Macmillan AHP, NHS Tayside.
In response to patient feedback, new walking routes have been designed by patients, volunteers and staff at Macmillan Day Care to encourage physical activity in line with Macmillan Cancer Support’s national ‘Move More’ programme. ‘Move More’ recommends four interventions – circuit classes, walking programmes, gentle movement (tai chi, chi gung, yoga) and gardening; aimed at offering something for everyone to become or remain physically active. Following on from the findings of the 2013 NHS Tayside AHP Apprenticeship Practice Development Scheme, patients who attended Macmillan Day Care indicated that walking was their preferred choice of physical activity rather than a circuit class. Staff in Macmillan Day Care have responded to this by developing Medal Walking Routes, carefully designed with different levels, at bronze, silver and gold, to encourage patients to maintain or increase physical activity levels within their abilities.
Promoting physical activity is now considered beneficial all stages of the care pathway and NICE (2015) recommends that all patients should be informed of the benefits of physical activity. Losing the ability to walk is often considered the single biggest predictor of disability; often prompting hospital admission and preventing discharge. Regular focus groups, continued informing, engaging and consulting with patients and staff ensured everyone involved had a sense of ownership in the route development. Benches, signposts and leaflets were all designed by the patients in partnership with several outside agencies e.g. Paths For All, Ramblers Association, Dundee City Council, Macmillan Cancer Support, the Commonwealth Games Legacy Team and NHS Tayside. Inspiring walking-related quotes were also chosen by patients and these were engraved into the benches and added to some signage.
Staff from the physiotherapy team attended walk leader training, enabling staff to take small groups of patients out for walks and increase patient contacts within current resources. The rest of the AHP team supported the initiative as they understood the importance and impact of walking on health.
‘A walk in the fresh air may help to stimulate a poor appetite’
Rhonda Manning. Macmillan Dietitian
The routes were completed in May 2015 and evaluation will follow the same processes used for the exercise class; continuing to provide information on patient preferences of physical activity interventions to enable more patients to access activities within the current resources. Finding purposeful and meaningful ways to engage patients in appropriate physical activity is key to facilitating long-term positive health behaviour changes. Patients who attend Macmillan Day Care appear to really enjoy ‘giving something back’ to help others and develop a person-centred effective and efficient service.
“I promote walking with my Palliative Care patients as it is an evidence based activity which has many benefits such as improving strength and fitness, improving mood ,especially when in a group, and it can allow a patient to achieve goals such as being able to walk to their nearest shop”.
Rosemary Brewster Macmillan Physiotherapist
Following on from the evaluation the next stages are to explore gentle movement activities. Gardening is available all year round with raised beds, hanging baskets and other various gardening activities. Patients and volunteers have recently planted a sensory herb garden in the Bronze walking areas which has encouraged patients to walk outside and explore.
“Walking is an easy form of exercise. It is easily and often unknowingly incorporated into our daily routines. Walking is a purposeful and meaningful activity which can make us feel good physically, mentally and/or socially. Whether it is walking to the loo or to the kitchen to make a cup of tea or even to the top of a mountain, walking is an easily adaptable goal driven activity. “
Lynn Sutherland Macmillan OT