Physical activity into healthcare Moving Healthcare Professionals Programme
Physical activity into healthcare Moving Healthcare Professionals Programme (MHPP) Dr Mike Brannan National Lead for Physical Activity East Midlands Clinical Senate 28th November 2018 Understanding physical inactivity 2 Sport England (2018) Active Lives Adult Survey. May 17/18 Report. Physical inactivity and health conditions 3
Sport England (2018) Active Lives Survey. November 2016/17 Health benefits of physical activity 4 UK Chief Medical Officers (2011) Start Active, Stay Active Disease care costs of physical inactivity (CCG costs alone) Coronary Heart Disease Diabetes 100m
Lower GI cancer 56m 155m Cerebrovascular disease 456m per year (0.9-4m per CCG) 5 82m
Breast cancer 61m PHE (2016) Physical inactivity: care costs to NHS clinical commissioning groups. National approach to physical activity Delivery of five key outcomes: physical wellbeing, mental wellbeing, individual development, social and community development and economic development. Focus on people who tend not to take part (i.e. inactive) Actions include to: promote the integration of sport and physical activity into care pathways and maximise the potential of advice, prescribing and referral interventions by health
and social care professionals 6 Why healthcare professionals? Physical activity brief advice in healthcare care is a top ten best buy for getting populations active National clinical guidelines (NICE) advise physical activity promotion with inactive and across conditions Around 600,000 skilled health professionals as key influencers at times of change and life transitions 1 in 4 people would be more active if advised by a GP or nurse, but not discussed with up to 70-80% patients 7 Global Advocacy Council for Physical Activity (2012) BJSM 46: 709-712; Orrow G et al. (2012) BMJ 344:e1389 ; Booth HP
et al. (2015) BMJ Open 5: e006642 Knowledge & skills of healthcare professionals Survey of 1,000 GPs found: 80% not familiar with UK CMOs guidelines Less than half (44%) confident in raising physical activity with patients Over half (55%) had done no specific training on physical activity Survey of 552 physiotherapists showed: Activity status of patients not routinely assessed 60% knew 150 mins recommendation, but only 16% all three elements of guidelines Did not routinely signpost to further sources of PA support 8
Chatterjee et al (2017) Knowledge, use, and confidence in national physical activity and health guidelines and tools. British Journal of General Practice. Lowe et al. (2018) Physiotherapy and physical activity: a cross-sectional survey exploring physical activity promotion, knowledge of physical activity guidelines and the physical activity habits of UK physiotherapists. BMJ Open Moving Healthcare Professionals Programme Aim: Increase the awareness, skills and change clinical practice of health professionals in the promotion of physical activity to patients at risk of or with health conditions Objectives: 1. Increase awareness & skills in physical activity for prevention & management of ill health 2. Change clinical practice in the promotion of physical activity
3. Evaluate impacts to identify what could be scaled up or developed 9 Embedding knowledge & skills across professional developmental E learning Peer2Peer Targeted training Conferences Professional Standards 10
Undergraduate education Curriculum Professional accreditation process e.g. exams Postgraduate education Moving healthcare professionals Themes / Workstreams Workstream 1: Upskilling healthcare professionals
o o o o Clinical champions peer education programme Physical activity e-learning resources Physical activity in clinical care resources Chief Medical Officers infographics Workstream 2: Upskilling the next generation o Undergraduate curriculum Workstream 3: Piloting clinical interventions o Physical activity clinical advice pad o Sport and Exercise Medicine in secondary care
Workstream 4: Developing cross-sector leadership 11 Clinical Champions programme Aim: Develop awareness, skills and changing practice of health professionals through peer-to-peer practical training. Progress: Stepped national expansion across professions: o 19 GP Clinical Champions o 18 nurse Clinical Champions o 4 non-medics (midwife, physiotherapist, psychologist, pharmacist) Delivered with local physical activity system, including local government & sports partnership
22,000 healthcare professionals trained through peer-to-peer education 12 Clinical care resources Moving Medicine Aim: Developing clinician-facing resources on physical activity in treatment and management of clinical conditions Progress: Partnership with Faculty of Sport & Exercise Medicine Interactive tool covers nine conditions and offers evidence based scripts Developed with over 300 healthcare professionals and endorsed and embedded by Medical Royal Colleges and health charities 13 www.movingmedicine.ac.uk
E-learning modules Aim: Develop awareness, skills and changing practice of qualified health professionals through robust and clinically relevant CPD e-learning. Progress: Nine e-learning modules on physical activity and health, plus a motivational interviewing module Broad usage across specialisms & primary / secondary care with 100,000 modules completed New set of modules planned for early-2019 on Health Education England's learning platform 14 http://learning.bmj.com/learning/course-intro/physical-activity.html?courseId=10051913
Clinical advice pad pilot Aim: Develop and pilot physical activity advice pad to encourage and as an adjunct to brief advice Progress: Develop advice pad integrated with national Active 10 marketing campaign and phone app Nine local partnership pilot areas selected with ~125 sites to test: o Acceptability with clinicians and patients o Use by different clinical professions o Impact on patient behaviour 15
Undergraduate teaching resources Aim: Review and expand coverage of physical activity undergraduate resources (or equivalent) across medical schools and pilot in nursing / AHP schools Progress: Over 20 health free-to-use slidesets developed by international consortium led by Exercise Works, peer-reviewed and approved by Council of Deans of Health Used by 17/34 UK medical schools & working with others Physical activity in learning objectives of new General Medical Council curriculum
16 Active Hospital Secondary Care Pilot Aim: Pilot palliative care-type model of Sport & Exercise Medicine (SEM) support and advice in secondary care to support integration into care of complex patients Progress: Led by Oxfordshire University Hospital Trust SEM consultant Active Hospitals approach: Culture change - from rest to rehabilitation.
Whole hospital approach - staffing & management structures, governance structures, training framework &research framework Signage and tools to engage patients and staff 17 Summary HCPs play critical role in increasing patient and population physical activity, with benefits for treatment outcomes and service costs Supporting HCPs through knowledge and skills development can support changing clinical practice, with a range of resources available at every level New three-year phase of MHP programme planned for FY19/20 focussing on scale and sustainability
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