Physical Activity Referral Scheme

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What is ‘PARS’?

PARS stands for ‘Physical Activity Referral Scheme’ and it is an ‘Exercise Prescription’ for you specifically from your GP or health professional- delivered by an exercise specialist within RVLC. The scheme provides 12 weeks of group exercise for your needs to improve quality of life and overall health and well-being. The idea is that PARPS clients continue after their initial 12 weeks onto ‘Healthy Towns’ programmes/classes and clubs.

Who will qualify for ‘Health Matters’?

When referring a patient to Health Matters, please consider the following:

The patient must be motivated to adopt a course of moderate physical activity
The patient must be considered capable of undertaking physical activity as a course of treatment
The patient must be sedentary and not currently a member of a leisure centre gym.

(a) The patient must suffer from one or more of the following:

Hypertension, mild – moderate greater than 140/90 mm/hg but less than 180/100 mm/hg
Controlled diabetes (refer to section (c) below)
Heart disease (refer to section (c) below)
Anxiety/stress/depression • Obesity (BMI greater than 30)
Asthma, bronchitis or COPD
Other significant long term illness (refer to section (c) below

(b) Patients with high risk of developing the following should be considered:

Coronary heart disease

(c) We do not recommend that the patient be referred to the scheme if they fall into any of the following criteria:

Uncontrolled hypertension
Poorly controlled epilepsy
Unstable angina
Uncontrolled diabetes
Cardiomyopathy, unless recommended by a heart specialist
Current severe disease or disability which impedes ability to take part in physical activity
Less than 12 weeks from a cardiac event
Less than 12 weeks from giving birth
Under the age of 16

Why complete the Referral Form?

The Referral Form demonstrates that a healthcare professional considers a course of physical activity to be beneficial to their patient’s needs. It is important to fill in all sections of the form and not to leave any sections blank. It is essential that this information is correct, as it will be used to design a physical activity course specific to the patient’s needs.

All information is treated as confidential.

It is essential to know the following information:

1. Reason for referral:

Patients referred for weight management will only be accepted if they have a BMI greater than 30
If a patient is referred for ‘other’ reasons, please state this condition in the ‘Comment(s)’ section of this form. Please note this should be a condition that a course of physical activity can help. The Health Matters Coordinator can be contacted to clarify whether this ‘other’ condition will be accepted onto the scheme or not.

2. Relevant, current or past health problems:

 Please use the ‘Comment(s)’ section of this form to advise of this information

3. Any relevant medication, for example:

Beta-blockers eg Atenolol, Metaprolol
Diuretics eg Frumil, Burinex, Bendrofluazide
ACE Inhibitors eg Captopril, Enalopril
Calcium Chellel Blockers eg Nifedipine, Diltiazon
Nitrates eg Isosorbide Mononitrate, GTN 4. Limitation of physical activity specific to the patient

5. Referrer’s signature
6. Patient’s signature

Once the form is completed and signed, please post to:
Health Matters Coordinator Please refer to the list of participating leisure facilities

What happens next?

Within two to six weeks of receiving the form, the patient/client will be contacted by the Health Matters Coordinator to arrange an appointment. (Referral forms will only be accepted when a practice has signed up to the Service Level Agreement.)

Feedback Form to Referrer

At the end of the 12-week scheme a feedback form will be completed. A copy of this form will be forwarded to the referrer, a copy shall be given to the patient and the leisure centre will retain a copy. Should the patient, for whatever reason, drop out of the scheme, it will be noted on the feedback form.

Health Matters Physical Activity Referral Scheme - Referral Form