Developing a toolkit to support health professionals in building community-based group exercise programmes for older people with chronic conditions

Lead Research Organisation: Bournemouth University
Department Name: Faculty of Health and Social Sciences

Abstract

As the NHS waiting list soars above six million people, with treatment wait times over two years, older people with chronic conditions face worsening symptoms, increased use of medications, more complicated surgeries with slower recovery, reduced quality of life, and loss of independence.

As part of its plans to tackle this crisis, the NHS promotes exercise as a "miracle cure" for arresting the progress of disease and helping disease management and recovery. However, current plans promoting individual, home-based exercise, as well as on-site hospital-based programmes of delivery, have met with only limited success, and face problems of decreased space, capacity, clinician time, as well as lack of knowledge and expertise with regard to effective behaviour change.

I am proposing to develop and promote a suite of materials and online resources-a toolkit or blueprint-to support health professionals in their development and scaling of non-hospital- (community-) based group exercise programmes for older people with chronic conditions. Key benefits for older people include arresting disease, delaying disease onset, reducing pain and need for medication, avoiding surgery, and leading a normal life. My long-term ambition is to develop a go-to resource for health professionals to use to manage a range of conditions associated with older people, for which building sustainable physical activity is an aim. If successful, our innovation has potential for substantial reach and impact, changing the way we manage (and improve the lives of older people living with) chronic conditions, creating cost savings for health systems world-wide.
 
Description • What were the most significant achievements from the award?
The key achievement was to build out our social venture. With my co-founder, we have created Group Works-we improve patient outcomes by helping health and exercise professionals to develop effective group exercise rehabilitation programmes using our framework and training. Alongside developing an online presence, we have built a training package for health and exercise professionals to harness the power of groups and group psychology to deliver exercise rehabilitation that truly enables people with chronic conditions to both physically rehabilitate and psychologically flourish. We have created a web-site for the project, run numerous talks and workshops, spoken with various beneficiaries, users, and potential customers, as well as deepening our existing (academic and non-academic) relationships and working with the University to build out this social venture.

• To what extent were the award objectives met? If you can, briefly explain why any key objectives were not met.
The award objectives were met. We developed a training package (with online presence) for health professionals. We collated information on currently-used interventions; drew on research on group exercise in older adults - drawing from our own and others' research; and interviewed health professionals, exercise leaders, commissioners and decision-makers (i.e., key stakeholders), and exercise attendees. This allowed us to assess effectiveness-that our proposed idea would make a positive difference in the lives of both the users (the health professionals) tasked with finding effective solutions to scale physical activity interventions, as well as those with chronic conditions who would attend such sessions-as well as desirability-that our users would want to engage with this training. And finally, feasibility-that we could bring together the people and resources needed to build the training. Overall, we believe we exceeded what we hoped to achieve during this project. The above notwithstanding, our key focus (and challenge) now is to build a spin-out via the University. We are, however, confident, that with the support from our Commercialisation Manager, this will happen by mid-2024.

• How might the findings be taken forward and by whom?
I am passionate about this project and have benefitted enormously from the UKRI funding. I am continuing to build the product/service and expect to make significant progress over the next 12 months.
Exploitation Route My ambition is to develop a go-to resource for health professionals to use to manage a range of conditions associated with older people, for which building sustainable physical activity is an aim. Group exercise is incorporated into treatment pathways, may hold the key to sustained engagement, and has potential to treat at scale. But success is mixed, clinicians are not trained in behavior change, leader behavior, or group psychology, and there is no guidance or framework for clinicians regarding how to set up group exercise programmes. Our innovation could change the way we manage (and improve the lives of older people living with) chronic conditions, creating cost savings for health systems in the UK and world-wide. The key focus is thus to take this forward via non-academic routes, and, as noted above, I plan to do this with my team.
Sectors Healthcare
 
Description • Details of emerging economic and societal impact arising from the award that you are reporting on (including how it has evolved) Societal impact would be that beneficiaries (people with chronic conditions) are being helped, and that users feel supported in improving their services. It would be too early to have concrete evidence for this. However, our users are already informing us that their practice is changing in light of the work we have done with them, and this should have downstream benefits with time for beneficiaries. • A summary of how the findings from your award are impacting the public, private or third/voluntary sectors, and elsewhere We have spoken with numerous users and beneficiaries. Users (health and exercise professionals) recognize the growing NHS capacity pressures, alongside their inability to treat sufficient numbers of patients. Although they recognize that groups are a convenient mode of delivery of exercise for rehabilitation, their capacity to provide optimal support is limited by lack of confidence, knowledge, and skills with regard to using exercise as therapy, alongside insufficient training in behavior change and group psychology. Beneficiaries (those with chronic conditions) see the need for our solution-they cite as beneficial: (a) being seen sooner (rather than languishing on NHS waiting lists); (b) weekly access to health experts during exercise sessions; (c) attending sessions within a group sharing a common issue; (d) being inspired to improve their physical state; (e) the empathy of the group leaders; and (f) the support from the group to encourage them to flourish. We have spoken with and run information sessions and training workshops with many potential users and customers, based on our Minimum Viable Product. This has helped us to better understand our users' and customers' needs, pain points, and preferences, and has helped to refine our Value Proposition. Our users suggest that our work with them is making a difference and that this is leading to change in practice within their clinics. • Challenges overcome to achieve impact Our key challenge will be to build the venture within the University. • Significant impact within academia, for example the nucleation of a new research area No. N/A
First Year Of Impact 2023
Sector Healthcare
Impact Types Societal

Policy & public services
 
Description User Group Workshops 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact I have run talks and workshops with between 51 and 100 physiotherapists and exercise professionals. In these, I have provided a background talk, based on the product/service I have been developing with the UKRI grant. I then used break-out group discussions and generated user feedback. Quantitative feedback, generated via Google Forms, has suggested that participants were very satisfied with the workshops and found them very useful. Great than 90% of respondents would attend and pay (as part of their continued professional development) for further training, and (via qualitative feedback) participants have already begun to incorporate insights from the training into their practice.
Year(s) Of Engagement Activity 2022,2023