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| Sport Wales Mums & sons, Sue and her son - left |
Sue Williams is the Health Disability Activity Practitioner for Powys Teaching Health Board (PTHB). During Mental Health Awareness Week, with its 2024 theme of Movement for Mental Health, it seemed the perfect opportunity to find out more about her role and how the pathway can support disabled people on their way to better physical and mental wellbeing.
What is the Health Disability Activity Pathway?The Health Disability Activity Pathway supports disabled people across the lifespan to become more physically active. The pathway has been created to enable health professionals to instigate referrals that support the signposting of disabled people to physical activities and sporting opportunities in the local community. This occurs using the expert knowledge of teams within Local Authorities. Moreover, the pathway can be used by anybody, not just healthcare professionals.
The referral and signposting process (which is not a medical referral), was rolled out nationally with Welsh Government funding in 2022 following a successful pilot project in Betsi Cadwaladr University Health Board (BCUHB). Notably, people can be referred to another scheme the National Exercise Referral Scheme (NERS) and also use the Health Disability Activity Pathway.
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Health Disability Activity Pathway Process |
Tell us more about your role as a Health Disability Activity Practitioner
I moved to this new role in PTHB in May 2022, having previously worked as a physiotherapist in BCUHB.
A major part of my role is delivering presentations about the pathway to staff groups and individuals who work with people with disabilities. I talk about the benefits of physical activity (including participation in sport). I also get the opportunity to attend conferences and events to promote the pathway and learn more about the opportunities available, particularly within local communities across PTHB, and to work on projects that help promote physical activity and its benefits.
Recently, I have also started co-delivering sessions to university physiotherapy courses with a colleague from Disability Sport Wales. I love that through this work we are also starting to embed engagement with the pathway from the very outset of health professionals' careers.
I moved to this new role in PTHB in May 2022, having previously worked as a physiotherapist in BCUHB.
A major part of my role is delivering presentations about the pathway to staff groups and individuals who work with people with disabilities. I talk about the benefits of physical activity (including participation in sport). I also get the opportunity to attend conferences and events to promote the pathway and learn more about the opportunities available, particularly within local communities across PTHB, and to work on projects that help promote physical activity and its benefits.
Recently, I have also started co-delivering sessions to university physiotherapy courses with a colleague from Disability Sport Wales. I love that through this work we are also starting to embed engagement with the pathway from the very outset of health professionals' careers.
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| Volunteering at a Boccia event |
This role brings together my experience as a healthcare professional, and my passion for sport and physical activity, and their many benefits. Through many years of NHS community and inpatient work, I have gained an excellent understanding of the teams who work with patients whether this is NHS, Social Services or the Third Sector.
I have taken part in sport and outdoor activities for most of my life, but not on a regular basis for several years while my children were growing up. When my son started playing hockey for our local hockey club, I gradually got drawn in. New starters were always welcomed (and still are) and another hockey mum and I started training. Very soon we were both playing in league matches. I never imagined I would return to competitive hockey at age 45, having last played on grass in school! I have experienced first-hand so many benefits of being active and being involved in a sports club; as a player, parent of a player, coach and committee member.
I’ve always been captivated and inspired by “the power of sport” in changing people’s lives whether through rehabilitation, bringing people together, the social impacts (individual and community) disability or masters sports for those aged 35 to 80+. Through the COVID-19 pandemic, I developed a growing interest in the benefits of blue and green outdoor spaces, in particular the positive impacts on mental health and wellbeing.
NHS Wales works closely with Disability Sport Wales and Local Authorities to provide this service. How does that work?
The pathway relies on collaborative working between Disability Sport Wales, the 22 Local Authorities, and their corresponding health boards. Each health board has a Practitioner in post who, as well as delivering training sessions, facilitates the links and relationships required to ensure the pathway is a success. Monthly partnership team meetings involving the Practitioners and relevant Disability Sport Wales team members is just one example of how this is achieved.
I’ve always been captivated and inspired by “the power of sport” in changing people’s lives whether through rehabilitation, bringing people together, the social impacts (individual and community) disability or masters sports for those aged 35 to 80+. Through the COVID-19 pandemic, I developed a growing interest in the benefits of blue and green outdoor spaces, in particular the positive impacts on mental health and wellbeing.
NHS Wales works closely with Disability Sport Wales and Local Authorities to provide this service. How does that work?
The pathway relies on collaborative working between Disability Sport Wales, the 22 Local Authorities, and their corresponding health boards. Each health board has a Practitioner in post who, as well as delivering training sessions, facilitates the links and relationships required to ensure the pathway is a success. Monthly partnership team meetings involving the Practitioners and relevant Disability Sport Wales team members is just one example of how this is achieved.
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| Wheelchair Fencing World Cup Cardiff 2024 |
To the best of our knowledge this pathway, or anything remotely similar, does not exist in any of the other Home Countries, or indeed elsewhere in at least Europe. There is an overall pathway, but not as simple or purely focused on disability, in place in Scotland. The all-Wales pathway focuses on signposting disabled people and giving them the chance to explore and access opportunities they historically may not have been aware existed. It also aims to make the most of every contact to improve their knowledge around the benefits of physical activity and the options available. All of this is led by the underpinning aim of increasing physical activity (including sport participation) and decreasing healthcare resource use.
