Active Practices: What would it take?

When England’s Chief Medical Officer said ‘if it was a pill, physical activity would be the miracle drug’, she wasn’t exaggerating. Some of the benefits of being active – for just half an hour a day are outlined in Doctor Mike Evans’ You Tube video from 2011.

Some benefits include:

  • Reduced risk of some cancers
  • Preventing type 2 diabetes
  • Lower risk of developing dementia
  • Improved mental wellbeing
  • Better quality of life
  • Reduced risk of cardiovascular disease.

A few weeks ago, we started to explore the art of the possible when it comes to enabling staff, patients and visitors to hospitals to ‘move more’ every day. The conversation continued to grow, and is captured here.

People reading it were finding it a useful conversation starter, and someone suggested that we gathered similar ideas for Active Practices.

Here is what we have gathered so far. This is a work in progress, so please tell us what we can add, via twitter comments or email info@gmmoving.co.uk

Clearly, no one practice can address all of these things at once, but if the headlines in 10 years time were to read:

“How an active practice has transformed lives for patients, staff and visitors, saved £millions and helped it’s local community”.. how might we have got there?

Let’s look at the whole system influences on everyday movement around GP Practices and see what can be done:

Population level change Chart

Policies, rules, regulations and codes

  • Dress codes: shoes you can move in.
  • Uniforms that enable movement.
  • GP’s and nurses walk to waiting room to collect patients
  • Staff policy 45 minutes per week paid time to be active – lunchtime walks or daily miles encouraged.
  • Standing desks
  • Walking meetings encouraged
  • Incentivise and enable active travel- bike to work, bikes and scooters for on-site and home visits
  • Social prescribing approach throughout the workforce
  • Develop an active travel plan, which provides information about how the practice can be accessed via public transport/ car share scheme etc.
  • Enable practice staff to proactively engage with patients and the public in the pharmacy, to offer them advice, support and signposting to other providers of physical activity services in the community.
  • Practice staff provide an update to Patient Participation Groups to advise what they are doing to enable patients to move more, every day.
  • Practice website and social media platforms that give key messages about physical activity and links to key documents and the websites of local services and providers.
  • Text message templates signpost and ‘nudge’ patients to move more and engage in activities following appointments.

 Built Environment

  • Stairs, not lift- for those who can.
  • Walking routes around practice. Signposted and clear.
  • Noticeboard / TV screens displaying local physical activity campaigns and information.
  • Space for bikes and prams to encourage active travel to and from the practice
  • Active waiting – space to be active whilst waiting for appointments.

 Natural Environment

  • The practice has mapped local assets including parks and green spaces, sports facilities, community centres within a 1 mile radius.
  • Walking routes mapped from the practice.

 Transport

  • Bike racks and lockers
  • How to travel to the practice by walking/cycling/public transport, displayed on practice website and messages given via social media.

 Organisations and Institutions

  • Sign up as a parkrun practice
  • Daily Mile (for staff and patients where possible)
  • Practice walks for staff and patients together
  • GP’s trained to use ‘Moving Medicine’ Website
  • All practice staff to attend PHE ‘Clinical Champion’ training
  • Staff record physical activity levels of patients through use of validated tools eg GPPAQ and any advice given to patients regarding this on patient records
  • Robust referral mechanism in place to local Exercise Referral Programmes which includes feedback capabilities
  • Practice fully engaged with voluntary and third sector organisations to provide volunteer opportunities for practice led activities eg Walk Leaders, Gardening etc.
  • Practice enables Patient Participation Groups to lead walks or activities from the practice.

Social Environment and Influences: individual relationships, families, friendships groups, support groups, social networks.

  • Change the conversation – make every conversation an enabling one. Strengths based. Supporting movement.
  • Identify the critical influencers and welcome/draw people in all along the way. Be inclusive, open and keep asking people to ‘join in’
  • Local community groups, charities etc part of practice life. Make social connections with people as part of the conversation.
  • Goodgym, intergenerational activity.

Individual Factors: capabilities, motivations, opportunities, knowledge, behaviours, attitudes

  • Positive communications- noticeboards, leaflets, online advice all supporting and enabling movement.
  • Classes and rehab less clinical
  • Classes and opportunities for long term visitors to be active
  • Buddying
  • Self serve tea and coffee in social spaces
  • Practice TV to prompt moving and connect people to what’s in the community.

 What might the outcomes be?

  • Reduced repeat GP appointments
  • Increased activity levels of staff
  • Increased activity levels of patients
  • Happier, healthier, more productive workforce
  • Reduced absenteeism
  • Change in narrative (bed blockers and bed rest)
  • Change in narrative ‘we’ not ‘us and them
  • Practice as part of the community
  • Community organisations, charities etc offer integrated support
  • A beacon of community health and wellbeing
  • Knock on effect to hospital outcomes
    • reduced length of hospital stays
    • reduced waiting times
    • reduction in re-admittance rates
    • Reduced staff absenteeism
  • If we could create exemplar practices, and share the learning along the way, imagine how we could change things together!
  • Please help, by sharing your ideas and additions to these lists, in the comments below on twitter, or via email info@gmmoving.co.uk, and we’ll keep growing the list, and start working with our practices to bring about changes. Big and small.

Author: hayleyleverblog

Be active, reach your potential, help others to do the same. Be the change you want to see. Passionate about the value of active lives in transforming people and communities. Change Maker, Community Developer, Strategic Leader.

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