Murrayfield Stadium, Edinburgh, 23 rd January 2013 Welcome to our NHS Physical Activity Promotion Learning Exchange Lorna Smith, HPHS Senior Health Improvement Programme Officer Email: lornasmith1@nhs.net
Health Promoting Health Service Overview Lorna Renwick, Programme Manager, NHS Health Scotland Email: lornarenwick@nhs.net
HPHS the journey Timeline, ethos and drivers Contribution of NHS people and place HPHS CEL (1) 2012 - interventions
Timeline, ethos, drivers Concept and Principles Evidence HPH - 4 test sites HPHS/HPH - Implementation CEL (14) HPHS 2008 CEL (1) HPHS 2012 2013 - Ministerial Working Group
HPHS CEL (1) 2012 - Interventions Smoking Alcohol Food and health Physical Activity Breastfeeding Sexual health Healthy Working Lives Active Travel
Monitoring HPHS Progress
Contribution of NHS and prevention Preventative medicine Quality Strategy ambitions and delivery Person centred Evidence based Effective Person centred Safe Effective Creating health through physical activity Sir Harry Burns, Andrew Duncan Murray Embedding practice and improvement Inequalities in health Behaviour change Assets approach Broader causes Policy, culture change, individual change
Further Info: NHS Health Scotland HPHS contact: nhs.healthscotland-hphsadmin@nhs.net Every health care contact is a health improvement opportunity Knowledge Network Portal NHS Health Scotland and NHS Education for Scotland (NES) have developed this site to provide a one-stop-shop service for those looking for information relating to health improvement within the hospital setting: www.knowledge.scot.nhs.uk/home/portals-and-topics/health-improvement/hphs.aspx
Physical activity within the healthcare setting: Current progress & professional support Flora Jackson Development Manager flora.jackson@nhs.net
NPAIP: NHS & Social Care Delivery
UK CMOs Physical Activity Guidelines Early years (under 5yrs): 180 minutes per day Children & young people (5 to 18yrs): 60 minutes per day Adults (19yrs to 64yrs): 30 minutes per day (150 minutes per week) Older adults (65yrs +) Something is better than nothing! Balance and co-ordination at least x2 per week.
Physical activity: prevention or management of the following common conditions: Anxiety/ stress Asthma Cancer CHD/CVD/Stroke Chronic back pain Chronic obstructive pulmonary disease Dementia Depression Diabetes Mellitus Type 1 Diabetes Mellitus Type 2 Falls in the elderly Hyperlipidaemia Hypertension Metabolic syndrome Multiple sclerosis Obesity Osteoarthritis Osteoporosis Pain syndromes Parkinson s disease Peripheral arterial vascular disease Pregnancy Rheumatoid arthritis Schizophrenia
Risk reduction among adults for specific chronic diseases as a result of physical activity Chronic condition All cause mortality CHD, CVD, Stroke Diabetes Hip fractures Colon cancer Breast cancer Loss of function Depression Dementia Risk reduction* 30% reduction 20-35% reduction 30-30% reduction 36-68% reduction 30% reduction 20% reduction 30% reduction 20-30% reduction 20-30% reduction *These figures are based on adults meeting the recommended 30 minutes of physical activity on at least five days of the week.
Physical Activity Within the Healthcare Setting The role of the NHS as an employer Staff Health Active Travel Active travel planning NHS Estate Health care Greening the NHS estate Physical Activity Pathway
Scottish NHS Physical Activity Pathway Cyclical pathway
Patient Recruitment: Eligibility & Contra-indications Eligibility criteria: Aged 19 74 years No contraindications It is appropriate to discuss physical activity with the patient Inactive patients contemplating or preparing to change when screened using Scot-PASQ. Contra-indications: Resting SBP _180mmHg / DBP >100 Febrile illness Uncontrolled / unstable angina Acute uncontrolled psychiatric illness Osteoporosis (T score _ 2.5) Significant drop in BP during exercise Uncontrolled tachycardia Unstable or acute heart failure Uncontrolled diabetes
Patient Recruitment Primary Care: New patient consultation Condition specific clinics (asthma, hypertension, diabetes etc) Opportunistic routine consultations Secondary Care: Cardiology Pulmonary rehab Mental health Diabetes Paediatrics Oncology Orthopaedics Care of the elderly Pre-assessment and 0utpatient clinics
Physical Activity Yr1 Progress HPHS (CEL01)
SCREENING TOOL
SCREENING: Question 1
SCREENING: Question 2
SCREENING: Question 3
Physical activity brief intervention Brief advice plus one or more of the following: Written advice: Get active your way everyday Explore options: Move more, sit less! Relapse strategies: How to avoid falling by the way Brief advice: Discuss benefits, barriers & solutions Signposting: Active Scotland or local knowledge Goal setting: Agree realistic goals
Introducing the National Physical Activity Pathway Chapters: Every Step Counts National Physical Activity Pathway Screening & Assessment Brief Advice Brief Intervention Taking the First Steps A resource for all NHS healthcare professionals, highlighting the importance of physical activity promotion in patient contact. http://www.knowledge.scot.nhs.uk/home/portals-and-topics/ health-improvement/hphs/nhs-physical-activity-promotion.aspx
Additional Resources Practitioner & Public Facing Resources Practitioner resources: E-learning: Raising the issue of physical activity Evidence briefings: Physical activity and health YouTube video: Every Step Counts Physical Activity & Health Alliance Public facing materials: Get active, your way, every day! Activity Wheel Active Scotland