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January is a difficult month for many of us. It’s dark, cold, wet and the glow of the festive season feels a long time ago.

But it’s also a moment when millions of people make a conscious decision to reset – to move more and invest in their health.

That’s why January matters so much for gyms, swimming pools and leisure centres. It’s consistently their busiest month of the year and not just because of New Year’s resolutions.

But beyond the first month of the year, there is a growing understanding that physical activity is preventative medicine and that a healthy population drives a healthy economy.

The places we move are of critical importance.

Earlier this week, alongside ukactive, I visited three very different facilities in one day – across both the public and private sector.

What struck me was how similar the stories were.

Operators talked about strong footfall, rising memberships and people coming through the doors for more than just exercise.

They’re coming for health, of course – but also for confidence, connection, and support.

This feels vitally important in a time that is characterised by increasing isolation, screens and polarised views.

Spaces open to everybody

Another feature which stood out was the remarkable diversity of the people there – from teenagers arriving in their uniforms after school, to the group of retirees who had originally been referred by the next door hospital and now were coming four days a week (and spending as much time over lunch as in the class).

It was also fantastic to see the level of innovation and use of technology to bring health and leisure closer together – with sophisticated health checks, devising personalised programmes for each individual, linking to 'e-gyms' and other virtual support.

This is the preventative health agenda in action. It’s getting active from the ground up and it sits at the heart of our ambition at Sport England, working with our partners to help millions more people become active.

January brings this ambition to life, but the real story is what’s happening year-round.

The scale and growth of the gym and leisure sector are significant.

The UK Health & Fitness Market Report 2025 shows a record 11.5 million people are now members of a health or fitness club – up 6.1% on the previous year – with 616 million facility visits recorded, an increase of 8.2%.

These are not short-term spikes. Participation has been growing over consecutive years, supported by a unique infrastructure of public, private, large, medium and independent operators working across the country.
 

Sport England’s Active Lives Adults survey 2023-24 reinforces this picture.

Fitness activities and swimming continue to be major drivers of physical activity behind walking, with 904,000 more adults taking part compared to the previous year.

Demand is being driven by what people value most.

Polling from ukactive shows that 77% of members join a gym or leisure facility primarily to improve their mental health and wellbeing.

People also cite better sleep, increased confidence, managing health conditions and making new friends. This is about quality of life, not just physical fitness.

We’re also seeing important shifts in who is taking part. Female participation continues to grow, particularly through group exercise and classes.

Projects like Safer Spaces to Move, delivered with This Girl Can, are helping to remove barriers and make facilities more welcoming and safer for women.

Key community assets

Our latest Moving Communities report shows participation in public leisure has increased for every age group over 45, while gym activity is rising among under-16s, over-65s and people living in the most deprived communities.

Since 2017, the number of children and young people taking part in gym and fitness activity has increased by more than 12%.

Standards matter too. Facilities are improving every year, driven by initiatives such as The Active Standard, Quest and FitCert, ensuring that quality, safety and inclusion keep pace with growing demand.

All of this sits squarely within the Government’s priorities for economic growth and improving the NHS through the 10-year plan.

Health drives wealth and the social value created by being active is immense.

The sector contributes £122.9 billion in social value each year, including £15.9 billion in healthcare savings and £106.9 billion in wellbeing value – the equivalent of £2,600 per active adult – and more than double that for people with long-term health conditions or disabilities.

We gain £6 billion in productivity, thanks to a healthier workforce that takes fewer sick days.

The sector creates £5.7 billion in revenue and supports hundreds of thousands of jobs, many for young people at the start of their working lives.

These are extraordinary numbers.

January is important. But the real opportunity lies beyond it.

Gyms and leisure centres are not just places we go at the start of the year; they – and the people that work in them – are essential community assets, powering healthier lives, stronger communities and a more resilient economy all year round.
 

On 26 November the Chancellor will deliver a much-anticipated budget.

In her pre-budget video message, the Chancellor has described the pressure on the NHS and the challenge of increasing growth, but among all the uncertainty, one thing is clear – finding the right package of measures will not be easy.

Against this backdrop, it feels timely to be publishing an update to our social value of sport and physical activity work. 

The new and expanded information shows what a positive force community sport and physical activity are.

A great cure with many benefits

The health and wellbeing benefits of sport and physical activity are well rehearsed and the UK Chief Medical Officers have previously described physical activity as the closest thing to a “miracle cure”, but based on the information we’ve published today, even that high praise seems to sell its value short.

Here are a few of the headlines from our latest data:

• Sport and physical activity are good for the nation’s wellbeing and health. In 2023/24, the wellbeing value of sport and physical activity was estimated at £107 billion, and it prevented over 3.3 million cases of non-communicable diseases or chronic health conditions ranging from depression to heart disease. 
• A more active nation means a more productive workforce. In 2023/24, £5.8bn of productivity losses due to morbidity were avoided due to sport and physical activity. 
• A more active nation saves the health care system money. In 2023/24, sport and physical activity saved £8bn in direct healthcare costs through disease prevention and reduced use of health services. 
• Community sport and physical activity is a net contributor to the public finances. In 2023, our sector generated tax revenue of £14bn for central government, compared with £2bn of public sector funding. This means community sport and physical made a net fiscal contribution of £12bn.

Furthermore, we know that sport and physical activity is a significant part of the economy. In fact, the Department for Culture Media and Sport’s 2024 Sport Satellite Account for the UK show that the direct contribution of sport and physical activity the English economy was £47 billion of gross value added and supports one million jobs.

So, from a public policy perspective, what’s not to like?!
 

The value of sport and physical activity is significant and wide-ranging but with the right support it could be even greater.

The information published today also includes our estimate of the social cost of inequality in sport and physical activity, that is the amount of social value we miss out on because some groups of people are less likely to be active than others.  

We estimate this to be £19.6bn a year.

Tackling inequality in sport and physical activity, and realising this value, is at the core of our long-term strategy, Uniting the Movement, so I’d like to end by paraphrasing the Chancellor: “I commend the value of sport and physical activity to the House.”

Sport changed my life. I have vivid childhood memories of being driven all over North Yorkshire by my mum and dad.

We spent our Saturdays going from one brilliant and unique cricket ground to another, and I can still hear those echoes of leather on willow when I see them today.

Those weekends set off a lifelong love affair with cricket and the county I’m proud to call home, and even more proud to represent every day as a Mayor of York and North Yorkshire.

Everyone should have the same opportunities to get moving that I did, and that is why I am proud to launch the £2.75 million Movement, Activity and Sport fund.

Bringing the joy of movement to everybody

This is the first of the funds to be launched under my Moving Forward campaign and we are working closely with partners to make sure this investment targets support for those who need it most.

Beyond the health benefits, there aren’t many better ways provided by sport and physical activity to meet new people and build strong relationships in our local communities.

However, this is particularly key in our rural and coastal areas, where there are some pockets of real deprivation.

Too often families cannot get over the hurdle of costly cricket bats, football kits or transport to games, which means that those who would benefit the most aren’t able to get involved.

But by funding activities for those who might otherwise turn to anti-social behaviour, we can change lives and make our towns and villages a better place to live.
 

Our research tells us that over 30% of adults are classed as physically inactive, meaning they do less than 30 minutes of exercise a week, and that over 60% are overweight or obese, increasing the risk of long-term health conditions.

But this reality can be turned, and early intervention and prevention can make a big difference.

We can help that by making positive choices like introducing physical activity in our day to day, by considering more walking, wheeling and cycling for our working commute or to meet up with friends.

We are moving in the right direction, but there’s still so much more work to do!

After years of being ignored or minimised, women’s sport is getting the recognition it deserves with success after success for our national rugby and football teams, but girls still don’t get the same opportunity to get moving when compared to boys.

Moving forward together 

I have seen that first hand, because while my son had the pick of so many football clubs, we struggled to find one for our daughter. How can that be happening in 2025?

