Desang Diabetes magazine article on social prescribing

30

LIVING

This message has been taken to

heart and NHS workers themselves

are not being ignored. Darcy Bussell,

the former Royal Ballet dancer and

Strictly Come Dancing TV judge, has

been recruited to sign up 100,000

NHS staff for an app-based dance

project called Move Assure, which

has similar fitness aims.

There is plenty of other evidence

that social prescribing can make

a difference. In March 2022 the

results from the Retirement in Action

(REACT) trial which prescribed

exercise programmes for over 65s

led by the University of Birmingham,

was followed by calls for the national

roll out of weekly exercise classes for

older people. The study involved 777

people aged between 65 and 98, split

into either an exercise or a control

group. Those in the exercise group

attended REACT fitness sessions

twice a week for three months and

then once a week for a further nine

months. The control group attended

three separate 'healthy ageing'

classes over the course of the year.

Two years later participants who

had attended exercise sessions had

significantly greater mobility. The

results published in the Lancet Public

Health journal, showed the cost of

delivering the programme was £622

per person, but the health care

savings were calculated at £725 per

person over two years, and longerterm savings

could be far higher.

Afroditi Stathi, professor of

physical activity and community

health at Birmingham University,

who led the study, says the evidence

is strong that physical activity

protects against diabetes, heart

disease and some cancers. "Many

older people face a downward spiral

of declining mobility. The less active

they are, the more limited they

become," he says. "We have shown

that this steady decline is avoidable.

It can be prevented, or in many cases

be reversed, through an exercise

programme that is individually

tailored and progressive."

Medicine must

step out of the

hospital and

GP surgery and

become part of

the community

~Michael Dixon,

chair of

the College

of Medicine

Committ to apps

More widely, the NHS is encouraging

people to commit to apps such as

Active 10 and Couch to 5k, which

was downloaded by more than a

million people during the covid

lockdowns. "Medicine must step

out of the hospital and GP surgery

and become part of the community,"

says Michael Dixon, chair of the

College of Medicine, the organisation

which grew out of Prince Charles'

Foundation for Integrated Health.

More NHS-approved apps are

being launched. One of them, EXi, is

described by its developers as the

world's first app to use individual

health information to generate a

personalised exercise programme. It

is designed for people with diabetes,

and uses a weekly prescription of

physical activity minutes or step

count. Active minutes or step count

are automatically recorded. Users

can meet their daily physical activity

goal at home or in a gym and use

a smart phone camera to measure

heart rate. The programme is based

on physical activity intensity, which

gradually increases over 12 weeks at

a safe and achievable individualised

rate. It celebrates and incentivises

every activity completed, awarding

a gold badge if 100% of the activity

prescription is met, a silver badge

if 80% of activity is completed

and a bronze badge if 60% of the

prescription has been achieved.

Trials to measure its efficacy

are currently under way at St Bart's

Hospital in London.

Meanwhile trials are also

underway at seven sites across the

country as part of a £5.5m scheme to

assess the health benefits of 'green

social prescribing'. Participants

are being offered walking, cycling,

community gardening and foodgrowing

projects, as well as practical

conservation tasks such as tree

planting. For people who need help

to get involved, there are supported

visits to local green spaces,

waterways and the coast, and other

outdoor activities to reduce isolation

and loneliness.

Even if the initial NHS savings

are modest, there is a growing

recognition that the wider and

longer-term benefits from these

initiatives could be life-transforming

for millions of people.

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