Keeping adults in Hertfordshire moving to prevent early deconditioning

A new proactive service has been successfully introduced by specialist physiotherapist, Kelly Bateman in the Community Adult Health Service in Dacorum, Hertfordshire. This innovative service is designed to help reduce patient deconditioning whilst waiting for therapy, promoting early intervention and encouraging self-management.

Developed over the past year, the new service called Inspired to Move empowers patients to stay active and engaged in their recovery from the very start of their referral journey. By supporting individuals before their initial physiotherapy face-to-face appointment, the service aims to reduce the number of in-person sessions needed - helping to ease waiting lists and improve access to care across the county.

Following a successful pilot programme involving 45 patients, 31 participants were safely discharged by week six, demonstrating the potential for earlier recovery and reduced demand on clinical resources.

The new approach begins within the first week of hospital, GP or social services referral. Patients who are eligible are identified through a screening process conducted within 48 hours. Within the first week after being screened they receive a welcome letter and the Inspired to Move booklet. This booklet provides safe exercises, additional information around healthy eating and benefits of exercise, whilst promoting self-management that can be carried out independently at home, helping patients stay active and engaged from the outset.

At the end of week one, a text message is sent to either the patient or their relative, to check in that they have received the information and to prompt them to contact the SPA (single point of access) if they haven’t so another booklet is sent out. At week three, another text message is sent out, this encourages and prompts engagement around the booklet, prompting to fill in the logbook. It also notifies that a call would be made at week four to complete a full triage which will determine if the patient requires a face-to-face appointment or if they can be discharged with the booklet.

Deconditioning is a process of physiological changes that happen after a period of inactivity, bedrest, or sedentary lifestyle. You may start noticing that you have lost muscle strength and that your mobility has worsened. The decline in muscle mass and strength has been linked to falls, functional decline, increased frailty, and immobility. The cause of deconditioning could be due to being in hospital for a length of time and not moving as much or not doing activities such as washing and dressing yourself alongside normal activities.

This initiative marks a significant advancement in delivering more agile, patient-centred community care. By empowering individuals to take an active role in their recovery, it helps reduce physical decline during the waiting period, ensuring patients are stronger and more mobile by the time a physiotherapist visits them at home.

Speaking about the booklet, Jean said: “I think the booklet is very good, honestly, I really do. Robin is much happier now in general, so thank you so much for that, and everything.”

Hear Robin’s story who is in his late 80s from Dacorum. He was recently discharged and received the Inspired to Move booklet to continue his exercises at home. With support from his wife, Jean, he has been able to stay active, maintain his independence, and build strength as part of his ongoing recovery, illustrating the difference the programme has made in his life.

Louise Ayres, Deputy Director of Operations said: “The Inspired to Move service provides patients the tools and confidence to take charge of their recovery right from the start. Many people feel uncertain while waiting for physiotherapy, and this service helps them stay active, maintain strength, and feel more in control. It’s been incredibly rewarding to see how much progress patients can make at home, with the right support. By engaging individuals earlier in their recovery journey, we’re helping them to stay active at home, but also improving health outcomes of our patients. This initiative is a testament to how innovative, community-based care can make a real difference in patients' lives.”

Building on its success, the service has now been expanded to Watford and Wandsworth in the South West division. Following its positive impact on patients, it is hoped that the service will be rolled out across other physiotherapy services within the Trust.