This plays out with so many families across the region and the UK every year, and it’s a big reason why girls are more likely to stop playing sport when they become teenagers. But we can also change that.

By enhancing skills development and training in the sector, alongside offering more inclusive activities, we will also tackle the barriers that people with disabilities face.

Disabled people are almost twice as likely to be physically inactive, but by working together with our partners we can start to improve those numbers and change lives.

My Moving Forward campaign is about backing people across our region to build the healthy and thriving communities they deserve. 

I believe in the power of our communities, the people and local organisations that keep them going.  

Our work is made so much easier thanks to the support of our strategic partners, including North Yorkshire Sport and the Place Universal Offer from Sport England and I’m truly excited about these, because together we can achieve so much more!

The best part of my job is seeing the huge impact that hard-working groups have on their neighbourhoods.

They know what they need, and we will work with them every step of the way as we continue Moving Forward together.
 

When most people picture senior Black men, they don’t immediately see us smashing forehand drives, diving for edge-of-the-table shots or celebrating doubles-wins with a triumphant chest bump (yes, it happens!).

But step inside an Over 50s Black Men Forum Table Tennis Centre and you’ll quickly realise that the sport is not just a pastime – it is medicine. It is therapy. And it is comedy.

A ping-pong ball, we often say, can travel faster than a GP appointment letter, making these centres our hidden health clubs.

But behind the rallies and the laughter, there is serious work underway.

A man that had survived a stroke mentioned that, as well as camaraderie and encouragement, table tennis had helped him physically by helping him improve hand-eye coordination, building his confidence and combating post-stroke fatigue.

These voices remind us that this forum is more than sport. It is hope, dignity, recovery and community.

Rewriting the narrative

Black History Month is here and the importance of rewriting health inequality narratives becomes even clearer.

Too often older Black men are described as "hard to reach”, but our response is simple: “we are not hard to reach; we are not being seen”.

The reality is stark – Black men in the UK shoulder a disproportionate burden of chronic disease.

Rates of hypertension, cardiovascular disease (CVD) and type 2 diabetes remain consistently higher than those of their White counterparts.

And we can’t forget that Black men are also more at risk of prostate cancer, so it's always a good idea to use Prostate Cancer UK’s risk-checker.

These inequalities are deeply rooted and cannot be resolved overnight, yet the work of the Over 50s Black Men Forum shows what is possible when solutions are shaped by, and for, the community.

By creating culturally-relevant, community-led, spaces we have not only encouraged men to take part in sport, but also to engage in their own health and wellbeing.

They arrive for the table tennis, but they return with their friends and, together, they build something far greater than the game itself: a hidden health club where camaraderie, wellness and dignity thrive.

Our first regional competition

This September, we hosted the UK’s first Older Black Men Community Table Tennis Competition, bringing nearly 70 men together from Essex and Bedfordshire. The atmosphere was electric!

Chelmsford proudly lifted the singles trophy, while Luton triumphed in the doubles. There were cheers, groans and more than one disputed line call.

Even Westminster took notice and Sarah Owen, MP for Luton North, celebrated her local players with a shout-out in Parliament.

Table Tennis England joined us in the hall, the Mayor of Luton presented trophies and the Sport England logo stood proudly across the venue.

It was more than a competition; it was a statement that older Black men belong in the story of sport, health and community.

Serving the future

We are proud of what has been built so far, with seven hubs running and more on the way. But this is just the beginning.

Our vision is to embed these centres nationwide, creating a network where sport and health go hand-in-hand for older Black men.

And the best part? The model is replicable!

What works in Luton can work in Leeds and what works in Southend can work in Sheffield, because at its core, this is not just about table tennis.

It is about dignity, community and the belief that everyone deserves the chance to live longer, healthier and happier lives.
 

Imagine a world where physical activity behaviours are as routinely discussed within your NHS consultations as smoking, or 'prescribed' as routinely as medications.

One where your healthcare professional (HCP) helps connect you into ways of being active that work for you.

That’s the aim of the work we are doing with our health and physical activity partners, through our Uniting the Movement strategy, to strengthen the connections between sport and physical activity, and health and wellbeing.  

Through cross-sector collaboration we’re enabling the conditions for systemic change, the spread and scale of effective interventions and a coherent joined-up movement for change.

Working together for people's wellbeing

The NHS is one of the most trusted sources of physical activity advice for people with long-term health conditions and for disabled people who, according to our latest Active Lives Adult survey, are almost twice as likely to be inactive than those without health conditions or disability.

Modelling undertaken by our health team, using Active Lives data and the social value of sport and physical activity data, concluded that supporting the one in four people who say they would be more active if advised to do so by HCPs would mean 2.9 million fewer inactive adults and 550,000 fewer less-active children and young people in England, saving up to £0.9 billion from the healthcare system.

The answer to the riddle in the title is easy – sport and physical activity.

At Sport England we’re always talking about the benefits of being active, but for nerds like me, the past few months have provided a particular treasure trove of data about the social and economic value of sport and physical activity.

And then on 1 October 2024, DCMS published a new Sport Satellite Account for the UK.

The positive ripple effect of being active

This revealed that during 2021, the combined economic impact of sport (direct and supply chain – including the production of sports equipment and apparel, the construction and maintenance of sports facilities or their marketing services) was equivalent to £83.1 billion, or 4.1% of the UK’s productivity (gross value added).

The document also showed that every £1 invested in sport generates £1.55 as gross value added in the economy.

A few weeks later we published the results of our new research on the social value of community sport and physical activity, revealing that in 2022/23 the social value of sport and physical activity in England was £107.2b.

This value consists of the individual wellbeing benefits of sport and physical activity (both participation and volunteering) and the wider health benefits of a more active population.

However, the report also highlighted the £15.6b of social value that we are missing out on due to inequality in sport and physical activity, and how the value of being physically active is greater for some of those who are least likely to be active, like adults with a disability or living with a long-term health condition.

When looking at creating inclusive opportunities for disabled people in our sector a lot of focus falls on participation, but fairness for this group of people applies to its workforce too.

For years our Annual Disability and Activity Survey has shown disabled people as underrepresented in our sector’s workforce. 

Understanding what needs to change 

The 2023-24 edition revealed that disabled people are half as likely to see ‘people like me’ working in sport and physical activity compared to their non-disabled peers, and that only 9% of disabled people agreed they have the opportunity to become a coach or take on a role in delivering sport or physical activity compared to 24% of non-disabled people.

Off the back of these concerning figures, we commissioned a research project to explore the barriers and enablers for disabled people to work in our sector.

The final report has now been published on our website and is fascinating reading for anyone working in sport and physical activity.

Initial findings showed that there are limited sources of data and that most of the insights were very high level, identifying barriers such as negative attitudes towards disabled people. 

However, the evidence to help understand these in more detail was limited and while national disability employment statistics delved into specific impairments, these were not broken down to reflect the reality in our sector.

Some research considered other marginalised groups in the sport and physical activity workforce, but did not take an intersectional perspective and treated each identity in isolation.

Coverage of enablers and barriers to disabled people’s participation in the sport workforce was limited, tending to offer a wider commentary reflecting statistics, rather than personal perspectives of disabled people. Only a handful of sources provided some insights, which helped us structure the primary research design and interview questions.

Two of these were Aspire’s EmployAbility Guides and ukactive’s Everyone Can initiative.

Based on initial findings we decided to carry out in-depth interviews to understand the barriers and enablers experienced by disabled people in the professional world, and to develop recommendations that would make a real difference.

Interviewees shared personal stories with examples of both good and bad practices, including a personal trainer who had to hear that the reasonable adjustments put in place to help them do their job were perceived as ‘unfair’ by a colleague.

The need for further change

Accessible application processes, upfront information about roles or inclusive approaches to interviews (for example, choice of video or in-person) made a real difference and gave many the opportunity to consider a role.

To truly understand the reality of employment for disabled people in sport and physical activity, the report should be viewed as a whole and organisations should take a person-centred approach to ensure people can apply and remain as part of our sector’s workforce.

