GP James Higgins explains how residents in Stockport, Greater Manchester are being encouraged to self-medicate – with exercise – thanks to the success of a local health intervention scheme
Since our collaboration with local sports and leisure provider Life Leisure, we have seen a surge in patients coming in to Brinnington Surgery to request a referral for its hugely successful exercise referral programme.
Aimed at people with chronic illnesses, Life Leisure’s Physical Activity Referral in Stockport (PARiS) programme provides expert advice and access to gym sessions and many other activities, some of which are condition-specific, to help patients manage their health conditions alongside a reduced reliance on medication.
We are now encouraging people to take even more control over their health by self-referring into the scheme. This removes the need for my involvement and, in turn, this frees up appointments for those who really need them.
The idea is to put people back in charge of their own health so that they become, and stay, physically active; this benefits their overall health, preventing unnecessary visits to us or, in some cases, A&E.
Taking back control
Ninety-nine percent of patients I see on a day-to-day basis are capable of exercise and should be doing some – no matter what their age or the state of their overall fitness – so the vast majority of my involvement with the PARiS scheme has been a ‘rubber stamp’ exercise. Now, whatever a patient’s condition, they will no longer need a doctor to sign off their referral; however, we will, of course, still provide advice and signposting where needed.
As well as giving more control to a patient, self-referral offers an opportunity to break down potential barriers, especially for people who don’t present to us regularly, or who may not want to ‘trouble’ us with requesting a referral.
Self-referral puts patients back in control of their own life – and their own fitness – making it more sustainable. By taking themselves off to the gym and speaking directly with qualified trainers they can manage their fitness in a way that suits them, without a lecture from me!
Ask the experts
When I’m referring people to PARiS I’m acknowledging that the physical activity professionals are the best people for the job, and I’m going to let them take control; they are better placed to ensure the activity prescribed is entirely 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 which raise questions, the fitness trainer will refer them to me – so there are absolutely no health risks.
In an NHS that is becoming more stretched we need to consider that people like Life Leisure can take care of specialist areas. Most areas throughout the country have the ability to offer this provision, you just need to speak to your local providers.
In the past 12 months 770 individuals from Stockport who completed a six-month PARiS programme saw their activity levels increase dramatically, with average weekly energy expended on exercise up by 287%. Participants also saw their average mental health scores improve by 5.5 points – a clinically significant jump.
Moving forward, we’re training our administration team to signpost patients onto schemes like PARiS at the triage stage, again freeing up GP consultations. We’re also looking at how we promote self-referral schemes to our patients by using in-house methods like the surgery noticeboard.
Stockport residents can self-refer though the Stockport Triage Assessment Referral Team (START) or directly via the Life Leisure website locally, completing a very simple online self-assessment. Suitable applicants then receive a one-to-one consultation.