Healthwise

Barnet
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Healthwise is a model for physical activity interventions covering a wide range of medical conditions.  Health professionals can refer patients to a low cost physical activity programme designed for individuals with existing health conditions, as well as those at risk of developing health conditions, such as diabetes and hypertension.

Healthwise offers a menu of established evidence based programme options including physical activity on referral, cardiac referral and weight management, providing supervised or independent pathways, delivered by highly trained staff.

Healthwise is a high-quality person centred model increasing an individual’s knowledge, skills and confidence – with the overall aim of improving their health and wellbeing. The focus is on supporting people to become and remain more active, facilitating long term sustainable lifestyle changes and full integration with local health services and care pathways. All programmes are compliant with NICE guidance and deliver behaviour change support.


Eligibility criteria

Inclusions

All clients for the Healthwise Physical Activity Referral must be:

  • Over 16
  • London Borough of Barnet resident or registered with GP surgery
  • Considering or ready to make a change to their physical activity levels i.e. Contemplation, Preparation, or Action stage
  • Not currently active (< 30 minutes per week/not an existing gym member in the last 6 months)

And with one or more of the following conditions:

  • Cardiovascular Established CHD - Patient must have completed Phase IV Cardiac Rehab    < 6 months
  • Family History of Premature CHD - Female < 65; Male < 55 and two other CVD risk factors
  • Hypertension - Medication Controlled ≥ 140-180SBP and or ≥ 90-100DBP
  • Stroke/TIA - > 3 months since stroke and < 1 yr. ago. Stable CV symptoms, no assistance required
  • Peripheral Vascular Disease - No symptoms of cardiac dysfunction
  • >20% CVD risk over next 10 years - Multiple risk factors as identified by QRisk/JBS2 risk tools
  • Mental Health/Depression - Mild to moderate (HAD Score: 8- 14), adherent to medication if prescribed
  • Anxiety Disorders - Moderate (HAD score: 11 -14)
  • Metabolic Hyperlipidaemia - ≥6.0mmol/l and/or raised triglycerides
  • Type 1/Type 2 Diabetes - With adequate knowledge regarding hypoglycaemia awareness and management. If relevant: With adequate advice about adjustment of carbohydrate/ treatment dosage (Insulin or oral hypoglycaemics)
  • Musculoskeletal Back Pain - After back rehabilitation, referral from hospital Physiotherapist
  • Fibromyalgia - Associated impaired functional ability
  • Chronic Fatigue Syndrome - Significantly deconditioned due to longstanding symptoms
  • Osteoarthritis - Mild/moderate with related mobility problems  (includes joint replacements e.g. hip, knee, shoulder)
  • Osteopenia - BMD between 1 and  2.5 SD below young adult mean
  • Osteoporosis - BMD  2.5 SD below the young adult mean or >4 on fracture index with no history of previous low trauma fracture or history of falls
  • Rheumatoid Arthritis - Mild where Physical Activity will provide symptomatic relief
  • Neurological Conditions - e.g. Young onset Parkinson’s Disease (stable), Multiple Sclerosis
  • Asthma - Mild to moderate.
  • COPD - Without ventilatory limitation. Patient must have completed Pulmonary Rehab <6 months ago

Exclusions

  • Established CHD - Stable Angina, Post MI, CABG, Percutaneous Coronary Intervention (PCI/Stent), Valve Replacement (refer to Phase IV Rehabilitation classes)
  • Cancer - Patients who are receiving or post cancer treatment (<1 yr. ago)
  • Overweight/Obesity - BMI >40 or with a diagnosis of obesity but with no evidence of chronic disease or other risk factors listed in the inclusion criteria
  • Acute Coronary Event/Intervention or Diagnosis - Referral to specialist services e.g. Oxleas Community Rehabilitation for a 4-10 week multidisciplinary programme before referral to Healthwise (if appropriate)
  • Clinical Diagnosis Osteoporosis - BMD > 2.5 SD from young adult mean, combined with one or more documented low trauma or fragility fractures
  • COPD - Patients grade 1-5 MRC to be referred into Pulmonary Rehabilitation (PR) for a 4-10 week multidisciplinary programme
  • Type 1/Type 2 Diabetes - With advanced complications
  • Psychiatric Illness/Cognitive Impairment/Dementia - AMT score less than 8
  • Severe Osteoarthritis/Rheumatoid Arthritis - With associated mobility problem
  • Sports/other Injuries - Individuals requiring a rehabilitation programme after an injury
  • Stroke/TIA - Recent, <3 months ago

How to refer

The following clinicians can refer to this service: GPs, Nurses

EMIS form

Referral methods: e-Referrals, EMIS managed referral

A referral form is available on EMIS in the BAR Global folder.