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Green GP - Our practice set up a green gym

Patients improve their fitness while taking part in valuable outdoor activity, says Dr Ian Wheatley.

Rosemary Blakesley, Bob Brown and Dr Ian Wheatley
Rosemary Blakesley, Bob Brown and Dr Ian Wheatley

Our PCT, NHS Lincolnshire, contacted its GP practices in October 2008 offering an additional non-recurring funding resource. Called the Rapid Improvement Fund, it was available for projects that would benefit patients.

Our surgery, the Hereward Group Practice in Bourne, put forward a successful proposal for a green gym. This offers people the chance to do physical jobs outdoors with the aim of improving strength and stamina, increasing practical skills and benefiting local green spaces.

My six-partner practice got the idea from local community member Rosemary Blakesley who has a background in horticulture and education. Keen to set up a green gym, she approached our practice manager Bob Brown to ask for the practice's support.

Sustainable activity
I had been reading about sustainable living, permaculture and conservation during the previous few months, so Rosemary's offer and the availability of funding seemed to fit into place.

The Green Gym scheme has been run by charity BTCV (formerly the British Trust for Conservation Volunteers) since 1998. Individual schemes operate at various locations throughout the UK and can take a variety of forms, ranging from tree planting and footpath clearance to allotment- based projects and growing vegetables.

The central theme is volunteers working outdoors on projects that will benefit the community, while obtaining health benefits from the resulting exercise and interactions.

The more I learnt about green gyms, the more appropriate and exciting having our own gym seemed. The UK's population has become increasingly sedentary and the rising obesity rate and its impact on health has become a serious problem.

Bourne, a market town in the south of Lincolnshire, is no exception to this trend. Many of us are disconnected from the land and from food production at a time when our lifestyles are becoming unsustainable.

To my mind, any initiative that will increase our patients' physical activity levels and improve awareness of ecological issues and responsible conservation is welcome.

There is also a social side to a local green gym with people getting to know each other while working together for the benefit of the community. And there is the advantage that patients who may be averse to more traditional exercise regimes can burn off some calories participating in an activity they may well find enjoyable.

After asking patients for their views, we applied for £24,000 for the first year, to cover the salary of the project manager - a role for which Rosemary offered her services - obtaining a BTCV Green Gym licence, start-up costs, training, insurance and tools. Two months later the PCT granted this funding.

We then did some further patient consultation, applied for the BTCV licence and Bourne Green Gym was officially launched in March 2009.

Breaking ground
Not only is this the first green gym in Lincolnshire. It is also the first in the UK to have been funded via the NHS's Rapid Improvement Fund as well as being the first one to be licensed and run directly through a GP practice.

We recruited a small group of patients who, for insurance purposes, were asked to formally register for the gym and to complete a physical activity readiness questionnaire (PARQ).

This enables us to assess the appropriate level of exercise for each member and to monitor patient engagement.

The first green gym session was in May and there is a three-hour session every Tuesday from 10 am to 1 pm. Group members have already been involved in refurbishing a community garden and working in Bourne Woods.

Each session includes warm-up exercises, work, tea break, more work, a tidy up, then cool-down exercises and cleaning of tools. Rosemary leads this group at present, giving instruction on tasks, developing skills, knowledge and confidence. In the longer term, she intends to recruit volunteer team leaders, so she has time to develop the project further.

It is still early days, but I feel sure that we will be able to build on our initial success.

Due to patient demand we will soon be starting a Saturday session, and are training volunteer team leaders.

Apart from advertising in the surgery and the GPs referring patients to the gym, we intend to promote the green gym to the wider community at public events and through local media coverage.

Future funding is an issue, but we have several leads, and will strive to ensure Bourne Green Gym is viable in the longer term.

Green gyms can improve the health of your patients, while benefiting your community and the environment.

That can't be bad, can it?

  • Dr Wheatley is a GP in Lincolnshire

Benefits of Green Gyms

  • 100 per cent of participants interviewed agreed that taking part has benefited their mental health, boosting self-esteem and confidence through learning new skills and completing new tasks.
  • The scheme provides moderate physical activity: people regularly active at this level are 50 per cent less likely to suffer a heart attack or stroke than inactive people.
  • Working out in green spaces is a great way to relieve stress and can help to combat depression.
  • Taking part improves muscle strength, which is particularly important for older people in helping to maintain independence in later life.
  • Participants report feeling fitter and having more energy than before.
  • Almost a third more calories can be burnt in an hour of some green gym activities than in a step aerobics class.

A national evaluation of green gym projects took place from July 2003 to August 2007 by Oxford Brookes University's School of Health and Social Care.

Visit www.btcv.org/greengym for a summary.


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