A Class Based Intervention Solution to Help People Achieve a Long-term Commitment to Exercise.

Purpose

One of the main causes of most preventable chronic and serious medical conditions, premature deaths and inequalities in health is lack of activity. As a sedentary society, over 40% of adults do not reach Public Health physical activity guidelines 1, 2, 4. A society-wide increase in physical activity could improve mental and physical health, reduce health inequalities and would save over £18bn of NHS costs, saving at least 15% of the NHS budget, however, there is a general lack of effective behaviour change interventions to increase long-term uptake of physical activity; therefore eliciting lasting behaviour change from the secondary-care physiotherapy setting is challenging 1,3. The “Fitness for Function” (FFF) class at St George’s Hospital has been developed to target this problem. The objective of the intervention is to bridge the gap between class discharge and uptake of community sessions for ongoing, independent health-management via behaviour change intervention, and enhancing links with local authorities, to develop opportunities for people to secure better health.

Approach

The intervention has been designed as a service evaluation project in response to NHS England’s “Make Every Contact Count” behaviour change research, and the “All Our Health” approach and “Everybody Active, Every Day” framework from Public Health England 5,6. The class is available to those who have pain and would benefit from moderately intense exercise. Self-reported participation in physical activity and quality of life is assessed with the EQ-5D Index and the Patient Specific Functional Scale, to identify changes the service user is intending to make and their learning objectives. Systematic, qualitative data is being collected including recording number of intervention interactions and collating the long term follow-up results created from them. This involves identifying issues/themes to track the impact of the class over time, generate an impact assessment and drive ongoing development of the intervention.

Outcomes

generate an impact assessment and drive ongoing development of the intervention.

Results: Early results of our intervention are encouraging. Service user’s (n=34) participation in physical activity prior to joining the FFF class has been below the Chief Medical Officer exercise guidelines 1 [mean 40 minutes/week moderately intense activity]. On class discharge, 100% of service users requested referral to local authority schemes. Collation of longitudinal data will enable results analysis of public health outcomes in the future.

Conclusion(s): As the NHS faces a £30bn funding gap by 2020 5, the need to tackle preventable illness and disease has never been greater. Shrinking resources and growing demand in healthcare means an increase in physical activity would have a powerful effect on reducing the burden on the NHS. It is therefore vital for the FFF class to make every contact count by empowering long-lasting, independent health promotion through behaviour change interventions. The results above are early results and provide a foundation to create a robust, sustainable model to help people achieve long-term behaviour change and become regular exercisers.

Cost and savings

At present, the service evaluation has not developed any additional costs to the department. Throughout its development, the needs of the staff, and consequently cost, will be continually evaluated and actioned as appropriate.

Implications

The study aims to impact the community by achieving higher levels of people meeting physical activity guidelines outside of physiotherapy services. Long term, this aims to reduce burden and cost to local MSK services and the NHS.

Top three learning points

No further data 

Funding acknowledgements

The study has been funded by St George’s Hospital Physiotherapy MSK Department. Funders were not involved in the conduct of the service evaluation or preparation of the abstract. The authors accept full responsibility for the abstract.