During the pilot project from 2013 to 2016 there were 560 signposts, with Disability Sport Wales reporting a 21% increase in physical activity levels in North Wales.
Who is eligible to receive support through the HDAP initiative? Is it All Age?
The pathway is for people with a wide range of impairments from age 2, but more opportunities are available from age 5. There is no upper age limit. Referrals for signposting can be made for all types of physical impairments including wheelchair users, sensory impairments, and intellectual impairments.
How are people referred into the pathway?
A form can be filled in with any healthcare professional/other or a self-referral can be made by an individual or their parent/guardian. The form is available on the HDAP website. Health Disability Activity Pathway | Disability Sport Wales + NHS Wales. The person referred or their parent/guardian will be contacted by a Sport Powys team member to arrange to discuss the referral. This is usually by phone. The conversation will aim to explore what the person is interested in and inform them of relevant opportunities. This is usually followed up with a further phone call or email.
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| Chartered Society of Physiotherapists' conference |
Tell us more about the mental health benefits of getting involved in sport and physical activity
The benefits of physical activity for mental health and welling are well-established; both in terms of general wellbeing and their role in the management of specific conditions. Benefits range from improving mood and sleep; increasing motivation and focus, and increasing self-esteem and confidence; to reducing stress, tension and anxiety, and preventing the onset and managing the symptoms of depression. Importantly, getting involved in sport and opportunities to be physically active can also reduce loneliness by connecting people.
There is some great advice and information from Mind about the benefits of physical activity on your mental health.
It is important to remember that there are so many resources available online if someone is not quite ready to try out a new club or activity. In addition, people can be active in so many other ways such as walking and gardening. There are benefits to physical and mental wellbeing from volunteering at a club as well.
What might happen to people if they did not receive the right support?
The pathway is there to bridge a gap. Staff/volunteers working with people with disabilities might only know about 1 or 2 local opportunities. Therefore, without a conversation about physical activity the person may not be made aware of everything available and might miss out on the right club/opportunity for them.
When people find something that suits them, and that they enjoy, they are more likely to continue with it and therefore gain more benefits, more regularly, and long-term.
What are the main challenges of your role?
NHS pressures: this can have a significant impact as there is often a lack of time to fit in training with teams. The geographical size of Powys is another challenge: at an individual level, barriers to engagement in opportunities can be travel or that a certain activity happens in one part of Powys, or indeed regionally within Wales, but not in multiple locations.
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| Will and Rygbi Gogledd Cymru |
Tell us about some of the most rewarding work you have done as a Health Disability Activity Practitioner
Without a doubt this is hearing about success stories: from people just trying a sport because of using the pathway, to being able to follow their journey. I met Will, who lives in mid Powys, last year after speaking with his physiotherapist. Will has a condition that has led to him having a curved spine, needing to use a wheelchair and only being able to walk short distances unaided. He had been playing wheelchair basketball since he was eight after being signposted to the N-able club in Newtown.
Will then found that two people with the same condition as him were playing wheelchair rugby including Wales and GB’s Josh Williams. Despite not having the correct sport chair and there not being a club in Powys, Will was determined to start playing wheelchair rugby. With the support of his family and Mark Baines of GB Wheelchair Rugby, in the past 12 months, Will has been training with and playing for RGC (Rygbi Gogledd Cymru) Wheelchair Rugby team and continues to progress in the sport. He will admit to being very competitive, but Will loves the social aspects and enjoys being able to play these sports with his friends and family.
My role and work have also challenged my own knowledge and perceptions; for example, observing Boccia training sessions and competitions has allowed me to gain a deeper understanding to be able to promote the activity in a more informed way. Seeing physiotherapy students' perceptions change when they learn about and take part in Boccia in the sessions we run, has been very gratifying.
My role and work have also challenged my own knowledge and perceptions; for example, observing Boccia training sessions and competitions has allowed me to gain a deeper understanding to be able to promote the activity in a more informed way. Seeing physiotherapy students' perceptions change when they learn about and take part in Boccia in the sessions we run, has been very gratifying.
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| The hockey playing Williams family |
I live with my husband on a small holding where we keep sheep, so some of my spare time is spent helping with farmwork especially at lambing time. A big portion of my time is for hockey related activity; I play for Dysynni Hockey Club Ladies 2s, I am the vice-captain, and also the club secretary. I have been getting more involved in coaching, particularly with the junior goalkeepers, and I am leading on the work for our club to become Insport accredited (Insport is a Disability Sport Wales scheme, delivered with the support of Sport Wales, which recognises good work in creating inclusive opportunities).
My husband and 2 children also play hockey, so we enjoy going to the social hockey session together, watching and talking about hockey! I love watching sports-related documentaries - one of my favourites and a huge inspiration for me taking this job was “Take His Legs”; about comedian and TV presenter Adam Hills and the inclusive rugby team (Physical Disability Rugby League) he joined. “The documentary deals with issues of mental health, Post Traumatic Stress Syndrome, and the true impact of sport and teamwork in overcoming both physical and mental challenges.”
You can find out more about the Health Disability Activity Pathway on the website or contact Sue directly by email suzanne.williams15@wales.nhs.uk
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