We published three key headline recommendations:

• Adopt a ‘flexible by default’ approach to job roles. Normalise adaptations and consider flexibility beyond whether the employee could choose their hours to include how adjustments could be made across the wider team. For example could the disabled employee do certain tasks while a non-disabled colleague picks up others?

• Provide advice and guidance for employing disabled people. There is a clear need for an effective source of advice and guidance for employers to turn good intentions into action and organisations should aim to create a culture that values - and is informed by - diverse voices and experiences.

• Proactively identify and remove barriers that exist at all stages of the 'work journey'.
  In our research we tried to break down this path into different stages to explore barriers and enablers at each point, but it became clear that many challenges recurred throughout. Employers need to provide clear information about their available role using diverse and suitable communication platforms. They need to learn continually and listen to their disabled staff continually. A good way to achieve this is employing disabled consultants to identify and remove barriers through an inclusive culture.

Organisations who were seen to be committed to inclusion appealed to participants, but the main conclusion to take from the report is clear: there is still a lot of work to be done in creating equal opportunities for all and there’s an urgent need for the sport and physical activity sector to address recruitment and retention strategies.

We hope that in highlighting real-life experiences we can shine a light on both the good, the bad and on the way forward.

There is undoubtedly a desire in the sector to ensure disabled people do not have to overcome barriers to enter the workforce and we firmly believe that this piece of research could be a key tool to unlocking those opportunities.

The EmployAbility Leisure project was launched in 2022 to develop guidance and structure to inspire and support more disabled people to find a job in the sport, physical activity and leisure workforce.

This project was initially led by Aspire, funded by Sport England and supported by a coalition of national organisations (Activity Alliance, CIMSPA, Community Leisure UK, EMD UK, ukactive, UK Coaching) academics (Professor Brett Smith and Dr Juliette Stebbings) and disabled professionals (Michelle Felix, Lee Welch and Sam James).

The project is now taken forward by the coalition of partners and together we promote and support careers in the sector as an attractive and achievable option for disabled people.

We have also seen changes with training providers and employers who are adopting recruitment strategies – including outreach to disabled communities, schools and colleges, offering job-shadowing opportunities in their organisations, trial commute runs and ‘get-to-know-your-colleagues’ lunches – and inclusion policies and are actively collecting more demographic data about their employees.

However, while this good practice is happening, the report concluded that the sector is not yet doing enough to consistently promote and utilise the EmployAbility Leisure Guides and to support the training and employment of disabled people in a collaborative way.

Plus the results of the Annual Disability and Activity Survey (2023-24) by Activity Alliance says that disabled people are more than half as likely to ‘see people like me’ participating, working, and volunteering in sport and physical activity (17% disabled people vs. 43% non-disabled people).

So there's still work to be done.

Next steps

At present our group has made a commitment to keep working collaboratively to achieve sustainable change in the UK’s physical activity and leisure sector to get more disabled people into their workforce.

In the last 12 months we have developed a new Terms of Reference for the group with a new focus and have discussed the learning from the original project.

We are now putting together an action plan, using the learning from the past two years, to guide us – and the sector – forward.

The new aims the group include:

• keep promoting careers in the sector as an attractive and achievable option for disabled people
• building confidence and knowledge within the workforce with regards to working with disabled people as employees
• developing more inclusive and accessible internal cultures across training, education and employer organisations.

I know that there is a lot of work that still needs to be done and I’m certain that, under the guidance of Activity Alliance (who’ll chair the group in 2025), our group will make great progress in the year ahead.

I invite anyone interested in this work to use the EmployAbility guides and to get in touch to be more involved on a strategic level.

We look forward to hearing from you, so please send us your questions or any interesting case study that you think we should be aware of.

Let's work together so the sport, physical activity and leisure sector improves its efforts to offer suitable work opportunities to everybody. 
 

Health has never been higher on the nation’s agenda and if this was ever in doubt, the launch of the government’s consultation to build a health service fit for the future confirms this.

Their ambitions are clear and aim to move health care ‘from the hospital to community’ and for us at the Active Partnerships network, this is high on our agenda too. 

Unfortunately we also know that our health and care systems are under huge pressure.

According to the Richmond Group of Charities, more than 14 million adults in England live with two or more long-term health conditions. That’s one in four of us and as an ageing population this number is set to grow.

We believe that wealth will be built through health, as people leading active lives turbo-charge our wellbeing and help to prevent and manage illness, saving the NHS billions and thereby boosting economic growth.

Backing this statement is Sport England’s latest social value of sport and physical activity report, which found that being active relieves some of the NHS burden by preventing 1.3 million cases of depression, 600,000 cases of diabetes and 57,000 of dementia. 

Being left out of sport from a young age just because you’re disabled sounds like something out of a dystopian novel and yet, sadly, this isn’t fiction but the reality of too many disabled children in the United Kingdom today.

This can look like a local park without specialist play equipment, a school PE teacher who lacks the knowledge to adapt sport for disabled pupils or a sports centre without accessible sessions.

As we celebrate Disability History Month and the International Day of Persons with Disabilities, which took place earlier this week, I would like to consign this woeful state of affairs to history, where it belongs.

Guidance from the UK’s Chief Medical Officers says that disabled children and young people should be doing 20 minutes of daily exercise, as well as doing strength and balance activities three times a week. But how can they achieve this with the odds stacked so heavily against them?

Sport England’s own research reveals that disabled people are twice as likely to be physically inactive as non-disabled people. Hardly surprising given their lack of opportunities to get active.

Locking us all firmly in sport

The side-lining of disabled people from sport and physical activity goes to the heart of why I founded my charity.

It was while I was volunteering for a disability charity myself, that I noticed gaps in the provision for disabled people.
 

Put simply, most schools, colleges and community groups were just not providing inclusive sports activities.

I wanted that to change, so I decided to create my own inclusive activity sessions, working with a range of organisations and teaching coaches how to run sports sessions so that no one was left out. 

My idea grew and 11 years ago I founded my own charity, Disability Sports Coach (DSC), running London-wide inclusive community sports clubs.

Without our clubs, members are locked out of sport.

Many cannot access gyms or leisure centres independently and it’s not just the physical barriers to participation – our members need a friendly, calm and accepting environment in which to exercise.

DSC also offers coaching and training services as it’s vital there are opportunities to play inclusive sport in schools, colleges and community groups.

That’s where our expert coaches come in – they go on site and teach the techniques of how to adapt sport for every impairment.

Our training courses help coaches and teachers to improve their knowledge of disability sport and how to deliver it.

Using my experiences as motivators

My work has been driven by my own personal challenges and experiences of being on the sidelines.

I have a severe stammer and dyslexia, which led me to experience bullying at school and in the workplace.

At one stage I was rejected at 39 interviews while looking for a job in sports development.

None of this has stopped me from pursuing my mission of levelling the playing field for disabled people in sport.

Now I’m proud to say that since DSC was founded, we have empowered more than 21,000 disabled people and their families through inclusive sport and physical activity.

We’ve also just introduced an exciting programme that is changing lives through sport – Inclusive Activity Leaders –  a free initiative in partnership with Nike to train disabled and non-disabled people side-by-side to qualify as sports coaches.

DSC has employed disabled programme graduates to coach in its community clubs with great success. Our graduated coaches get a paid job and become great role models for members. It’s a win-win!

The power of Paris

Forming partnerships is an effective way of broadening our reach.

We collaborate with national sports organisations and we link up with specialists when needed, such as delivering our first aid training.

This year it’s been great to see the Paris 2024 Paralympic Games shine a much-needed spotlight on disability sport.

ParalympicsGB is spearheading its #EqualPlay campaign to ensure that disabled children have the same access to PE at school as non-disabled children.

Their research reveals that just one in four disabled children say they take part in school sport.

As a society we need to ask the question ‘are we doing enough to ensure that sport and physical activity is accessible for disabled people?' And if the answer is no, we need to do more.

