Update on Physical Activity and Health

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(No Transcript)
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Update on Physical Activity and Health

• New Policy Context
• NICE Guidance
• GPPAQ
• Physical Activity Care Pathway

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Choosing Activitya physical activity action plan
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Relevant PSA targets

• Obesity (DH,DCMS and DfES)
• Coronary Heart Disease Mortality (DH)
• Physical Activity (No official target)
• Sport (DCMS)

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Whats New?

• Our health, our care, our say a new direction
  for community services (Jan 06)
• NICE Guidance on Four commonly used methods to
  increase physical activity (March 06)
• Launch of Small Change Big Difference (April
  06)

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Whats New?

• Caroline Flints new role to maximise sporting
  participation and fitness (PMs letter June 2006,
  Public announcement Aug 06)
• Health Challenge for England next steps for
  Choosing Health (Oct 06)

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Inter-ministerial PA Group A new and ambitious
strategy to maximise sporting participation and
fitness

• Focus on sedentary adults
• Actions to promote walking
• Cycling?

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Inter-ministerial PA Group

• Small Change Big Difference campaign to engage
  business
• NHS Physical Activity Care Pathway
• Regional delivery and data collection

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National Institute for Health and Clinical
Excellence

• Public Health Intervention Guidance no. 2
• Published March 2006

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National Institute for Health and Clinical
Excellence

• Brief advice in primary care ?
• Exercise referral
• Pedometers
• Community-based walking cycling schemes

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Nice Intervention Guidance

• Brief interventions in primary care
• Identify inactive adults using validated tool
  (e.g. GPPAQ)
• Advise to aim for 5x30 min
• Provide written info on benefits and local
  opportunities to be active

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Nice Intervention Guidance

• Brief interventions in primary care
• Follow up individuals
• Monitoring for impact on disadvantaged groups and
  effectiveness of different disciplines

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Nice Intervention Guidance

• Practitioners, policy makers and commissioners
  should only endorse exercise referral schemes to
  promote physical activity that are part of a
  properly designed and controlled research study
  to determine effectiveness
• (NICE Public Health Intervention Guidance no.2,
  Section 1.2)
• www.nice.org.uk

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GPPAQ

• General Practice Physical Activity Questionnaire
• Patients 16-74
• Self-completion (30 seconds)
• Identification of patients who would benefit from
  increased physical activity
• Not suitable as a research tool

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GPPAQ
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GPPAQ
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GPPAQ
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GPPAQ
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GPPAQ
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GPPAQ

• Next steps following screening for activity

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Physical Activity Care Pathway
Community Sports Coaches
Sport Clubs Competitive Sport Elite Sport
Leisure and Active Travel Walking the Way to
Health Dance Gyms Pools Keep Fit

• NHS
• Exercise referral
• Brief advice

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A Physical Activity Care Pathway

• Revised BHF Primary Care Toolkit (including
  brief intervention syllabus for GPs and practice
  nurses)
• Use of GPPAQ
• Brief Intervention

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A Physical Activity Care Pathway

• Algorithm for referral to schemes appropriate to
  patient risk or info on local opportunities
• Priorities diabetes, hypertension?
• Follow-up
• GMS / PMS

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Draft Primary Care Physical Activity Care Pathway
(Adult)
Health Professionals
Opportunistic
BRIEF INTERVENTION
SERVICE DELIVERY
OUTCOME
MAINTENANCE
GPPAQ
Existing Condition Clinic
Practice Nurse ?
Condition Unlimited
Patient
ADHERENCE LOOP
Health Screening
Green Exercise
Walk Group
Seeking Advice
Local Classes
A Structured Activity
Success
Success

• BI syllabus
• BI script
• Advise
• Agree
• Negotiate Goals

Sports Clubs
Leisure Centre
Fit Club
Review _at_ 6 mths
Review _at_ 12 mths
Active Travel
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Pedometer Prgm
Active Workplace
B Self Directed Activity
Parks Green Spaces
BI follow-up _at_ 3 mths
Determine referral route based upon Condition and
PA Index
Active Daily Living (Gardening, DIY)
Record Praise Encourage Incentivise
Relapse
Relapse
Relapse
RELAPSE LOOP
Jo Foster / John Harkin NHS London / Sport
England London
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Issues

• Suitability and relevance of GPPAQ
• Alternative care pathways and entry points
• Communication of local, community based,
  inclusive opportunities for physical activity to
  support brief interventions

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Thank you for listening

• Paul Stonebrook
• Tel [phone]
• paul.stonebrook_at_dh.gsi.gov.uk