The Active Westminster Physical Activity Referral Scheme (PARs) is delivered by Everyone Health in partnership with Westminster City Council’s leisure contractors Everyone Active, and was previously known as the Exercise Referral Scheme.
Summary
The Active Westminster Physical Activity Referral Scheme (PARs) is delivered by Everyone Health in partnership with Westminster City Council’s (WCC) leisure contractors Everyone Active, and was previously known as the Exercise Referral Scheme.
The scheme has been designed to gently ease participants into physical activity over a 12 week period with the aim of increasing activity participation levels and knowledge about the physical and mental wellbeing benefits of physical activity through a combination of one-to-one support, supervised activity sessions, group exercise classes or swimming.
The challenge
A GP referral scheme had been in place in Westminster for many years but senior managers saw the need to broaden this as a service. Conversations were held with Public Health and through a desire to develop their reach the service put themselves forward to be registered with the National Institute for Health and Care Excellence (NICE).
Starting small scale with one sports centre (Moberley), the service grew from a paper-based one to employ a Physical Activity Coordinator and initially focused on gym-based activity. A membership was introduced of £1 to remove the barrier of cost and encourage individuals to keep returning for activity. Relationships were gradually built with the individuals who developed a routine of coming to the leisure centre, and the service linked with local doctors who instead of prescribing pills were prescribing exercise.
The service gradually developed over the years into the PARS scheme, and it is now a 12 week programme with reduced rate membership offered for life.
The solution
Previously funded through the Central London Healthcare Partnership the service operated from Moberly and Little Venice sports centres as the Exercise Referral scheme, then from 2016 it was included in the Everyone Active contract with all seven WCC centres. This also helped Public Health step away and direct investment into other programmes.
Everyone Active initially administered the programme and then this was taken on by sister company Everyone Health which brought the support of a national manager and a Westminster coordinator, along with 5-6 instructors covering the various sites. Scheme admin has been centralized which has removed the need for instructors to be involved in the actual referral process. The scheme then changed its name with terminology to better reflect the focus on activity rather than the images that the word ‘exercise’ can suggest.
The role of the Physical Activity Coordinator is important and they are able to provide personalized support to individuals along the lines of the ‘Make Every Contact Counts’ principles.
The service has widened to link and integrate with initiatives such as ESCAPE-pain, Change4Life, Sport for Confidence and One You Westminster – with cross referrals taking place. As opposed to only gym activities outdoor spaces are now also being utilized such as Paddington Recreation Ground which is an important local hub for a range of activities and walking initiatives.
Occupational Therapists (OT) help to bridge the gap between the perception of leisure centres and those not confident to attend one. The OT’s have a good relationship with the PARS coordinator whose aim is to do outreach work, speaking to GPs and health practitioners to promote the scheme and related programmes to encourage physical activity.
Lessons learnt
- Systems and processes need to be right for the scheme to be effective – local approach (triage) to a centralized approach has helped make operations more streamlined and efficient.
- Having the right staff for the programme is crucial, not just in terms of qualifications but importantly in interpersonal skills such as empathy and having the experience to work with different individuals depending on the demographics and needs in a specific locality.
- Culture change can be delivered by linking different programmes together - for example Active Westminster have been using outdoor spaces, ESCAPE-pain, Change4Life (now Better Health) and Sport4Confidence.
- Embedding the scheme in the contract has been a successful thing to do with the intention to include this in future contract discussions.
- Don’t be too evangelical about sport and physical activity, it’s about getting people moving and active. It needs to be personal and focused on those people’s issues.
- Recognising that sport is just one of the things in a much bigger picture of movement and activity, also getting the language right is important.
- The key is developing a connection with people, hand holding and once they get into the habit of activity, making them feel welcome through the staff.
How is the new approach being sustained?
Active Westminster are currently in advanced discussions with 4Global and working towards implementing the data hub to demonstrate the social value of the scheme. This is particularly important around evidencing health inequalities, obesity levels and NHS admittance rates.
There are plans to diversify the types of activities that referrals can access, with a boxing/health programme, expansion of the outdoor space offer and developing the partnerships with the external providers mentioned above.
In addition there is the ambition to reconnect a partnership with another local gym, the Jubilee Hall Trust who would then be able to signpost further referrals and expand the PARS scheme in another part of the borough.
Links with GPs are being focused on and have improved over the last year however the team recognize that these could still be strengthened further.
The impact
The impact of PARS is measured through a combination of quantitative data and qualitative individual feedback.
Regular monthly monitoring provides data around scheme take up and the service has previously been oversubscribed. Figures are collected around those referred, starting and completed activity programmes. The KPI data collected is extensive and helps managers to track and improve the programme.
Amongst participants there is visible positive impact upon strength, mobility and health outcomes, and the production of case studies evidence this with many citing the behaviour change from inactive to active.
The growth of the programme has been essential to provide access for more people across the seven centres in Westminster.
Contact
Coreen Brown, Head of Sport, Leisure and Active Communities Services