We must right the wrongs and ensure that disabled people are no longer left on the sidelines of sport.

History will be the judge of our efforts.

In February 2024, Move Consulting teamed up with the Active Partnership National Organisation (APNO) to lead an exciting project funded by Sport England to develop national guidance for creating physical activity for health pathways.

But what exactly is a Physical Activity for Health Pathway?

The term 'pathway' highlights how local organisations connect, using their resources to support the community.

Our goal is to figure out how to enhance collaboration between the health and physical activity sectors ensuring that everyone can access the support they need to be more active in ways that suit them.

Meeting needs through collaboration

We know that one in four people in the UK are living with one or more long-term health conditions, and that this audience is twice as likely to be inactive compared to those in good health.

This is why it’s important to provide clear and accessible support to ensure that those who may benefit the most from engaging with activity are able to do so in a way that works for them.

We also recognise the influence health and care professionals can have on this audience, because studies show that one in four patients would be more likely to be active if their GP or nurse encouraged them.

This highlights the need to empower health professionals and others to guide people on physical activity options and to signpost them to opportunities or to make referrals where appropriate.

From our discussions with the health sector, we’ve noticed inconsistent engagement with physical activity as a solution.

Common challenges include a lack of awareness of local offerings, limited referral options and capacity issues within existing services.

As highlighted in the Easier to be Active resource developed by Sheffield Hallam University in partnership with Sport England, there is a need to support better collaboration between the health and physical activity sectors.

The development of physical activity for health pathways can form part of the solution. 

From consistent approaches and raising awareness to increased systematic change achieved through greater collaboration in service provision, we can unlock valuable resources in our communities and better meet the needs of those living with, or at risk of, long-term health conditions.

A broader approach

Throughout our work to date, there have been calls for innovation and flexibility in how the system operates and while there are pockets of innovation across the country, it’s essential that we expand the offer and our approaches. 

Take Exercise on Referral – this long-standing model connects people with qualified fitness professionals, typically in a gym setting.

While it can be effective, it doesn’t really work for everyone, so we need to consider whether we’ve fallen into a one-size-fits-all approach or what nuances to the model are being made, if any.

The conversation around 'risks' and physical activity has also evolved significantly over the past year.

The 2021 Consensus Statement still resonates, emphasising that the benefits outweigh the risks when it comes to being active with a long-term health condition.

Ongoing work from the Faculty for Sport and Exercise Medicine (FSEM) is helping reshape how we view risk, encouraging a model of medical guidance to complement an emphasis on patient-centred care, rather than medical clearance.

In other words, we want to empower people to make informed choices about being active.

Consistency is key

We’ve known for years that physical activity is beneficial for people’s physical and mental wellbeing, yet we’re still not harnessing its full potential.

To create effective pathways, we need more consistency in how they’re designed and we’re curious to identify common considerations being implemented across the board.

One area that often lacks consistency is behavioural change support.

Many view this as a simple step from inactivity to activity but it actually involves navigating a complex array of behaviours.

We need to support individuals as they incorporate activity into their lives in ways that feel right for them and this is more than just adding programmes.

It’s about meaningful engagement and shaping solutions with people, not for them.

Shaping the future together – get involved

Collaboration and co-design are at the heart of our approach.

We’re partnering with stakeholders like NHS Horizons, the Office for Health Improvement and Disparities (OHID) and the Chartered Institute for the Management of Sport and Physical Activity (CIMSPA).

Our community of practice groups consist of 39 organisations, bringing together voices from the Active Partnership network and other sectors.

We’re also reaching out through sector-wide surveys to gather insights and share best practices.

Our current Pathways Perspectives survey focuses on behavioural change support and is open until the end of November 2024.

We’d love your input, so please complete the survey and share your experiences.

Stay informed

Want to learn more about the Physical Activity for Health Pathways project?

Visit us our website or our LinkedIn profile, or sign up to our monthly Move newsletter to stay in the loop.
 

World Mental Health Day brings a welcome opportunity to shine a light on mental health awareness.

With mental health issues on the rise, action is needed now.

But how can we deliver this change through a system that, as outlined by the Darzi report, is on its knees after years of neglect?

This is the genuine challenge that the Government and policymakers face, and while work on the future of the NHS continues, I believe we still have an incredible opportunity – through sport and physical activity – to deliver real change for mental health outcomes.  

Earlier this week I sponsored a roundtable meeting in Parliament which focused on the role of physical activity in supporting improved mental health – and how the healthcare system can do more to support people to be active as part of their treatment. 

The evidence shows that being active has a profoundly positive impact on mental health. New research from an upcoming Sport England report has found that in 2022/2023, 1.3 million cases of depression were prevented through active lifestyles.

And being active can save our services money too; the report also calculated that reduced mental health service usage, thanks to sport and physical activity, saved £780 million. 

The annual Active Lives Survey demonstrates a clear positive link between activity levels and mental wellbeing.

While some activity is good, more is better.
 

Adults with higher wellbeing scores and without a diagnosed mental health condition are more likely to be active than others.

In fact, nearly two thirds of people (65%) without a mental health condition are active – but just over half (53%) with a mental health condition are active. 

The NHS, despite the challenges it faces, remains a deeply trusted organisation; more than half of adults say they look to the NHS for advice on how to be active.

Our health system and the dedicated people that run it is uniquely placed to support and encourage people to be active, and to empower them to enjoy better mental health.

In fact, nearly all (99%) of NHS Talking Therapy staff – those at the forefront of helping patients – say physical activity is important in improving outcomes for people with common mental health conditions, like anxiety. 

So, what can the healthcare system do to improve mental health?

As was done in Parliament yesterday, with a cohort of experts and leaders coming together, better connecting the health system with the sport and physical activity sector is a welcome start. 

From there, we can build meaningful change.

Every interaction with the health system should be seized upon as an opportunity to encourage people experiencing poor mental health to be active. 

We can train clinicians to routinely talk about physical activity within their practices and connect community exercise and activity groups with local health services – particularly in communities that are more like to report poor mental wellbeing. 

We can prioritise and integrate physical activity within mental health prevention and treatment pathways and plans, making it as important as other forms of intervention.

We can encourage and normalise active working cultures so that everyone has the opportunity to be active in their daily life.

When I was a junior doctor, I developed a passion for keeping people well.

When my colleagues were interested in mending a broken bone, I wanted to know how we could stop it breaking in the first place. 

We do not have to accept poor mental health as inevitable.

More movement, more often, to protect mental health from being broken, is my priority as an MP and I will do all I can to deliver this.
 

We’re in the middle of a mental health crisis.

Two million people are currently stuck on waiting lists for NHS mental health services and, on top of this, the stigma associated with mental health is still a significant issue that sees real people with mental health problems being left behind by a broken mental health system.

They need support now. Not in six months’ time. Not in a year. Now. So this World Mental Health Day, we’re asking you to join the fight for mental health.

A united front for mental health

At Mind – and across our network of over 100 local Minds (independent charities in local communities across England and Wales) – we provide a range of services and support for people experiencing mental health problems.

On our own we can’t reach everyone – the scale of the challenge is huge – but with political and systemic change, we can create a future where no mind is left behind, and that's why we've chosen this as the title this year's campaign.

Given the strength of evidence the role sport and physical activity can play in the treatment of many mental health problems, this sector can be part of the solution alongside medication, talking therapies and peer support.

Energised by the Mental Health Charter for Sport and Recreation and Uniting the Movement, along with campaigns such as We Are Undefeatable, the sector is already delivering programmes across the whole of the mental health spectrum – from prevention to recovery – with the potential to do more.

But for the sport and physical activity sector to be able to support the increased demand for mental health services, it needs to show it is safe and effective.

Not just physically, but psychologically too, with the mental health and wellbeing of everyone involved being front and centre.
 

There are many examples from clubs on how to do this well, with informal support such as check-ins and peer networks for deliverers, or more formal support such as values-based recruitment, regular supervision and peer reflection.

But this isn’t consistent everywhere.

