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PARCS: Person-centred Activities for people with Respiratory, Cardiac and Stroke conditions

Improving the physical and mental health of people with long-term conditions:

an integrated approach

 

Person-centred Activities for people with respiratory, cardiac and stroke conditions

Background

In Scotland, people are living longer than ever before. It is the ambition of the Scottish Government and of health charities to ensure that those later lives are as healthy as possible.  More people are living with one or more conditions that impact on their health and quality of life.  Services must evolve and respond to individual circumstances; new ways must be found to reach those in need and deliver a quality assured service at an affordable cost.

The Scottish Government invited the partner charities to explore how more and improved generic exercise opportunities could be offered to people with long-term conditions throughout Scotland, in an integrated way.  These activities have been demonstrated to provide clear benefits in maintaining both physical and mental health.  The report details the work of the PARCS project, and is accompanied by a web-based resource pack, aimed at service planners and managers and service delivery staff, with the aim of enabling them to provide the highest quality service in their area.

Target audience

  •  NHS, leisure, social care and third sector staff working with and for people with long-term conditions, or at risk of developing these
  • People with a long-term condition, or at risk of developing one

Purpose

The project informs practice around service delivery in the transition from health to community based activity, in the prevention and management of long-term conditions based on the evidence from the project.  Recommendations are made to maximise recourses whilst providing person-centred and quality services.

The PARCS partnership project

The PARCS project evaluated community based physical activity,exercise maintenance and other community based activities for long-term conditions, focusing on cardiac, respiratory and stroke conditions. Health care professionals, other experts and people using services were consulted throughout.

  • Chest Heart & Stroke Scotland (CHSS) scoped services available across Scotland
  • The British Heart Foundation (BHF) evaluated comparable services across the rest of the UK and produced a resource pack to assist implementation
  • The British Lung Foundation (BLF) commissioned a qualitative evaluation of the experiences and needs of both engagers and non-engagers (of services). An economic evaluation of services was also produced

Recommendations

1) The Scottish Government should adopt the proposed national service framework for community-based physical activity and promote it to NHS Boards, Local Authorities and Health & Social Care Partnerships

2) The framework should be implemented equitably across Scotland, recognising the diversity of local circumstances and incorporating the key elements of: a person centred approach, partnership working, a single point of referral, peer and professional support, and telehealth and other innovative approaches

3) Resources to facilitate implementation should include the Integrated Care Fund, the PARCS Resource Pack, the PARCS Implementation Co-ordinator, and a national learning event

4) Services should be as widely accessible and inclusive as possible to ensure that they contribute to tackling health inequalities

5) A standardised national approach should be adopted for specialist instructor training in Scotland

6) A standardised national approach should be adopted to data collection, audit, health evaluation and cost-benefit analysis 

Key messages

CHSS scoping of services available across Scotland

  • there needs to be a structured approach to service delivery, with menu-based options incorporating professional and peer support
  • service availability varies across Scotland, with often a lack of knowledge and signposting or referral to available services
  • NHS rehabilitation should be delivered in the community and linked to community based physical activity and exercise maintenance services, with local access, professional and peer support and social interaction
  • exercise class service users with cardiac, respiratory and stroke conditions report:
    • improvement in their condition(s)
    • achieving physical activity targets
    • benefits of social support/interaction
    • motivation to exercise and remaining more active
    • reduced re-admissions to hospitals in the last year

BHF evaluation of services across the rest of the UK

  •  value of an overarching national framework (Wales) sensitive to local need and demographics
    • single point of referral via regional co-ordinators
    • multi-tiered process matching level of required support with instructor qualification/training
    • clear interface between health and community support services
  • significant variability (England and Northern Ireland) in service inclusion criteria, outcomes measured, terms of engagement and methods of support available

BLF qualitative evaluation

  • follow up and ‘safety nets’ to engage and re-engage people at the right time
  • motivators, enablers and barriers were multi factorial; social interaction, tailored supervised exercise, local access, and accessibility were important
  • health care professionals are key influencers on people’s likelihood to engage
  • pathways are system centred, rather than person centred

For more information contact:     

Sarah Florida-James (MSc, BSc, MCSP) PARCS Project Manager

Email: sarah.florida-james@chss.org.uk

Telephone: 0131 225 6963