physical activity programme designed for individuals with existing health conditions as well as those at risk of developing health conditions, such as diabetes, hypertension and depression who would benefit from specialist support to become and remain more active. The programme has been designed to help participants to increase their knowledge, skills and confidence, and improve their health and wellbeing. This is a 12 week programme incorporating one to one assessments, behaviour change techniques and individual tailoring of activity plans – all offered at a low cost to participants.

Cardiac Rehabilitation

The Phase IV Cardiac Rehabilitation Programme (12 week) is continued cardiac rehabilitation for those clients who have successfully completed Phase III or for those who are referred by their GP/Health Professional with heart conditions.

The scheme provides clients with access to appropriate group exercise classes and progression onto an individualised gym programmes. The purpose of the course is to increase awareness of the benefits of physical activity and provide tools to change or maintain physical activity patterns and other positive lifestyle behaviours including healthy eating and stress management.

The programme includes the following components in accordance with BACPR Standards and Core Components for Cardiac Rehabilitation

  • Lifestyle
  • Physical Activity & Exercise
  • Diet and Weight Management
  • Smoking Cessation
  • Stress Management/Relaxation
  • Education Risk factor management
  • Long term management strategy

In a number of our partnerships we also provide the Phase III element of Cardiac Rehabilitation with a Cardiac Nurse working from our consultation rooms, screening patients alongside our physical activity specialist team. This has provided a seamless referral pathway for patients.

 

 

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Adult Weight Management

Adult Weight Management Courses run for a ten week period and encompass both educational and physical activity components to promote healthy eating and an active lifestyle.

Courses are aimed primarily at patients with a BMI>28, but are also available to those with a BMI>25 who have little knowledge of healthy eating and would benefit from guidance. In addition to those clients referred to PARS solely for weight loss/obesity, clients who have other secondary medical conditions may also be signposted to the course as part of their health intervention.

GLL are currently commissioned to deliver the Tier 2 Weight management pathways within a number of partnerships and additionally support the provision of the Tier 3 Weight management courses with specialist physical activity provision.

 

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Family Weight Management

GLL have had extensive experience of delivering Family weight management courses over the last eight years. As such, we have developed our own course which has drawn upon the considerable involvement of our teams who have learned from the successes and experiences of those who have taken part in courses previously.

The eight week course has been designed to provide families with a fun, informative and balanced approach to nutrition and physical activity. A graduate pathway is available for participants which supports weight loss for all members of a family.

 

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Musculoskeletal Programme

Back pain is a very common condition and can affect adults of all ages. It is estimated that one in five people will visit their GP in any given year because of back pain. And 80% of adults will experience at least one episode of back pain at some time in their lives.

Chronic back pain is less common than acute back pain, but it is still very widespread. Chronic back pain is a very common cause of long-term disability (after arthritis). After stress, it is the leading cause of long-term work-related absence. A recent study found that one in every 10 people reported having some degree of chronic back pain.

The Better Health team working in partnership with local Physiotherapy teams have created a musculoskeletal course designed to give individuals tools and information to help them manage their condition over a ten week period. The classes take the form of group exercise, i.e. around 10 - 15 people under the supervision of a qualified exercise instructor and contain both physical activity and educational components to ensure that individuals have the ability in the long term to self manage where possible.

The range of exercises has been designed to strengthen muscles and improve posture. They include:

  • aerobic activity – exercises designed to strengthen heart and lower blood pressure, such as jogging or swimming
  • muscle strengthening
  • stretching

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Falls Prevention

Falls Prevention Classes are attended primarily by vulnerable older people who have either had, or are at risk of, a serious fall. The participants generally have limited mobility, as well as compromised strength which often leads to social isolation.

The sessions are also open to clients from other referral routes, such as GPs or Physiotherapists & self referral. Various types of activity sessions such as Tai Chi, Pilates and exercise special classes (both studio and gym based) are available to complement the service and provide appropriate exit routes and may be subject to additional

The class users also experience secondary benefits from participating in Falls Prevention classes, which are designed primarily to improve mobility & health. These include:

Social interaction

Greater independence

Feelings of confidence

Expose to new activities, interests & services

Reduced fear of injury

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COPD

Alongside the Cardiac Rehabilitation course, the Better Health teams offer a support service to the Pulmonary Rehabilitation teams working within our Partnerships.

This programme helps individuals to learn how to breathe more easily and improve their quality of life. It includes breathing re-training, exercise training, education, and counselling.