There are examples where physical activity deliverers don’t have the skills, knowledge, confidence or help from their organisations to safely and effectively support mental health.

We want to support the whole sector to embed the very best practices and learn from one another, so that the strong skills, knowledge and confidence to safely and effectively support the mental health of both the workforce and participants is the norm.

Sadly, mental health problems are more prevalent in the sector’s workforce than the wider working population, with studies showing approximately one in four – or even as much as 44% of the sector are experiencing mental health problems – compared to one in six people in the wider working population.

To help organisations better support their workforce, we are co-designing guidance on how to safely and effectively support the mental health of both participants and the workforce across sport, physical activity and movement settings.

We hope this will contribute to strengthening the trust and connection between mental health services and community sport and physical activity.

What we’re doing

We’ve taken practical steps to make this endeavour come true and have brought together stakeholders to explore current practices.

People with lived experience of mental health problems are at the heart of this (both adults and young people) along with frontline coaches and deliverers.

Over 44 sport sector organisations and 36 mental health organisations have taken part so far.

We’ve hosted focus groups, workshops and interviews to understand what good practice looks like and what support is available to participants and the workforce in:

• community open sessions (e.g. sessions in leisure centres, parks and community settings)
• community targeted ‘mental health’ sessions (e.g. walk & talk sessions, mental wellbeing football)
• primary care sessions (e.g. targeted ‘mental health’ social prescribing activities or physical activity delivered alongside NHS Talking Therapies)
• secondary care sessions (e.g. community and inpatient physical activity sessions).

What’s coming next?

We’re in the process of playing back what we’ve heard through the co-design process and refining the guidance based on feedback.

We’re also working with colleagues in the health sector to understand how this guidance fits with their own policy and practices, and we plan to launch the recommendations and supporting resources in 2025.

We’re also working with organisations such as the Chartered Institute for Sport and Physical Activity (CIMSPA) and Sport England to identify how we can support the sector to adopt this guidance.

With increasing demands on mental health services, physical activity and movement could help ease the pressure on the NHS, but it can only work if it’s safe and effective for everybody – not just for the people accessing the activities, but also for those delivering it.

Please feel free to reach out if you want to hear more about this or any other of our projects.

My name is Ahsan and I want to share my story because I want more people to join Mixed Ability sports and be active, especially Asian people.

I was born and live in Bradford. I went to a mainstream school where they said I have a learning disability. I’m also partially deaf with mild cerebral palsy, which affects my balance sometimes.

When I left school, I went to a local college but couldn’t find any work and ended up staying at home every day.

Opening doors for my community

In 2008 I attended an adult class to learn about social skills and I found out about an opportunity to do sport with the Mixed Ability rugby team at a local rugby club.

My mum started to give me lifts there and take me to the training, but after a while I learned to travel independently to the ground.

I was the first Asian player with a learning disability and the first Asian playing rugby union in my community.

It was very clear for people in ancient Rome – there’s a direct link between our mental and our physical health or as they said: "Mens sana in corpore sano."

Fast forward a few centuries and in honour of Mental Health Awareness Week, today we’re releasing a special new report – 'Understanding the impact of movement on the nation’s mental health and wellbeing’ – which deep-dives into the connection between being and feeling well.

Because after years working in our sector, this week’s recognition is a real cause for celebration; a true appreciation of the decades of growing and building the evidence-base for the role that sport and physical activity can play in supporting our mental wellness.

Report headlines from our Active Lives Adult Survey

The release of our latest Active Lives report shows a mixed picture of the relation between physical and mental strength.

On the one hand we continue to see a positive association between activity levels and mental wellbeing indicators – a well-established survey trend since the 2016-17 survey.  

More activity (150 minutes of moderate intensity per week) correlates with higher mental wellbeing and conversely lower levels of anxiety.
 

But on the other hand, the Covid-19 pandemic and the cost-of-living crisis have had a long-lasting impact on the nation's mental wellbeing and there has been a general drop in average scores across all indicators of mental wellbeing.

These have yet to recover to baseline levels from 2016-17 and in particular for two of these markers ('happiness' and 'life worthwhileness'), the decrease in wellbeing is almost twice as great for the inactive versus the active.

Our data also shows that poor mental wellbeing disproportionately affects individuals who are physically inactive – younger adults (aged 16-34), women, individuals with non-binary or self-described gender identities, people with disabilities or long-term health conditions, specific ethnicities, people living in areas of greater deprivation and those from lower socioeconomic backgrounds.

Delving deeper into the attitudes towards sport and physical activity to support our mental health, 25% of adults strongly agree and 44% agree that it is important to exercise for their mental health.

But while this is promising, 11% do not take up sport and physical activity in supporting their mental wellbeing.

There is moderate recognition of the benefits that moving more has on sleep, mood and the prevention and management of long-term health conditions.

But less so of the importance of movement in helping people worry less and its value in supporting people to be social.

This attitudinal insight suggests there’s still work to be done in public messaging to improve the awareness and knowledge of the role movement as a tool to support mental wellness.

Children and young people's trends

In the latest Active Lives Children and Young People Survey, just like in the adult's one, findings too reveal a positive association between levels of engagement in sport and physical activity and mental wellbeing.

In short – children who are active also feel happier and more resilient.

However, the latest data shows an overall long-term decline in average mental wellbeing scores for secondary school children compared to the 2017-18 survey.

This trend was driven by the lower-age secondary children (Years 7-8), while upper-age secondary children (Years 9-11) showed recovery to their baseline levels in the last 12 months.

The State of the Youth Nation survey further delved into attitudes for approximately 1,000 children and young people aged 16-24.

The study reported that 62% of young people overall agreed that physical activity is important to them in supporting their mental health and wellbeing – an opinion that’s more popular among young women than young men.

So, if we support children and young people to have a meaningful relationship with movement and physical activity, this will positively contribute to their mental wellbeing later on in their lives.

Working together for better results 

The evidence is there, so what could help us get to a place in the future where more people recognise the value of movement for their mental and physical wellness?

Unfortunately, there is no silver bullet here.

But I do think some of the answers lie in raising awareness and increasing the profile of movement as a tool that can support self-nourishment and care within public health messaging.

This should be accompanied by a joined effort that goes beyond our sector, so together we fly the flag for the role of movement in supporting mental health.

But what else could we do?

I think there are a series of important actions that we can do to strengthen that trust and collaborative working among sectors. These include:

• moving forward as one, strengthening and better connecting with the health system both around the prevention and management of health conditions and diseases
• getting tighter on return on investment, as well as being clearer on how to do this at scale and with ease
• further understanding the barriers for those who are most inactive and at risk of mental health challenges, plus learning more about what supports these groups' needs
• exploring the policy blockers that prevent many from leading an active lifestyle and advocating as a greater voice for key enablers locally and nationally.

Today, I started with a reference to the Romans but we don’t need to go back so far in time to prove that they were right, as we have plenty of modern evidence that proves the role between moving more and feeling better.

Now let's work together so the message gets clearer and everyone can reap the benefits that an active lifestyle can bring.

The problem is that lots of people feel they do not have the opportunity to lead an active life, despite wanting to.

Many of us face barriers to moving such as living with long-term health conditions, caring responsibilities, financial constraints, work commitments and desk-anchored jobs.

So we want to show easy ways for everyone to find a way to be active and that’s what our aim has been with Get Moving.  

The page has been updated with with lots of inspirational ideas to help people move more as a way to support their mental health.

These include tips, guidance and advice on how to keep or start getting active, with activities for both indoors and outdoors, ones the inspire family fun, challenges and more.

Every movement counts

We know that children and young people (5-18 years of age) need to be active for an average of at least 60 minutes per day across the week, whereas adults need at least 150 minutes of moderate intensity activity a week, or 75 minutes of vigorous intensity action a week.

It may sound like a lot, but we often neglect the little things we can all do, day-to-day, that really count towards that important quota of daily exercise.

It's what we call the moments for movement. 

