With the national agenda on palliative rehabilitation and with an increase (up 66%) in referrals to Dorothy House Physiotherapy team in 2015, the team reviewed their gym sessions and in 2017 opened the gym sessions out to include outpatients, day patients and inpatients. This service is now available five days a week and provides group and individual sessions. Due to the increase in sessions and availability of the gym the contacts have increased 327% from 17/18–18/19.

The review originated from a Palliative Rehabilitation Steering Group that aimed to address wellbeing, falls prevention and rehabilitation in a safe environment. The ultimate aim was to encourage people to work on what they can do now and be able to move to community leisure facilities as/when they are able.

Benefits

• Partnership working with local leisure providers;

• Eased pressure on Dorothy House Hospice Care community Physios;

• Provided a safe environment for people to build confidence and self–esteem when exercising;

• Monitors and addresses other symptoms such as pain, breathlessness and fatigue;

• Can be accessed by all patients referred to Dorothy House Hospice Care;

• Inclusive use of outcome measures e.g. grip strength are used to monitor patients’ physical health.

Issues

• There is not always an appropriate place for patients to move on to;

• Variations in exercise provision in the different counties;

• External communication could be improved to GPs;

• Palliative care means that there often needs to be an option for patients to move between service providers if their symptoms improve or deteriorate. This can be more difficult at times.

The future

• Increased partnership working to ensure that the patients will be able to access exercise facilities and support, no matter what stage of their illness they are in.

• Dorothy House Hospice Care physio continues to provide specialist treatment and advice for those who need it.

• Consideration of seven–day week support (funding dependent).