Once there was little to help patients exercise safely once they left hospital. But times have changed, reports MATT CLARK.

IT WAS five hours before Terry Binnington knew what had happened. He went to bed as normal and slept soundly. But at about 1am Terry had a stroke, not that he knew anything about it. When he woke up he couldn’t move or say a word.

That was two-and-a-half years ago and Terry still can’t talk or use his hands too well. When he was in hospital, staff made sure he had regular exercise to keep his muscles working, Not long ago that would have ended on discharge, but City of York Council has developed a community programme called HEAL (Health, Exercise, Activity and Lifestyle) to help people like Terry to take part in some form of exercise when they leave hospital.

Through his wife, he says why the programme is so important to him: “When you have had a stroke you need to do exercise, but going to the gym on your own could make things worse because you don’t know what you’re doing. This programme is a godsend; it’s a lifesaver and I’m just so glad it’s here.”

Terry had been suffering from depression and was getting frustrated because all his thoughts were stuck in his head and he couldn’t get the words out. Now at the weekly gym sessions he has made new friends, his morale has lifted and he can laugh once again.

Katie Ellis, who co-ordinates the HEAL scheme says half of us in York are not doing enough exercise to maintain a healthy lifestyle. And for many with a medical condition, HEAL is there to help.

To take part you need to be recommended by a GP, physio-therapist or practice nurse, but the scheme is open to anyone aged 16 or over who would benefit from becoming more physically active.

“People are becoming less fit, obesity is the highest it’s ever been,” she says. “I think people are beginning to wake up to the fact that something could happen if you don’t stay healthy.

“We realised there was a massive gap for people who had undergone operations so we decided to work with local health professionals to see what we could do to help when they return home.”

HEAL is designed to help people suffering from conditions such as heart failure, strokes, obesity and certain levels of high blood pressure, but the list is comprehensive and includes Parkinson’s disease and Multiple sclerosis.

Katie says a bit of physical activity can help prevent and manage more than 20 chronic conditions including diabetes and cancer.

Not that much is needed. Half an hour spent exercising five times a week, will stave off many ailments, but most people don’t do anything like that much.

Not only is it doing us no good at all, it needlessly costs the Health Service £5 million a year to put us back on track. That’s something Katie is trying to address.

“HEAL is very goal-oriented, but it’s not for us to set the goals. Some people just want to be able to walk to the bus stop again, but we had one man who wanted to take part in the Great North Run. That’s why the first question we ask is ‘what do you want to do?’”

There are a lot of activities on offer and Katie says the most important thing is to encourage participants to find an activity they enjoy doing.

That way they are more likely to keep exercising in the long term.

“The first step is the hardest and even if someone doesn’t feel up to it we still ask them to just come along. Gyms can be very off-putting, so what we do is completely non-threatening.”

In short, Katie wants to reduce costs to the NHS while improving the overall health of the city.

In York, physical inactivity has been identified as a priority to tackle, which is where the HEAL programme comes in. The council’s sport and active leisure team have produced a range of programmes and initiatives to encourage adult residents to kick the couch potato habit. Examples on offer range from cardiac rehabilitation classes and Nordic health walks to back pain circuits and swimming. And it’s not just about exercises; there are new friends to be made as well.

“We exercise in groups and because everyone has had a similar experience, I think that gives them more confidence,” says Katie. “The other thing is they are exercising in a healthy setting rather than a hospital, which is somewhere you go when you’re ill.

“It’s about living normally again.”

People can join a specific group programme or take part in activities across the city and there are classes on leading a healthier lifestyle.

While the last thing you might think a heart attack victim needs is exercise, Katie says that’s a myth; anyone can try out the exercises.

Sue Newlove agrees. “I did rehab at the hospital, but last year I didn’t do as much as I should have done. I was starting to think I must do something when I received a letter from Katie telling me about this programme.

“As soon as the weather improved I joined and I’m glad I did. It is brilliant, and gives you the confidence to exercise in a safe environment.”

Debra Eagle had her heart attack last year at the age of 54 and her favourite activity is the exercise bike.

“I didn’t really do any exercise before,” she says. “I did some when I was discharged from hospital then with the coronary support group at Burton Stone Lane and it was there I heard about the HEAL programme.

“I knew exercise would help the condition and for me, taking things easy meant not rushing around so much. But actually I find I’m doing more now, not less.”

Debra says HEAL is also a very sociable activity. Sometimes she and her circuits partner are chatting so much they forget to keep moving – until Katie gives them a knowing look.

The HEAL programme continues to grow, with Katie and her team developing new programmes such as the cardiac rehab programme which physios like Judith Plant say we need more of in the community. In my experience there wasn’t much available until now,” says Judith. “People are confident in the arena of the NHS, it’s where they feel safe, but to then say go out and do this on your own, is often too much.

“With HEAL they can self-manage their conditions, it’s empowering and at the end of the day, this programme helps keep people out of hospital.”

The HEAL programme is available by referral from a health professional such as a GP or physio, but there are some ground rules.

Participant’s conditions should be low to moderate risk for them to be accepted and they must be in the correct mindset to make a lifestyle change and be able to commit to the recommendation programme.

But as Terry, Sue and Debra will tell you, that’s a small price to pay.

• To find out more about the programme and how it can help you improve your physical activity levels and help control your condition, phone Katie Ellis on 01904 553440 or email katie.ellis@york.gov.uk

HEAL fact file

The HEAL programme follows the National Quality Assurance Framework for Exercise Referral Systems (Department of Health, 2001). For more information, log on to doh.gov.uk There are a wide range of activities on offer including:

• An introduction to Energise and Yearsley Leisure Centres, including 50 exercise classes, swimming, aquafit and back to swimming lessons.

• A ten-week physical activity programme, including using the gym, aerobics, circuits, walking, yoga and swimming.

• HEAL for cardiac rehabilitation.

• Renal exercise group: a low impact circuits class for those with renal failure.

• Walking for health and guided cycle rides.

• Nordic walking – for those with poor mobility and joint problems, as well as those with lower fitness levels.

• Jogging and running.

• Buggytone – for pregnant women and women who have recently had a baby.

• Participants will also have access to more than 200 sports clubs.

• All staff who work on the HEAL programme are suitably qualified.