Easy ways of getting active to help boost people's mental wellbeing, daily, because – paraphrasing one of the most influential slogans of our time – every movement counts.

This could be anything from dancing in the kitchen to your favourite song, to ditching the car at the school drop-off/pick-up and scoot or walk instead.

It could also be encouraging your colleagues to try a walking meeting to get away from the desk and breathe in some fresh air (and hopefully get a bit of sunshine too!) or trying a short run over lunchtime.

So many people swear by it as it gives them a shot of energy and it gets their creative and focus juices flowing.

#MomentsForMovement

Going back to our proud collaboration with Mental Health Awareness Week, there will be lots taking place across those seven days.

We would love for you all to get involved, encouraging your partners, community groups, colleagues and family members to find new ways of moving more in our daily lives.

And this is when the beauty of social media comes along!

Think of tips and ideas of how to get active, including local activities that may inspire other places to do something similar, and talk about why our mental health is important.

We ask that you capture those active moments with photos or videos and that you share them on social media with #MomentsForMovement.

To help spread the word, the Mental Health Foundation have created new assets for anyone to use, including logos, images and editorial copy that can be downloaded for free.

Every day in Mental Health Awareness Week we will be exploring different themes via our social channels and we would love for sector partners to align planned comms where possible so we can make the biggest collective impact.

The themes for each day of the Week will be:

• Monday 13 May: Moments for Movement 
• Tuesday 14 May: Our workforce
• Wednesday 15 May: Active Travel 
• Thursday 16 May: Green and blue spaces 
• Friday 17 May: Children and Young People.

Please encourage your partners, colleagues and relevant clubs and sport organisations to join in too. 

I can’t really wait for May, and while I may not be ready for a lunch run just yet, I think I’m going to try those walking meetings, even if it’s around the house – until the rain stops.

Any day now, I’m sure.

I joined the charity in 2018 and embarked on a very steep learning curve, with lot to do and a lot of people to meet. 

Many barriers, like access to transport, cost of sessions and a lack of trained and condition-aware activity providers, are common across the sector and the wider population. 

But after one person with Parkinson’s described the condition as "like having permanent jet lag, alongside tremors, freezing, falling, anxiety and depression", you begin to understand that it’s not just as simple as helping someone get to a gym.

It’s fair to say that back in 2018 our understanding of the benefits of being active was limited (to say the least). 

As a charity we supported a lot of local activity sessions but we lacked a strategic approach, resources and dedicated staff. 

Fast forward to 2024 and thankfully, we’re seeing a very different picture.

Get active, stay active

Physical activity and our ‘Get Active Stay Active’ strategy is a priority for the charity. We wrote a strategy to elevate our delivery from regional to national, and united colleagues from across the charity, healthcare and activity professions and the Parkinson’s community.

We have a dedicated physical activity staff team, a UK-wide grants programme, support for innovative partner-led pilots, education and training for providers, and a wide range of new guides, booklets, courses, videos and support for the collective Parkinson’s community.

Support from Sport England has been at the centre of this development and allowed us to put this new strategy into practice, translating the needs of the Parkinson’s community into on-the-ground delivery.

From that original small pilot project called 'Parkinson’s Power', we managed to demonstrate not only the value of our work, but its potential. 

With enthusiastic support from our CEO Caroline Rassell and chair Gary Shaughnessy, by 2023 Get Active Stay Active was born.

Research into the benefits of being active with the condition has also accelerated. 

Why movement helps people with Parkinson's

The benefits of being active are widely known, but for people with Parkinson’s movement can slow down both the progression of symptoms and the medication intake.

But we also know that individuals' relationship with exercise is different, so we focus on providing options for everyone, so they can choose between being active alone, in groups, at home or at organised sessions.

As a charity we lead the way in funding and supporting research to find a cure and develop new treatments, but we also know how important it is to help people right now, moving beyond a strategy and delivering for the people we represent.

Get Active Stay Active funds hundreds of physical activity projects around the country, including supporting individual providers, local authorities, active partnerships and prominent sports clubs like Leeds Rhinos or Arsenal FC. 

We’ve secured free gym memberships and activity sessions for people with Parkinson’s and their carers, and trained and educated hundreds of activity providers, leisure centre staff and volunteers, so people with Parkinson’s can go to the gym, play table tennis, swim, take part in walking football or dance. 

They are supported by trained providers who, through their expertise, help people with the condition stay at work, tie shoelaces, sleep better and steadily hold a cup of tea.

It also increases understanding about the need for moderate to vigorous intensity, the value of varied exercise and the benefits outdoors activity and with other people.
 

A few years ago a colleague and I visited a non-contact boxing session in Manchester and met a couple who had travelled from Leeds to take part, which they did weekly. 

They walked into the class (led by Tommy, who has Parkinson’s) with determination and obvious Parkinson’s symptoms. 

An hour later they left dripping with sweat and big smiles on their faces, but not a hint of Parkinson’s between them. 

That’s how powerful being active with Parkinson’s is. 

That’s why Sport England and Parkinson’s UK have invested in our physical activity strategy and why our ambition is to support everyone with Parkinson’s to become and stay active.

I’ll close with another quote, this time from someone who, after a lifetime of inactivity, embraced being active when diagnosed and never looked back.

"Being physically active has changed my life with Parkinson’s. I feel back in control."
 

For us, co-production is at the heart of the work that we do, so we support people with lived experience of mental ill-health, which we call 'Experts by Experience' or EbEs, to work in equal partnership with healthcare professionals or professionals in other relevant fields, ‘Experts by Training’ (EbT), so together they can come up with effective solutions.

What we’ve learnt

One impactful outcome of our partnership with Sport England is the design and dissemination of a questionnaire co-designed with EbEs.

The questionnaire, based on the Theoretical Domains Framework, examined the emotional barriers, environmental context and resources, social influence and beliefs about the consequences and capabilities, with respect to engaging in physical activity.

A great example of how barriers and enablers interact with a person moving appeared when one of our EbEs mentioned how a change in financial circumstances meant she had to join a different gym to reduce costs (environmental context barrier).

She didn’t enjoy the new gym and felt judged and unwelcome because of her size (emotional barrier), but thanks to the support from family and friends, and as long as they attended with her, she continued to go (social influence enabler).

One person living with bipolar disorder in our focus groups understood the importance of physical activity in her routine, mentioning how when this was lost she’d felt she lacked energy, her mood would lower and she wouldn’t be able to achieve what she had planned for the day.

So she started planning physical activity into the day to help with routine.

Another person living with schizophrenia explained that when in the gym they would always have a shower, but that otherwise they would sometimes go for days without showering if their mood was low.

Improved physical health was not mentioned as a benefit of physical activity as much as mental health was.

However, poor physical health was often mentioned as being a barrier to physical activity, hence breaking the assumption that physical activity aims for physical health only, or mainly.

And that’s not all!

More than two-thirds of survey respondents felt they would gain socially from engaging in physical activity with others.

One EbE talked about taking part in walking football and how the gained peer support allowed him to feel “less alone”.

Working for an active future

In all of this, the impact of Sport England's funding has been instrumental.

We are creating a ‘move-more mentor’ role aimed at supporting people affected by mental ill-health to have deeper conversations about physical activity by providing the emotional and practical support identified as necessary.

Working with EbEs and EbTs, we are linking together conversations about physical activity with stronger support and physical activity provision.

This includes working with leisure services to co-produce sessions and a good-practice guide and collaborating with healthcare professionals to improve conversations about physical activity, and connecting those with our wider work.  

By continuing our partnership with Sport England and piloting scalable, sustainable interventions, we are creating a brighter future.

We are reaching more groups and expanding our impact, and while this is (much) more than one day, World Mental Health Day is a great time to remind ourselves of the many benefits of physical activity for those with severe mental illness. 

So don’t forget to talk about it this World Mental Health Day. Physical activity truly is a fundamental human right.
 