Regular exercise has many benefits. Exercise, especially aerobic exercise, can:

  • Improve circulation and help the body better use oxygen.
  • Improve COPD symptoms
  • Build energy levels so you can do more activities without becoming tired or short of breath
  • Strengthen heart and cardiovascular system
  • Increase endurance
  • Lower blood pressure
  • Improve muscle tone and strength; improve balance and joint flexibility
  • Strengthen bones
  • Help reduce body fat and help reach a healthy weight
  • Help reduce stress, tension, anxiety, and depression
  • Boost self-image and self-esteem; make you look fit and feel healthy
  • Improve sleep
  • Make you feel more relaxed and rested

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Health Checks

A separate physical activity care pathway has been developed for those individuals who are identified as being ‘at risk’ of developing a medical condition through the NHS Health Checks Programme. This programme utilises the same protocols of the PARS but provides those referred with a higher degree of support and motivation from their instructors.

Participants are supported in their activity sessions through telephone contact and regular contacts. Weight Management courses are operated alongside to support those referred to this programme with a BMI in excess of 28.

 

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Smoking Cessation

As part of the NHS Smoking Cessation service, large numbers of our frontline staff have been trained to appropriately signpost individuals to local Smoking Cessation services, with many courses being hosted within our Centres. Pilot programmes are underway to deliver smoking cessation courses through the teams working at the Centres, looking at different methods of motivating individuals in their ‘quit’ attempt.

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Cancer Rehabilitation

The most prevalent types of Cancer are those with relatively high incidence and good prognosis and every year many people receive successful treatment (BASES). However, even at the end of this treatment Cancer survivors can find themselves still facing many challenges including: recurrent cancer other chronic disease, fatigue, pain, depression, anxiety, lymphedema, menopausal symptoms and impotence.

Evidence has suggested that physical activity can help to prevent or manage these conditions and as such, GLL is committed to delivering a programme to help cancer survivors. Teams delivering PARS are now qualified in Cancer Rehabilitation and linked to support programmes to ensure that an aligned care pathway exists for participants.

 

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Mental Health Classes

As part of a specifically commissioned referral route this pathway follows the same pathway as the PARS programme and additionally incorporates a series of classes focus on relaxation and meditation which support a physical activity programme designed to increase mental wellbeing.

Diabetes and NDPP Pathway

With the recently commissioned National Diabetes Programme (NDPP), GLL have developed a pathway specifically for those with Diabetes. This supports the work of the NDPP. Participants are guided through a PARS programme of activity and are invited to attend three workshops within the Health Hub addressing the issues of:

  • Diabetes and me (raising the issue of how to manage diabetes in every day life);
  • Diabetes and Physical activity (how physical activity may effect the management of diabetes); as well as
  • Diabetes and Healthy eating (providing practical support on healthy eating).

This course is also suitable for those who have been through the NDPP programme. This pathway fits well with our extended diabetes pathway with referrals being referred directly from local specialist diabetes teams.

 

Innovation

We are currently working with our partners locally to develop innovative programmes to impact the health of the local community. Initiatives include: Libraries for Health, a children’s referral programme, Diabetes, Parkinson’s and workplace health & fitness promotion. Programmes rely on a partnership approach and available resources.

 

Other Specialist/Tier 3 programmes currently delivered by GLL in partnership include:

Stroke Rehabilitation, Parkinson Referrals, Seated exercise, Phase III Cardiac Rehabilitation, Heart Failure Classes, MS Referrals, Change 4 Life Clubs, Weight Stigma Training, Activate Healthy Schools, Community Activators, and Healthy Walks/jogging groups.

Within each partnership that our Better Health Team operates, we implement our established governance structures and approaches to ensure a safe and effective service. Our governance procedures include:

·         Tried and tested operating procedures

·         Effective staffing structure

·         Incident reporting systems and reporting

·         Effective Clinical governance procedures

·         Staff management protocols and experience

·         Gold standard client management system and integrated clinical record

·         Award winning Staff training and development programme

·         Established benchmarking and monitoring approaches

·         Establish Quality improvement cycles

·         Experience contract management

·         Information Governance structures

 

Healthwise evaluation:

A number of our Healthwise schemes have undergone extensive evaluation as part of our commitment to continually develop this service area from academic organisations. These evaluations have shown:

  • A high completion rate
  • Positive physiological and psychological changes in body weight, mean arterial pressure and well-being for those who complete the scheme.
  • Significant increase in level of physical activity,
  • Significant improvements in quality of life scores and physical activity levels 6 months after completion of the scheme.
  • successful targeting of unemployed and retired patients
  • positive feedback from patients including improvement to health, confidence and Social isolation
  • Patients additionally report that they visit their GP surgery less often and have reduced their medications.

 

 

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