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Dr Richard Pile

GP Partner

GPSI in Lifestyle Medicine & Cardiology

Clinical Lead for Lifestyle Medicine, Prevention & Inequalities

Herts and West Essex Integrated Care System

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Why create the Living Well course?

To be proactive
To help those at highest risk of long term conditions
Taking a holistic approach because people are complicated
Because modern medicine is [sometimes] rubbish and the drugs don’t work [very well]
Putting evidence-based lifestyle medicine into practice
To learn from doing
To collect outcome data & prove concept
To enable wider rollout and further development

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Course design

Purpose and meaning

Connections

Sleep

Nutrition

Movement

Stress & Relaxation

4 weeks, group based, face to face.
Introducing wellbeing/lifestyle medicine
Focus on behaviour change throughout
6 pillars of wellbeing
90-120 minutes
presentations/discussions/Q&A
Inclusive movement-based session each week
Team of lifestyle medicine doctors, personal trainers, & a health coach

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Recruitment

Searches were written for GP practices to identify “at risk” patients with conditions such as obesity, raised blood pressure, raised cholesterol and depression
Text invites/letters sent from practice directly to patients
Sign up via email/phone call/text
Follow up call with practice care coordinator to confirm attendance
Course materials, including frequently asked questions, sent out as reminders

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About ¼ of those invited sign up, and ⅔ of this group actually attend
People enjoyed talking, which enhanced the session
Building relationships keeps people engaged and coming back throughout course
Most people who started also finished (90-95%)
People love making new friends, which anchors learning and behaviour
High appreciation for medical professionals giving their time
Movement sessions need to be accessible
People found it transformational and wanted more

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Feedback

Highly rated (content 4.6/5, enjoyment 5/5)
Evidence for topics and benefits of lifestyle changes was important
Appreciation of holistic approach
Benefits of discussion re motivation and goal setting
Found instructors helpful in activity sessions
Appreciation of medical input
Requested a wider range of options for physical activity session
Desire for follow up conversations and signposting
Friendships made in group have encouraged enduring lifestyle changes

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More feedback

56% report an increase in wellbeing scores from pre to post course
42% changed from disagreeing to agreeing with statement “I am actively involved in my own health”
48% increase in confidence in making health changes
80% reported a better understanding of sleep, 87% of eating well and 70% of the importance of support network
40% reported an increase in sense of purpose in life.

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‘Great course and great to see that the surgery is promoting this style of medicine that I was previously unaware of. Thank you so much’

‘I really loved the ‘real’ element of the course. We are all human and all different and everyone respected this. I didn’t feel I was being told off. Fantastic all round’

‘I thoroughly enjoyed the course. It was delivered in a non-judgemental way and I really appreciated hearing all the statistics and evidence.’

‘The course was really fun and real with no preaching. I liked having an informal introduction to the gym environment as it can be very daunting’

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Outcomes (12 months after the course)

HbA1c (blood sugar): 47% of the group (8/17) reduced their HbA1c (72% of group for whom we have repeat result)]

LIPIDS: 35% (6/17) of the group had reduced their total cholesterol (60% of those with a repeat result)

WEIGHT: 53% (9/17) of the group reduced their weight (69% of group for whom we have a repeat result)

BLOOD PRESSURE: 47% (8/17) had a reduced BP (73% of group for whom we have a repeat result)