Last week, I chaired a roundtable of leaders and experts at the House of Lords exploring how the NHS can better utilise movement and exercise to meet its current challenges.

The occasion was hosted by Baroness Amanda Sater, a committed advocate for young people’s participation in sport.

It was a rich and wide-ranging discussion with contributions from NHS England, MPs and peers from both sides of the bench, primary care and public health specialists, health charities and movement, sport and exercise organisations.

The importance of our personal experiences

I kicked off the conversation with the reflection that each person’s experience of movement, health and wellbeing is different.

Our experiences are impacted by the community we live in and how we engage with professional services, and they also depend on a wide-ranging, skilled and well-equipped workforce.

This reminded me that active people are the best advocates for getting active.

There was a strong echo of this point as we discussed how supporting the NHS workforce to get active themselves could be a significant way to unlock a movement to encourage patients to increase their activity levels.

Opportunities for change

Our national partnerships lead, Suzy Gardner, presented what we refer to as the three key opportunities for change – working with the NHS, changing attitudes to risk and making the most of physical activity to improve mental health.

In response to these, the group discussed:

• The need to work together more, to speak as one voice with a clear message.
• How GPs are reimagining primary care services.
• The need for training and development for health practitioners.
• The significant benefits and some of the limitations of physical activity for individual and community health.
• The opportunity to work locally and hyper-locally to create health and wellbeing services that blend primary care, community connection and opportunities to move more.
• The need for full participation of children and young people in driving change with us.

The premise of our discussion was that, given the strength of evidence, physical activity can be better utilised as a tool to help deliver key health outcomes and priorities, helping to reduce the challenges the health system is currently facing.

It was only a few weeks ago that we were celebrating the 75th anniversary of the NHS, and the  transformation and changes needed to enable it to weather the extreme strains it's under.

The UK Chief Medical Officers were most eloquent when they compared physical activity with “a miracle cure” because of all the illnesses it can help prevent and treat.

This is a reference we’ve used in the past in our work and it appeals to the core of our long-term strategy, Uniting the Movement.

We know that, even in small amounts, moving our bodies is beneficial at all stages of life, particularly for the most inactive individuals where the greatest health gains can be made.

We also know that individuals and communities want support, with one in four saying that they would get active if told to do so by their doctor or nurse.

And this is just the tip of a growing evidence base!

Social prescribing and sound advice from health professionals are key to shifting people’s habits but significant structural barriers remain.

Overcoming these requires all of us to be brave in designing services that cut across traditional institutional boundaries and keep people at their heart.

Working together 

At Sport England, we want to accelerate and amplify the work we have done with partners in this space.

Our resolve to build a coalition of allies that can help us advocate for the value and role of physical activity, to improve the population's health and to help reduce health inequalities is stronger than ever.

But this is not work we can do alone – we need trusting, long-term partnerships.

Our key priority moving forward is to work closely with partners and places to continue to understand the key policy changes required that can enable the right conditions for physical activity to integrate, particularly through local integrated care partnerships and boards.

It was clear in the room that we’re starting to build momentum for change and we finished the round table by committing to take action together.

We are really excited by the opportunities that lie ahead and will continue to evolve our approach and our coalition of partners to strengthen the connections between sport, physical activity, health and wellbeing.

As I start this blog, I reflect on the many times I, my friends and family have relied on the NHS - GP appointments, exploratory testing, psychological therapy, A&E visits, labour wards, cancer treatment, the list could go on.

And it strikes me just how accessible, diverse and expert the NHS is, and how easy it can be to take all this for granted. 

But, whilst there is much to celebrate, there is no escaping the many challenges the NHS faces, both now and looking ahead.

It’s a complex picture

The data’s clear: we’re an ageing population and we're spending more of our time in poorer health.

Almost half of us has at least one long-term health condition (LTHC) and one in four live with multiple LTHCs - a statistic that's projected to worsen over the next decade. 

We Are Undefeatable research also tells us that almost 25% of people with LTHCs look to the NHS for trusted advice on how to get active.

And whilst our latest Active Lives Survey highlights a welcome return to pre-pandemic activity levels for adults, you’re still almost twice as likely to be inactive if you live with one or more LTHCs when compared to those without.  

In fact, physical inactivity is associated with one in six deaths in the UK, and it's estimated to cost the UK £7.4 billion annually (including £0.9 billion to the NHS alone).

So, what can we do?

Physical activity can expand the capacity and capability of the health and care workforce.

According to the CIMSPA's State of the Nation report 2023 (due to be published in summer), there is a 588,000-strong paid physical activity and sport workforce, alongside millions more volunteers - 8.8m in 2018/19, according to our latest Active Lives Adult Survey - who could help to provide the 'first mile of healthcare' if fully optimised.

Furthermore, the sector’s vision for the future of public leisure reveals a renewed commitment to work with the health sector and support more people to be active in a way that works for them.

Importantly, there is some real momentum to build upon (particularly at an Integrated Care System/Partnership level), driven by the likes of Active Partnerships and drawing upon resources such as the Moving Healthcare Professionals Programme, the Royal College of General Practitioners Active Practice Charter, and the We Are Undefeatable campaign. 

We’re also making great strides to build physical activity into NHS talking therapies, while supporting person-centred approaches, such as social prescribing, to deliver a range of positive health and wellbeing outcomes.

Additionally, our work to activate NHS systems is helping to open doors and enable positive change within the NHS, as reflected by the recent series of blogs on our work with the Office for Health Disparities and Disparities and NHS Horizons.

Taking an integrated approach

The forthcoming Major Conditions Strategy provides a key opportunity for physical activity to become a core part of the solution to some of the NHS’s biggest challenges. 

Building on the new NHS Long Term Workforce Plan, this isn’t about adding workload to an already overstretched health system, but about doing things a little differently and together.

We’ve been listening to partners and feel there are key opportunities that can help create the right conditions for enabling positive change. These include:

• A clear, accountable leadership – nationally and locally – that, through a cross-sectoral and collaborative approach, positions physical activity as key to supporting health and care agendas and priorities. This includes a focus on preventative health, but woven into all policies that aspire to improve our health and wellbeing.
• A health and care system that prioritises physical activity as part of and alongside routine care, recognising physical inactivity as a key risk factor for poor health, and taking a systematic approach to identifying and supporting inactive patients. This includes enabling all current and future healthcare professionals to value physical activity and to feel confident in delivering evidence-based, personalised advice, and building trusted relationships and pathways between health and physical activity.
• Supporting the wider determinants of health through greater promotion, protection and utilisation of green spaces, using active design to support active travel, and the integration of physical activity into government commissioning frameworks for children, young people and families.

Our NHS

The NHS is part of who we are as a country. It’s part of our identity.

By reframing physical activity as part of our health and care system, we can all work to support the NHS, helping it to overcome its challenges (our challenges) so that in return it can keep helping us for another 75 years - and beyond. 
 

At Sport England we're lucky to have the leading voice for disabled people in sport and activity as a key strategic partner.

I'm talking about the national charity Activity Alliance, a vital organisation full of knowledge and passion that's working with us to achieve our long-term strategy - Uniting the Movement.

This month sees the release of the fourth Activity Alliance Annual Disability and Activity Survey.  

The report has warned that the rising cost of living and its wider impact are having a negative effect on disabled people’s levels of activity and wellbeing. 

It's also said there has been no improvement in the proportion of disabled people who feel they are being given the opportunity to be as active as they want. 
 

This year, Activity Alliance spoke to almost 2,000 disabled and non-disabled adults to help track disabled people’s perceptions and experiences of sport and activity.  

Their survey helps us all understand this audience better than we’ve ever done before and has proven the fact that a greater insight is needed if we are ever going to close the activity gap.

Some stats for you 

According to our Active Lives Adult Survey, disabled people are much more likely to be inactive compared to non-disabled people and they continue to remain as one of the least active groups in society.  

Before Covid-19 we saw some of the highest activity levels by disabled people ever, thanks to some great work done by partners in the sector. The pandemic destroyed those hard-fought gains.  

