Tackling Obesity in England - National Audit Office

TACKLING OBESITY IN ENGLANDCase Study 1: Exercise on Prescription Scheme in North West EnglandIn partnership with North West Lancashire Health Authority and Preston Borough Council, two leisure centres in Preston haveset up an exercise on prescription scheme they call "Exercise Your Options". There are over 20 practices enrolled in thescheme, and both general practitioners and practice nurses from those practices can refer patients.Prior to referring patients, the general practitioner carries out a health check, recording height, weight, blood pressure andresting pulse. The patient is then referred to a LifeStyle Fitness Officer who carries out a health screening and fitnessassessment. The LifeStyle Fitness Officer will then tailor an exercise programme to meet the patient's needs and level offitness.After four to five weeks a mid-programme check is made by the general practitioner or practice nurse. At the end of the eightweek programme the LifeStyle Fitness Officer will re-test the patient and the results will be discussed with the generalpractitioner. If the programme has been satisfactorily completed, a further four weeks of free exercise is available. After12 weeks patients may be re-prescribed exercise if the programme has proved beneficial.The programme is free to patients. To ensure commitment of the patients, a "contract" is signed by both the patient and theprescribing general practitioner or practice nurse.The scheme is evaluated yearly. Since 1995, when the scheme was initiated, over 2,000 patients have been referred.Forty-three per cent of these patients completed the programme. Of the 779 patients who provided follow-up data,58% experienced a decrease in weight, and 94% showed a decrease in body fat.Source:National Audit Office survey of general practiceCase Study 2: Innovative approaches to the management of excess weightThe Surgery GymA general practice in Saltash in Cornwall has set up a gymnasium at thesurgery for the use of patients and the wider community over the age of14. The gym is open during surgery hours and is staffed on a part time basisby a qualified fitness instructor. It was set up by the general practitionerusing private funds and savings from the drug incentive scheme. Thesurgery charges a £10 induction fee and £2 per week for an unlimitednumber of visits, with all profits reinvested in the gym. The gym is small,but is equipped with commercial quality equipment and can take three tofour persons per hour, who book in advance to use the facilities. While thesurgery has not done a formal audit of gym use, it is often fully booked andthey estimate that 150 patients, 10% of their patient list, and many morenon-patients use the gym.Source:National Audit Office survey of general practiceThe Health Walks ProjectOne surgery has organised a Health Walks Project to increasesignificantly the fitness and well-being of an entire community, usingthe resources of the local environment. The philosophy underpinningthe project is that walking in the local environment is the most basicform of exercise, involving no special equipment, no cost and isavailable to all. Walking routes are mapped, and group walks aregraded to encourage all levels to participate.Patients who would benefit most from increased activity are encouragedto participate - those who are sedentary, or those with chronic healthconditions, such as coronary heart disease risk factors.The surgery also offers organised group cycle rides on a twice weekly basis and provides maps of local cycle routes.Evaluation of the project found that 61 per cent of those using Health Walks reported that they were more likely to walkshort distances as a result of the project. The project was developed with the support of the Countryside Commission andthe British Heart Foundation.part threeSource: Active Transport 2725