Active NoW offers a straightforward, and efficient method for directing patients to suitable physical activity based on their requirements - a single point of referral for physical activity and exercise across Norfolk and Waveney. It gives health and care professionals the peace of mind that their patients are being supported into high quality and appropriate activity.

Our priority is to support our colleagues within the Primary Care Network and health and care professional who may operate outside the NHS. Our aim is to:

• Support quick and easy referrals.
• Provide peace of mind that people are being supported into physical activity that is appropriate to their needs.
• Deploy appropriately qualified and trained staff to operate and deliver the service.

Active NoW is for inactive individuals who do less than 30 minutes of moderate intensity exercise each week, as well as people living with a long-term health condition (LTC), whose condition could be managed or improved by being more active.

The initial priority is to support health and care professionals who work with those with the following conditions:

• Diabetes
• Pre-diabetes
• Hypertension
• Individuals who are at risk of a fall. A person must be classified as a 3, 4 or 5 on the Rockwood Frailty scale to be eligible for referral.
• Individuals with a stabilised serious mental illness (SMI) being referred at point of a SMI health check in primary care only.

Referring a person who is at risk of a fall: All health and care professionals can refer a person to Active NoW regardless of their assess to clinical records.

Referring a person who has a long-term health condition: Anyone who has access to patient records can refer. Unfortunately we are unable to accept referrals from non-health frontline professionals at this time.

Referring a person with an SMI (stabilised serious mental illness): Only health care professionals delivering SMI health checks in primary care settings with access to patient records may refer at this time.

Self-referrals are not currently available, but we hope to explore self-referrals in the future.

If you have access to clinical records, referrals can be made within SystmOne/EMIS preventing the need for  manual input of patient data.

If you do not have access to clinical records, referrals can also be made using the Active NoW Online Referral Form.

How to refer to Active NoW

Referral Criteria

The referral form has been largely aligned with NICE guidance for exercise referral, the referral criteria and patient pathway, as well as our own experience of delivering the exercise referral scheme.

The questions related to disability and medication, are standard practise for exercise referral and important to collect at point of referral to ensure the patient is suitable for the scheme. This also ensures the triage team/instructors have sufficient information prior to contacting the patient. The feedback from our triage and assessment team is that the referrals received from this new form have been more detailed than previously, allowing for conversations more beneficial to the patient and preventing back and forth with referrers to collect further information, and preventing delays to the referral process.

• Flyers and Posters for electronic download: Flyer and Poster
• Printed flyers and posters: These can be requested via Norfolk County Council's Health Information Leaflet Service. Visit: https://brochure.norfolkslivingwell.org.uk/leaflets-and-posters-physical-activity

Referrals will be acknowledged by text immediately. The individual will be contacted within 12 weeks of receiving the referral.

The Active NoW team are constantly building on our directory of services for which we can refer or signpost patients on to.

We have exercise referral schemes available at leisure operators across all council districts – these offer discounted membership and include either exercise referral classes, or guided gym access by an Exercise Referral instructor. The discounted membership will typically include access to all other facilities at the centre, but this may vary as each individual centre is responsible for their provision, offer and pricing.

Alternatively, patients may be referred to community activities such as parkrun, wellbeing walks and independent providers of exercise. Patients will also be offered access to digital resources such as the exercise referral app – Exi, or online exercise classes.

Patient is referred to Active NoW

The individual is referred to the Active NoW exercise referral service via their health professional. 

This happens when a healthcare professional deems that a patient’s health conditions would benefit or be improved by a structured fitness programme. 

Triage and assessment

The person will be contacted by our Active NoW coordination centre at South Norfolk and Broadland Councils to discuss their referral. 

Our trained staff will ask the individual some questions about their health and lifestyle and help them find the most suitable physical activity option – this may be at a leisure centre, a small community gym, or a local exercise class. The Active NoW exercise referral service has a range of activities to offer throughout Norfolk and Waveney.

With the person’s consent, our staff will share the referral with an agreed activity provider, so that the provider can then contact the person directly. 

If it is decided that an exercise referral scheme is not suitable, the individual may be referred on to home-based exercise or a community initiative such as parkrun. In which case, they would move directly on to step 5. 

Initial assessment

Once the referral has been shared with the agreed provider, the provider will contact the person to arrange an initial assessment. This appointment is with a qualified instructor who will help build an appropriate programme of exercise for the client. 

The aim here is to gain as much information as possible about the client so that a programme can be tailored to their specific needs. 

Although the healthcare professional will have passed on any medical notes and information about the individual, this is an opportunity for the instructor to ask additional questions. 

During this assessment, the instructor will ask some further health and lifestyle questions, complete some basic questionnaires, and take some biometric measurements if appropriate. 

The exercise referral scheme begins

The person will begin attending the programme and be supported by the instructor throughout. They will guide the individual through exercises designed specially with their health condition in mind. 

This will normally last 10-12 weeks.

End of the program

The follow-up of any exercise programme is arguably just as important as the programme itself.

At the end of the exercise referral scheme, the exercise referral instructor and the client meet for a final assessment. During this appointment, similar questions ad measures will be taken from the induction appointment. This is a good way to measure the progress made throughout the scheme.  

The instructor will also discuss with the individual whether they wish to continue exercising and possible exit routes for the client to follow – if necessary, Active NoW can support the person into alternative activity options. 

The Active NoW team will also circulate a survey for completion allowing the programme effectively evaluated.

Extensive research has been conducted on the effectiveness of exercise referral programmes. For example, this study by the National Institute For Health Research revealed that individuals participating in exercise referral schemes had a 12% higher likelihood of reaching the recommended 90-150 minutes of weekly exercise compared to those not enrolled in the programme.

Furthermore, the research indicated that participants in the programme engaged in a greater amount of weekly exercise compared to individuals who received exercise advice alone. These findings suggest that the scheme effectively motivates patients to increase their physical activity in pursuit of improved health.