The population’s inactivity problem is being addressed by some decisive action from NHS England and CCGs. Baroness Tanni-Grey Thompson applauds their work
2016 promises to be another incredible summer of sport. We’ve got the Euros, Wimbledon and of course the Rio Olympic & Paralympic Games to look forward to.
But despite unprecedented elite sporting success in recent years, the UK is struggling to come to terms with its £20bn inactivity problem.
Most of the population simply don’t exercise enough to maintain good health.
So we’ve got to applaud the leadership of NHS England, spearheaded by Simon Stevens, for their strong manoeuvres in the past couple of months to put physical activity at the heart of the NHS agenda and bring the Five Year Forward View to life.
The launch of the healthy towns pilot, the rollout of the ambitious National Diabetes Prevention Programme and the announcement late last year that NHS staff would have access to free zumba and yoga classes are a welcome step in the right direction, and strike observers like myself as signs of an NHS that is getting serious on prevention.
The scale of the problem they are aiming to tackle is enormous. As many as 12.5 million people in the UK fail to raise their heart rate for even half an hour a week, and by 2020 the average Brit will be so sedentary that they will use only 25 per cent more energy than if they spent the whole day sleeping.
Physical inactivity, in its own right, separate from obesity, is the fourth leading cause of global mortality.
The promotion of activity and healthy lifestyles has the potential to drastically reduce demand of critical services
Undoubtedly, Britain’s issue with exercise is one of the most pressing challenges facing the NHS. HSJ readers will be all too aware of the issues posed by a population living longer at a higher risk of non-communicable disease.
And the rise of inactive lifestyles in recent decades has been one of the primary contributors.
But in the same way as physical inactivity is causing a number of the country’s health issues, the promotion of activity and healthy lifestyles has the potential to drastically reduce demand of critical services and ease pressure on the NHS over the short, medium and long term.
With the government machine moving painfully slowly to tackle childhood obesity, and a strategy which has been delayed yet again until after the referendum, NHS England has forged ahead with its own policies to put prevention at the heart of delivery and to develop a robust plan to increase activity levels.
A push forward
The Department of Health is bogged down in a series of unwinnable battles with the professions, but NHS England flexed the full power of its new remit to push ahead with these important measures.
In 2014 ukactive published its report, Turning the Tide of Inactivity, which for the first time exposed the full extent of inactivity in the UK. Since then, local authorities, acting through the public health grant, have prioritised activity, doubling health grant spending on programmes which aim to get more people more active, with a special focus on those who don’t currently meet activity guidelines.
We’re seeing CCGs become increasingly interested in the role of leisure centres and gyms, yoga classes, and Parkruns
But the public health grant (an annual £2.4bn payment to local authorities) is a drop in the ocean when it comes to creating the societal “industrial shifts” in behaviour change which Public Health England says are required.
Clinical commissioning groups now recognise that prevention is their agenda as much as it is the local authorities, and have stepped in throughout a number of pilot areas to joint-fund the programmes which they recognise will deliver savings (in financial terms but also in the reduced need [for critical services) further down the line.
Whether it’s the Mobile Me scheme in Norwich, part funded by the CCG and Active Norwich, the County Sport Partnership, or the ingenious Let’s Get Moving programme in East Sussex, where those at risk of long-term conditions are offered a free activity counselling session via their GP surgery through a targeted programme, there is a recognisable paradigm shift into the prevention agenda here.
And with it unlocks a whole new type of commissionable service and partnership for the NHS to pursue. We’re seeing CCGs become increasingly interested in the role of leisure centres and gyms, yoga classes, and Parkruns, and the ability these have to promote and protect the nation’s physical, mental and social health.
This long termism being pioneered now by CCGs and NHS England is admirable and long may it continue.
The staggering low QALY cost of physical activity interventions (between £20 and £440 according to the National Institute for Health and Care Excellence) compared with between £10,000 and £17,000 for statins or £9,515 for smoking cessation, means that physical activity really does have the potential to be the silver bullet which keeps us all healthy.
According to the Royal Academy of Medical Colleges, physical activity amounts to a “miracle cure” and if it were a drug it would be prescribed to everyone.
So it is of great encouragement to those of us who have long thought that the NHS should take the lead in promoting active lifestyles that activity is becoming a core part of the delivery of health. Well done, Mr Stevens.
Baroness Tanni-Grey Thompson is a crossbench peer in the House of Lords