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Having been approached by a collaboration between a GP and fitness training professional, the Beacon PBC Cluster, based in South West Essex, decided to undertake a pilot to implement a programme which integrates the expertise of fitness professionals into a primary care team for the benefit of patients, clinicians and commissioners. The programme is called 1-Greatlife.
The aim of the 1-Greatlife programme is to provide a lifestyle modification service to patients that addresses important lifestyle factors which influence morbidity and which is inclusive of physical activity, education on nutrition, stress management, wellbeing management, confidence building and personal development.
What did they do?
The programme was adopted by the newly formed Beacon Cluster. The PCT identified £3000 from their Choosing Health budget with which to fund it. The pilot consisted of a six week programme for nearly 50 patients in groups of 10 to 15. With support from pharmaceutical companies a once weekly maintenance session continued for approximately 6 months, and funding for a further year was provided by the Department of Public Health. To launch 1-Greatlife, the programme leads put together a workshop aimed at general practices which provided advice on how to interlink lifestyle modification with the patient pathway. After the success of the small scale pilot of the 1-Greatlife programme, from July 2006 to May 2008, the programme a procurement tender. This resulted in a substantive commissioned service which was agreed and implemented from July 2008 onwards.
NHS South West Essex performed a statistical analysis of 1-Greatlifes biomarker data. This included the following key performance indicators:
|Measure|| Impact |
|Activity levels||117% increase following introduction course and 32% increase following maintenance course.|
|Waist circumference|| 3% reduction following introduction course and 2% reduction following maintenance course.|
| Exercise tolerance|| 28% increase following introduction course and 16% increase following maintenance course.|
|HAD scores for depression||50% decrease following both introduction course and maintenance course.|
The potential cost efficiency savings were calculated by an independent source from the NHS South West Essex commissioning team:
| Patient Type|| Saving per patient|
| All patients (with our without diabetes)|| £330|
| Patients with diabetes||£315|