This blog looks at making effective referrals and is part of a short series addressing the contribution health and care professionals can make to improving health and wellbeing. Please also see our blogs on starting conversations and on our research into front line professionals views on the wider prevention agenda. Don’t forget to also take a look at All Our Health which helps all health and care professionals maximise their contribution to achieving a radical upgrade in prevention.
You’ll no doubt have seen much media debate about how we tackle the increasing demands on our health and care services. Health and care professionals across the country are doing an incredible job managing these demands.
But the pressure on the system isn’t just a winter issue. People are living longer but often in poorer health, suffering from illnesses that could have been prevented.
Our most deprived communities are spending more years in ill health than the most affluent. These profound health injustices are not just linked to deprivation as we see similar a similar story for people living with a mental health condition or people from our LGBT communities.
Across the whole population two thirds of premature deaths and ill health could be prevented by addressing key risk factors such as obesity, tobacco use, high blood pressure and physical inactivity.
As health and care professionals we have a hugely important role in responding to these issues, making the most of the trust and value our communities place in our advice.
This isn’t just an issue for specialist public health teams - it requires a full systems response - and with an estimated two million health and care staff working across the country our collective efforts can be a real force for change, driving action that can prevent or delay the onset of conditions like type 2 diabetes, heart disease or dementia.
Through our research, and via meeting you at events and conferences, we know that you are committed to building more “prevention” into your practice but we also understand that there are challenges.
I’ve blogged about offering brief advice and starting conversations around issues like weight or smoking and in this blog I want to look at making referrals, either to local support services or trusted online information.
In some areas of the country there are “one stop shop” websites or helplines for healthy lifestyle advice and services, in others there might be a range of providers with services linked to specific geographical boundaries or targeted towards specific high risk groups.
One of the top challenges you tell us about is that it can be difficult to make these referrals to lifestyle services supporting behaviour change.
I acknowledge that this can become complicated when having to remember eligibility criteria and referral pathways, so how as health professionals can we ensure we are accessing and signposting information?
Building up a local picture
How do you know what’s available in your area to help people get active, lose weight or stop smoking for example? Many local authorities list a range of lifestyle and health and wellbeing support services on their websites but if you’re unsure where to start, make contact with your Local Authority public health team as I am sure that they will want to work with you to make the most of your contacts with members of the public.
Stop smoking services
In my blog about starting conversations I cover offering very brief advice on smoking cessation. Smokers are more likely to quit with professional support so it’s really important all health and care professionals are aware of the sort of support available in their locality.
The RightCare patient decision aid sets out the issues clearly and the Smokefree campaign website offers a postcode search facility to find stop smoking support and is also a really useful resource to signpost any member of the public to who is ready to make a quit attempt.
Helping people get active
Again, your Local Authority public health team is a good source of knowledge on physical activity options and County Sports Partnerships also offer useful information which can help you signpost or refer members of the public.
The Walking for Health Website (which includes a postcode search) lists free, short walks all over the country and Parkrun advertises free 5km runs for all abilities, with many locations across England. Online information or apps are also an option to direct patients to, such as the One You website which offers advice and links to smartphone apps like Active10 and Couch to 5K.
Achieving a healthy weight
My blog on staring conversations flags our “Let’s talk about weight” resource which covers making referrals. It’s important to be familiar with your local obesity care pathway so you are aware of the weight management services in your area and the referral criteria and process.
The public health team at your local authority and clinical commissioning group should be your first point of contact if you’re unsure. If local provision isn’t available I’d recommend signposting local commercial weight loss services and clubs.
If people are overweight or obese, a weight management service or support group is one of the best ways to lose weight but this won’t be right for everyone. The One You website and How Are You quiz are useful options to signpost if needed.
My blog on starting conversations explains that asking a patient about their alcohol consumption and giving simple advice that alcohol can impact on health is often enough encouragement to help people drinking above low risk levels to reduce their consumption and cut their risk.
Referrals to specialist services for assessment and treatment are important for people showing signs of dependence. Make yourself aware of local specialist services via your local authority public health team or use this alcohol addiction services search facility on NHS Choices.
The NHS Health Check
People living in England aged 40-74 years of age, who are not already diagnosed with cardiovascular disease or being treated for key risk factors such as high blood pressure or high cholesterol, are eligible for an NHS Health Check every five years.
This is an important programme as it addresses the top risk factors which are driving premature deaths and ill health in England. Your promotion of the NHS Health Check could help increase the number of people accessing this service. Visit the NHS Health Check website for more information.
More and more health and care professionals are building the prevention of premature ill health and death into their day to day practice and at PHE we’re keen to know more about your successes and help with the challenges you face.
This blog starts to explore how we can collectively work together as a force for change by increasing the number of people accessing important evidenced based lifestyle services.
For more information on the contribution of health and care professionals in tackling priority public health issues such as obesity or physical inactivity visit All Our Health, a resource which provides a range of advice as well as information on how you can further contribute to the essential upgrade in prevention!
Image: Sport England