SHAPE – A First real evaluation model in the UK

July 5, 2017 1:47 pm

A 12 week healthy lifestyle program supporting people with a diagnosis of mental health difficulties is to be implemented across the UK, following a successful introduction of the service in Worcestershire. The initiative, which was first launched at the McClelland Centre for Health and Wellbeing in Worcester, and funded by the Health Foundation is a joint enterprise between Worcester health and Care Trust and the University of Worcester.

It was implemented initially when Worcestershire Early Intervention Services identified a need for improvements in assessment processes and documentation in the monitoring of physical health needs of young people living with mental illness. Following initial service evaluation findings of physical health measures were found to be to be inconsistent with gaps in service provision and care plans that did not routinely address physical health needs. Worcestershire EI recommended that a more substantial evaluation process was needed, and formed a project group together with the University of Worcester, proposing a 12 week physical health and wellbeing programme, SHAPE (supporting health and promoting exercise) based on the University Campus at the McClelland Centre for Health and Wellbeing.

The programme allowed staff to build a baseline picture of patients accessing mental health care physical health status in order to map a patient’s journey in relation to their physical health needs and identify future cardio metabolic risks.

With the introduction of a consistent physical health assessment tool and documenting baseline physiological measures staff were able to support patients identify individual goals in order to make positive changes to their physical health and identify future risks. Embedding the LESTER tool as part of training for staff ensures they follow the correct pathway once a physical health need is identified.

Recruitment to the programme by Marie Band Clinical lead with the initial focus being to recruit patients and improve the physical pathway and outcomes. By evaluating outcomes over a 12 month period, the teams were able to positively impact on levels of activity, diet and slow down weight gain.

The SHAPE program showed immediate benefits with a positive impact on mood and motivation of patients and increased levels of engagement in carers and peer group support. The program also noted increased attendance at other groups as bonds were formed. Attendance outside of the group increased efficacy and encouraged peer support.

The program was not without its challenges as retaining staff momentum during team changes due to sickness and leave was difficult, as well as responding to the higher than anticipated levels of outside interest in the program. Using Earn as You Learn students from the university allowed SHAPE to challenge the stigma associated with mental illness and normalised behaviour. The program has also involved other disciplines such as then physiotherapy students, sports exercise students, Occupational Therapists and nutritionists.

At the end of the 12 months, evidence showed that positive impacts can be made by intervening early in mental illness – often following the first psychosis episode – and encouraging patients to make informed treatment and lifestyle choices. Collaboration of skills across health and education has also added huge value to the programme.

In 2016, a further bid secured an additional 18 months funding from the Health Foundation which was then used to improve the SHAPE model and spreading improvement by building a digital platform for professionals, carers and patients as well as providing links on how others could implement the SHAPE program. The website provided an online tool box of vital information, such as an exercise manual and lifestyle programme which facilitated training and implementation.

The success of the program has resulted in further budget allocation being approved to roll out SHAPE across the country and support to meet Care quality Initiatives and Quality Aims. With the introduction of physical health lead the plan going forward is to secure and sustain the model within the trust. By using peer support workers within the model to facilitate groups and support patients to attend adds value form a lived experience and aids motivation and understanding.

There is a requirement to embed further staff training and consideration to be given to where the model sits – perhaps as a preventative model and allow self-referrals. Focus is now on streamlining of interventions and processes across AMH/LD and adapting the SHAPE model to other services, recruiting full time staff and embedding nutritional/ physiotherapy pathways and improving shared care protocols and policies in relation to physical health needs of those accessing mental health services.

SHAPE is now been accepted as a NICE shared learning model.