Milton Keynes Exercise Referral Scheme (AMKERS)
| Description | Suitable adults (over 16 years) are referred to a 12-week programme of individually tailored activity at leisure providers across Milton Keynes. |
|---|---|
| Setting | Eight community leisure providers |
| Populationting | Adults 16 years and above identified by primary care health professionals as sedentary using the General Practice Physical Activity Questionnaire. |
| Intervention summary | Twelve weeks of individually tailored physical activity at their local community centre of choice. |
| Outcome Summary | Physical activity improvement at 12 weeks followed up 3, 6 and 12 months after. |
| Startup Cost | £5,000 reward grant from Awards for All and officer time (developing the protocols and engaging leisure providers and health professionals). |
| Running Cost | £4,000 per annum for staff training and resources used, plus 1.5 days per week administration time. |
| Funding | AMKERS steering group has received £5,000 from Awards for All and continued to be funded through Milton Keynes Primary Care Trust (PCT). |
| Started | April 2004 |
| Ended | Ongoing |
| Location | Milton Keynes unitary authority |
| Contact |
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Background
The AMKER scheme enables health professionals, including general practitioners, practice nurses, health visitors and other public health professionals (such as smoking cessation officers), to refer suitable sedentary individuals, aged 16 years or over, to exercise professionals across Milton Keynes. They undertake a 12-week (24 session) tailored programme of physical activity to improve their health and facilitate a change in behaviour to maintain healthy levels of physical activity in the long term.
What is the problem you are trying to solve?
Physical activity makes a major contribution to health and wellbeing. As the majority of the UK adult population is sedentary 1 and there is good scientific evidence to support the development of population-based programmes to encourage and facilitate schemes that support the increase in the population's physical activity, 2 this scheme was developed to support adults to become more active.
What local organisations are involved?
Significant joint planning has taken place between Milton Keynes PCT, Milton Keynes Council and eight different leisure providers across the borough, including both national and local independent facilities.
How many people are running this project and who are they?
The scheme is coordinated by a health promotion specialist within the PCT, supported by one administration officer for 1.5 days a week and developed through the AMKERS steering group, which includes one lead from each leisure provider involved in the scheme.
What local population are you targeting?
Adults aged 16 years and above who are sedentary, who have mild to moderate controlled conditions, such as coronary heart disease, diabetes and depression. There are strict inclusion and exclusion criteria for the scheme based on the 2001 Department of Health National Quality Assurance framework. 3
How many people are you targeting?
There are currently over 400 referrals a year to the scheme.
Interventions
What interventions are you using to address the problem?
Each patient referred is given a choice of times, days and leisure provider to attend. They are given an individually tailored physical activity programme to suit the patient’s needs and support them through their programme.
Is the project design based on evidence? If so, please state reference.
The project is based on the National Quality Assurance framework for exercise referral schemes, 3 and also on best practice. It is constantly adapted with reference to new evidence on programmes that support adherence to increased physical activity.
Outcome
What outcomes or planned outcomes are you measuring?
The main outcome is physical activity as measured by the General Practice Physical Activity Questionnaire, with secondary outcomes of body mass index (BMI), blood pressure, resting heart rate, and waist circumference. Psychological improvements are also recorded by before and after SF-36 questionnaires.
Do you have any outcomes or results yet? If so, what are they?
Patients attending 12 or more exercise sessions were found to have significantly reduced systolic and diastolic blood pressure, waistline and BMI.
Is your project relevant to a government target or guideline?
The project supports the public service agreement (PSA) target for increasing 3 x 30 minutes a week of sport and indirectly the PSA target for reducing obesity in children under 11 as part of the Government’s wider obesity strategy.
Feedback
What obstacles did you have to overcome to set up this project?
The major obstacles were getting “buy in” from primary care including providing primary care professionals with supportive evidence for them to feel able to refer into the scheme. Support was also required for the leisure providers to be at a standard to receive referred patients. This included having exercise professionals qualified to Level 3 on the Register of Exercise Professionals (REPS), having a specific GP referral qualification and a first-aid qualification.
What have you learned about the project so far?
To enable an efficient and effective scheme to run, partnership is key; from having buy in from primary care to making sure the leisure providers are able to offer appropriate services.
What would you do differently?
I would spend more time talking to primary care and the leisure providers on the initiation and development of the scheme to achieve buy in from the start. This would improve referral rates and develop the scheme quicker to provide a better service for referred patients.
References:
- Department of Health. Health Survey for England 2003. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_4098712
- Department of Health. At least five a week: evidence on the impact of physical activity and its relationship to health. 2004. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4080994
- Department of Health. Exercise referral systems: A national quality assurance framework. 2001. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009671