Swansea Bay Health tackle obesity and social isolation

Quick read

Digital Communities Wales helped the Swansea Bay Health cluster to create a digital inclusion project aimed at tackling obesity and social isolation. The DCW team brought together partners from health, education and the libraries service to develop the pilot scheme.

Six patients were identified by their GPs and referred onto the pilot – all were chosen as they would see health benefits from a more active lifestyle.

Swansea City Adult Community Learning developed a five-week education and fitness programme. Fitbits were given to the patients to help them track their progress and learn how to use digital tools to monitor their progress.

All of the patients had a positive response to the course and most went on to continue to use fitness apps and wearable trackers.

The scheme is now being opened up to people who want to self-refer and promoted through libraries and community organisations.

What was the issue that needed to be addressed?

Swansea Bay Health is made up of eight general practices working together with partners from social services, the voluntary sector, and the Abertawe Bro Morgannwg University Health Board.

The cluster serves over 75,000 people, many of whom are elderly (22.5%). Working together, the practices aim to prevent ill-health and enable people to keep themselves well and independent for as long as possible.

To support this aim, Swansea Bay Health wanted to focus on tackling two key issues – social isolation and obesity. They worked with Digital Communities Wales (DCW) to bring those two issues together into one digital inclusion project. The project aimed to increase fitness, support weight loss, increase digital skills and promote registration for MyHealth Online.

What was the intervention and how did it work?

 The initial pilot project brought together a partnership of Swansea City Adult Community Learning, Swansea library service, DCW and patient groups.

The GPs identified six people who they felt would benefit from a more active lifestyle and each GP practice (made up of two surgeries) referred one patient to the project.

The referral process evolved during the pilot. Initially it focused on patients with a high BMI and evidence of social isolation but practices felt this missed some patients who could potentially benefit. Referral criteria were expanded, for example, to include patients with diabetes.

All six patients in the pilot were over 65 years old and had type 2 diabetes.

Centre for Economics and Business Research calculate savings to the NHS through individuals learning digital skills amount to £121 million a year by 2025 through reduction in GP visits and reduction in use of offline services. On a per capita basis, this would mean savings of £5.5 million a year in Wales by 2025.

Digital Inclusion in Health and Care in Wales summary report (Bob Gann, November 2018)

Swansea City Adult Community Learning developed a five week digital health course which could be delivered to the selected patients. DCW then provided a number of Fitbit devices to the cluster to be loaned out to this group to help them track their progress.

Swansea City Adult Community Learning trained the patients to use the Fitbits as well as showing them a range of other online health tools and apps.

In the final week of the programme, participants were made aware of other community groups which could support them to continue their progress such as local walking groups and park-based activities.The participants were also encouraged to link up with the National Exercise Referral Service (NERS) to build on the progress that they made through the pilot project.

 What was the impact of the intervention?

• Refining the referral process helped to increase uptake. In the next phase the cluster will link with the library service, health visitors and nurse practitioners. Together they will promote the scheme more widely and allow patients to self-refer.
• Geography and travel time were factors in getting people engaged with the project. The Cluster will use the central library for future programmes to make it easier for people to attend.
• Running sessions during the day meant the majority of participants were not of working age. The Cluster would like to involve a wider age range by varying the time that sessions are held.

What has been the outcome in terms of new skills, better health and enhanced well-being?

• All six participants felt that they benefited from the course and said it was extremely useful.
• Five people said they would use health related technology and would consider using health and wellbeing apps, wearable technology and health websites in the future.
• Half of the participants went on to purchase their own fitness tracker devices and most of the group said that using the FitBit had encouraged them to exercise more.
• The participants also felt that the digital health course had encouraged them to use technologies in different ways.
• Feedback from practice managers has been positive and they are supporting the development of the next phase of the programme.
• Linking with the NERS and physiotherapy services is seen to have increased the value of the programme to participants.

Evaluation of Phase One of the NHS Widening Digital Participation programme in England […] estimated £6.40 saved for every £1 invested as a result of reduced avoidable contacts with the NHS due to increased self care through access to information and advice online.

Digital Inclusion in Health and Care in Wales summary report (Bob Gann, November 2018)

What can we learn that could be repeatable, transferable or scalable?

DCW’s role as broker was key to bringing together all the partners to develop the project:

• The project was a partnership between primary care, adult education, library services and the health board
• The partnership approach has helped to secure funding for the project beyond the pilot stage

Participants benefit from onward ‘referral’ for support with exercise and nutrition:

• The response from patients has been very positive with the majority continuing to maintain the exercise plan.
• It was time-limited so it was important to be able to refer patients on to ongoing support such as physiotherapy services, community activity groups or the National Exercise Referral Service.

By taking a flexible, adaptable approach to the pilot, the practices were able to refine the referral process as they went:

• This enables a wider range of patients to benefit from the pilot
• It also helped to inform the approach to the next phase of the project, including the development of self-referral routes