Physical Activity in North Wales Julie A Jones Macmillan Services - - PowerPoint PPT Presentation

Physical Activity in

North Wales

Julie A Jones Macmillan Services Effectiveness Lead

June 2015

Person Centred Care

Mrs Pat Pilkington, Person Centred Care Manager Mrs Jo Garzoni, Health & Well Being Coordinator

Betsi Cadwaladr University HB

• Acute, primary, community and mental health

services – pop^ 676,000

• 3 district general hospitals; 18 community and acute

hospitals

• over 90 health centres, clinics, community health

team bases and mental health units.

• 121 GP practices and NHS services provided by North

Wales dentists, opticians and pharmacies

• Over 16000 staff
• > 27000 living with or beyond cancer, estimated to

rise to more than 48,800 by 2030

Recovery Package – Translating Person Centred Care Locally in North Wales

Person Centred Care in BCUHB

Patient

Holistic Needs Assessment & Care Planning Health & Wellbeing / Rehabilitation

Treatment Summary

Key Worker

PA: Aim Across BCUHB

To improve the health, fitness, and quality of life for cancer diagnosis patients, increasing the potential to live life actively and independently, and decrease clinical dependency.

• To improve confidence and skills of HCP to provide

advice, and support patients to become more physically active.

• To develop and promote PA/exercise opportunities in

local communities for PABC, their family and carers

• To work in collaboration with NERS, LA and third

sector organisations across North Wales.

Health and Wellbeing

• BCUHB are piloting Health and Wellbeing

events with a view to establishing such events as an integral part of the cancer pathway across North Wales.

• Developing and implementing rehabilitation

pathways across BCUHB for people living with and beyond cancer.

• Maximising physical activity opportunities

and facilitating a cultural shift in the approach

• f clinicians to education for patients

BCUHB PA Lead

• Project lead responsible for clinically

championing the importance of physical activity to clinical teams across HB

• To facilitate and support training and up

skilling of clinical teams to enable a change in clinical behaviour and

• To embed PA into the cancer care pathway for

patients.

Engaging with Professionals

Health care professionals working with adults with a cancer diagnosis. These groups included :

• Multi-Disciplinary Teams
• Medical and Clinical Oncologists
• Surgeons and surgical teams
• Clinical Nurse Specialists
• Therapies and Clinical Support staff
• Radiotherapists
• Nursing and Healthcare Support Workers

Exercise schemes delivered by NERS Exercise Professionals (level 4 Cancer Rehabilitation training)

Engagement

• Survey of health care professionals in

collaboration with Bangor University

• Attendance at clinical meetings, MDT,

individual staff

• NERS leads; 43 NERS volunteers trained at L4
• Survey of walk leaders across Gwynedd to

understand needs

• Awareness of people living with and beyond

cancer and consequences of treatment

• Integrated with Person Centred Care

Evaluation

• CaPASEF – to standardise evaluation
• NERS – number of referrals to determine

increase

• Collaboration with Bangor University – staff

attitude and behaviours towards PA

• Patients – via Health and Well Being clinics

Physical Activity: Exercise through NERS

9 6 2 23 39 55 32 34 48 10 20 30 40 50 60 Anglesey Conwy Denbighshire Flintshire Gwynedd Wrexham

North Wales NERS Cancer Referrals

April 2012- March 2013 April 2013-June 2014

Embedding physical activity into the cancer care pathway for patients through the National Exercise Referral Scheme (NERS) and local opportunities

Opportunities

• A monthly walk in Denbighshire in partnership

with the Physical Activity Development Officer from Denbighshire County Council.

• Activity walks in Wrexham in conjunction with

Actif Woods Wales.

• Developing a strategic approach to

understanding training needs of volunteer walk leaders across Gwynedd in conjunction with the Physical Activity Development Officer from Gwynedd County Council.

Challenges/Opportunities

• Strategic engagement due to restructuring

within the health board

• Engagement of staff on the ground due to

competing priorities/increasing patient activity

• Structure of the health board
• Engaging patients to reduce clinical

dependency

• Culture shift – core business

Successes

• Feedback from PABC
• Working towards sustainable change by

engaging all HCP (primary and secondary) – a traditional therapist role

• Integration of PA into PCC across the HB to

embed PA into psyche of organisation

• Working with engaged/enthusiastic individuals

e.g. NERS exercise professionals, volunteers

Influencing Pathways

What has helped us / worked well?

• Formulating a communication strategy
• Utilising improvement methodology
• Inform and educate
• Raising awareness and effective marketing internal

and external to the organisation

• Understanding “What’s in it for me?”
• Tailoring information needs to your audience
• Engagement with the MDT (via the patient pathway).
• Engaging with primary care through locality

leadership teams, GP clusters, District nurses

• Impact measured through routine monitoring

Patient Story

• Female with breast cancer
• Surgery x3, chemotherapy, radiotherapy, Herceptin
• Following chemotherapy, commenced ‘little bits’ at a

gym

• Exercise professional gave her advice and guidance
• n what to do
• Exercise professional had cancer training which made

feel patient feel fully supported

• In turn, resulted in patient having confidence to

achieve her goals

Patient Story

“Because I had my surgery in the summer, over this winter it has got me out of bed. It’s given me motivation, it’s so easy when it’s a horrible day to just roll over, and then you are sitting there feeling sorry for yourself and I thought, no I am not doing that, I’m going to move. “ “It [PA] has certainly motivated me to get out of the house and meet different people.“ “I have changed my lifestyle now. I am doing more things to keep me fit now, after the cancer, than I did ever before.“

Thank you

Jo.garzoni@wales.nhs.uk Pat.pilkington@wales.nhs.uk Julie.jones14@wales.nhs.uk