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Why working with health systems is key to Uniting the Movement

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Posted 12th April 2023

Caitlin Thomas. the national programme manager for physical activity at the Office for Health Improvement and Disparities (OHID) presents the first of a three-part series on the partnership with Sport England and NHS Horizons for the management of health conditions through sport and physical activity.

Physical inactivity is detrimental to our health and contributes to the development of more than 20 chronic diseases, placing a burden on our health and social care systems.

The UK’s current data shows 12.4 million adults (27.2%) do less than an average of 30 minutes of physical activity a week, and that 2.2m children and young people (30.1%) are classed as ‘less active’, achieving fewer than 30 minutes of daily physical activity.

The UK Chief Medical Officer’s Physical Activity Guidelines highlight the essential role being active can play in supporting our physical and mental health. They state: “If physical activity were a drug, we would refer to it as a miracle cure, due to the great many illnesses it can prevent and help treat.”

Leading a more active life can help reduce the risk of developing chronic diseases, and being physically active helps many of the 19 million people in England living with long-term health conditions to manage their symptoms.

Physical activity can also bring wider benefits, including better mobility and improved self-esteem, and has an overall positive effect on wellbeing.

Integrating physical activity into health systems has been identified as one of the eight ‘best buys’ for physical activity.

And there’s relevant research that provides examples to enablers of how to integrate physical activity into health and wider systems. It’s these opportunities that we must explore in future.

We know that embedding physical activity in everyday healthcare could bring significant benefits due to the wide reach that healthcare professionals (HCPs) have across the population.

According to NHS Digital, there were almost 431m general practice, outpatient and A&E attendances in 2018/19.

So, at the Office for Health Improvement and Disparities (OHID) we’ve been collaborating with Sport England to work with partners in the health system to create change in practice, culture and systems.

We know people regularly engaging with HCPs (those with, or at risk of developing, health conditions) are far more likely to be inactive and experience other inequalities.

Insight from the ground-breaking We Are Undefeatable campaign revealed that the NHS and healthcare professionals are trusted sources of information. A quarter of people say they would be more active if told to do so by their GP or nurse.

There is an opportunity to transform people’s interactions with HCPs and embed physical activity within the NHS to reach those who have the most to gain from being active and to increase their knowledge, confidence and motivation.

So how do we go about enabling HCPs and the system they work in to better integrate physical activity into their daily practice to bring benefit to individuals and communities?

Taking action

The team at OHID and Sport England have been working together since 2017 to embed physical activity within the health system to help reduce physical inactivity in the population.

Together, we have delivered an ambitious, multi-layered programme, the Moving Healthcare Professionals Programme (MHPP), which sought, in part, to address barriers that HCPs and allied HCPs had when addressing patients.

These included a lack of formal knowledge, skills and confidence in discussing physical activity.

The programme developed education and training packages to help overcome these barriers. It also sought to influence changes within the NHS system and make physical activity part of the norm.

These changes sought to influence the system, infrastructures and cultures and establish physical activity as part of an evidence-based preventative approach.

The evaluation of the MHPP found that it contributed to whole-system change, including greater recognition and value of physical activity.

HCPs reported the training tools increased their knowledge, skills and confidence to promote physical activity.


The above diagram shows the multi-layered workstreams for activating the NHS through the MHPP.

Between 2019 and 2022, the programme reached approximately 157,400 professionals through physical activity training or training tools.

HCPs reported improvements in their knowledge, skills and confidence to promote physical activity, increasing their motivation to mention it in conversations with patients.

Patients themselves also reported better aerobic fitness, reduced pain, improved mental health/mood, a better management of fatigue and greater enjoyment of physical activity.

Joining forces

In 2020, NHS Horizons joined our partnership, bringing their specialist transformation and change knowledge forward.

This enabled us to be bolder and more innovative in developing our whole-systems approach, raising the visibility of physical activity and exploring how to embed it consistently as part of the norm for the prevention and management of health conditions.

Our partnership focuses on supporting people and the system to do things differently to improve outcomes; enabling people to better manage their own health through leading a more active life.

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