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by Paul Ansbro
29 April 2019
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Paul Ansbro, practice manager of Brinnington surgery in Greater Manchester, explains how its partnership with a local health and fitness provider enables the team to encourage people to take control of their own health.
In an NHS that is becoming ever more stretched, practices need to consider looking outside their own four walls and partner with local services to share some of the workload.
One partnership that has been particularly successful at Brinnington Surgery is that with Life Leisure, a not-for-profit social enterprise that manages sports and leisure facilities and specialist programmes here in Stockport.
The collaboration has routed many patients away from a doctor’s appointment and straight into managing their own health and wellbeing.
With support from Life Leisure, frontline surgery staff are able to triage patients and help them manage their own health conditions through exercise. This has been particularly important for many of our patients with chronic illnesses and an ongoing reliance on medication.
We recognise that the specially trained fitness professionals at Life Leisure are the best for ensuring the activity prescribed is appropriate to the individual’s conditions, ability, age and objectives. So it makes sense for them to be the first port of call.
Of course, if a patient presents with issues that raise questions, Life Leisure refers them back to the GPs at the practice.
At the start of this journey we began referring patients onto Life Leisure’s Physical Activity Referral in Stockport (PARiS) programme, which provides expert advice and access to gym sessions and many other activities, some of which are condition-specific.
Suitable PARiS applicants receive a one-to-one consultation on what kind of exercise is appropriate for them based on their fitness and condition. This ranges from low level chair-based activities to Nordic walking, condition specific classes and supervised gym sessions.
Originally a GP was required to sign off PARiS referrals in order for a patient to be accepted onto the scheme. This meant patients needed a GP appointment, just to be cleared to move more.
But Life Leisure, recognised that most patients – including those who have diabetes, joint pain, chronic obstructive pulmonary disease or depression – do not need a doctor’s permission to exercise.
The team at Life Leisure worked closely with doctors at Brinnington to remove GP sign off, which means patients are now able access the scheme by filling in an online form themselves.
And it’s the responsibility of Life Leisure and everyone here at the practice – from admin staff to GPs – to ensure patients are aware of the service. This not only gives patients more control over their health, in many cases it by-passes the GP completely, saving valuable appointment time.
Patients can be directed to the scheme as early as the triage stage, without attending the practice, or after meeting with a clinician or nurse. They can self-refer though the stockport triage assessment referral team or directly with Life Leisure using an online self-assessment.
The self-referral scheme also benefits patients who may not be keen on talking to a doctor, or who might be concerned they will get a lecture about their lifestyle choices.
The self-referral scheme has benefited the entire practice, saving our team a significant amount of appointment and administration time.
Out of the 2,024 people who have signed up for the scheme across Stockport since December 2017, more than 320 self-referred, accounting for 16% of total referrals.
This figure is sure to increase as we promote the scheme more within the surgery and through community partners.
The PARiS scheme has achieved discernible health gains for our patients, with participants increasing their activity levels by more than 850% in 12 months.
Self-referral means patients are placed in control of their own health and fitness, making them more likely to stick with any changes.
For people with long-term health conditions, it can often feel as if they have no control over their symptoms or treatment.
Letting them take the lead regarding to their fitness, with the guidance of fitness professionals, puts them back in charge. Participants on the scheme saw average mental health score improve by 5.5 points – a clinically significant jump.
We recognise that this partnership is vital in ensuring our patients have access to the support and help they need before and after they visit the GP.
The introduction of self-referrals has enabled the entire team – whether it’s staff on reception or clinicians operating out of the practice – to share the load by proactively supporting this potentially life-saving service.
Paul Ansbro is a practice manager at Brinnington Surgery in Stockport, Greater Manchester