We've also seen that taking part in activity is less common for adults with a disability or long-term health condition (47%), than those without (68%). 

But there are some positives as well, as adults with a disability or long-term health condition have seen activity levels recover over the past 12 months. 

It sets out the primary and secondary drivers for change, alongside the small steps to create change, with the figure below setting out some current examples.

The driver diagram enables us to be responsive and adapt our actions based on what we are learning.

So, while we are clear and remain fixed on our vision and desired outcomes, we are also working dynamically, using the insights from each engagement and action to adapt our approach and always asking questions as we keep advancing towards our overarching goals.

It has taken time to get used to this way of working but this agility has helped to ensure we are finding routes to create the change we are seeking within the system.

This has been a truly rich and rewarding experience.

Throughout, we have been guided by a strong commitment to supporting people to enjoy the benefits of physical activity, and the potential to build healthier lifestyles by embedding activity in healthcare settings.

There is still more to do, but we are excited by the challenge and will continue to evolve our approach to make it happen.  

Our mental health is our most valuable asset and moving regularly is proven to help us to look after it as well as our general wellbeing, which is key to leading a happy, healthy and fulfilling life.

The benefits of physical activity are well evidenced, playing a role in both protecting us from ill-health and in managing and alleviating mental health struggles and, for this reason, physical activity is often described as a ‘wonder drug’.

However, it remains as one of the most under-utilised public health interventions.

Whilst anyone can experience a mental health challenge at any point in their life, we know some are more at risk than others, and challenges such as the Covid-19 pandemic and the cost of living crisis are also contributing negatively.

Being active can significantly support those with mental health conditions but the symptoms associated with mental health problems such as low mood, fatigue, lack of motivation and anxiety – the focus of this year’s Mental Health Awareness Week – make it even harder to do so.

It really can be a vicious circle that many people find difficult to break, and that’s because it’s not as easy as ‘just doing it’ or ‘telling’ someone to move more. If only!
 

We don’t always consider how the various barriers towards being active can be too significant to overcome for some, and that these many need greater support to get started.

For this reason, Uniting the Movement focuses on supporting people on their journey to living a healthier and more active lifestyle by helping remove barriers and scaling up the enablers that will address these inequalities.

What we'll do

We know that mental health challenges start young – half are established by the age of 14 and three quarters by the age of 24 – and that’s why, as a foundational step into children and young people’s mental health we will be conducting an evidence review.

The aim is to establish the evidence for the role of sport and physical activity in the treatment of diagnosed mental health challenges for this segment of the population, and to identify what works and where the gaps are to inform future investment.

Through our adult funds, we will continue to explore how we can better connect sport and physical activity provision with local NHS Talking Therapy services so more people have the opportunity and support to access physical activity as a treatment.

Plus we will be exploring the impact this has on clinical outcomes and comparing against standard talking therapy.

We will also work with partners to develop a series of support resources to make it easier for mental health services to understand how to go about embedding physical activity into routine care, plus we will keep building on our existing work with Rethink Mental Illness.

There's currently a lack of studies that focus on the role of physical activity on those affected by severe mental illness, so in order to tackle this shortage of knowledge we'll explore how physical activity can play a major role in improving physical and mental health, as well as social and overall wellbeing in Tower Hamlets and North East Lancashire

Working in local health systems, these trailblazing projects will aim to improve the support to those from culturally diverse communities and deprived communities.

This will require understanding the determinants (barriers and enablers) to physical activity for people severely affected by mental illness, while specifically exploring how local systems can better support people living with severe mental illness.

But that’s not it!

Our long-term relationship with mental health charity Mind, will focus on helping community-based sport and physical activity organisations to support the mental health of people experiencing inequalities, with a focus on young people aged 11+ (especially those experiencing trauma), people from ethnic minority groups (who are both disproportionately impacted by mental health problems and inactivity) and people from the most deprived socio-economic groups.

We'll also continue to advocate to national and local policy makers the role of physical activity as a helpful population health tool and a driver for supporting the nation's mental health and wellbeing.

While we know the coming months and years won't be without their challenges, we have one simple ask of you today (and every day, actually) - when things get a little difficult or stressful, get up and move.

Keep moving while you make that cuppa.

Get yourself outdoors and take notice of nature.

Turn that Teams meeting into a walking meeting.

Your mind and your body will thank you for it.
 

Because while, according to Sport England's Active Lives Children and Young People Survey, children and young people’s activity levels overall have recovered to pre-pandemic levels (47% are exercising for 60 minutes or more each day), which is definitely good news, there are many more kids who could – and should – be enjoying a regular walk.

Walking to school helps contribute to the 60 active minutes a day recommended by health experts to keep children healthy and happy.

Being active helps to prevent long-term chronic health conditions such as certain cancers, type 2 diabetes and heart disease, and the potential mental health benefits of walking to school from a young age are also significant.

Walking stimulates the release of neurotransmitters and brain chemicals, including endorphins, oxytocin and serotonin. These trigger positive and happy feelings, help improve mental wellbeing and reduce stress and anxiety.

Horizons are a team that facilitates transformation and innovation across the healthcare system by using large-scale change techniques to build energy and broker connections.

In 2021, we joined forces with the Office for Health Improvement and Disparities (OHID) and Sport England to deliver the Moving Healthcare Professionals programme (MHPP).  

This ambitious initiative, running since 2017, aims to embed physical activity within health systems to support people to stay healthy and to support the management of long-term conditions.

Together, we are working to help ensure this becomes the norm, rather than the exception.

This work provides a great opportunity for us to connect the dots to other large-scale transformation work we are leading across the NHS and to maximise the benefits for individuals, society and the healthcare system.

The potential to drive change is hugely exciting, but it’s also a leap into the unknown.

Below are some of the approaches we’ve explored together and some highlights from what we’ve learnt along the way.
 

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.

I was 17 when I developed paralysis of my right leg and foot drop due to a cancerous tumour on my spine. Given six weeks to live, walking wasn’t a high priority and I accepted that, should I survive it, I would be a wheelchair user for life.

Following treatment, I was able to become somewhat ambulant and here is where my issues with representation started.

Wheelchair users in sport have some fantastic role models and it’s easy to see yourself. However, those of us with some mobility have fewer heroes like us.

I found that I fell into a kind of no-man’s land where I was too disabled to play able bodied sports but not disabled enough for parasports.

At this point I gave up sports and physical activity.

Access to gyms in my area was limited and I didn’t have any clear way to participate – I wasn’t wanted by sports and so I cut it from my life.

I had been a rugby league fan but chose not to watch the games. If they didn’t want me, I didn’t want them.

But in lockdown I rediscovered my love of watching sports, albeit played in empty stadiums. I watched hours of old games on YouTube and reconnected with friends who are also supporters.
 

I decided to try wheelchair rugby league in 2022 and found a real passion for the sport. I then started playing physical disability rugby league and later, coaching all forms of disability rugby league.

Disabled people need representation in sport. We need to see it in order to be it.

Last year England won both the physical disability and wheelchair rugby league World Cups.

Both teams have players who are ambulant disabled. Some are amputees and some were born with their disability, but both teams were united in offering clear representation to disabled people.

Wales also took part in the Wheelchair Rugby League World Cup and had two female players.

This shows young girls with disabilities that they can be sports stars, that they can represent their country and that they can inspire the next generation.

The campaign Every Body Moves, which has been developed by Paralympics GB and Toyota and that used to be known as Parasport, is key because there is a sport or movement out there for everyone, you just need to find the one that works for you.

More comfortable in your own space? Perfect – you can do online wheelchair boxing or dance classes. 

For those who want to be outdoors there’s Nordic walking or learning disability rugby league like me!

The first step is building more movement into your life. It doesn’t need to be an organised activity; it can be as simple as moving in time to your favourite song.

Participating in rugby league has given me so much more than being active. A recent survey by Savanta tells us that disabled people are twice as likely to say we feel lonelier and more isolated now than before the pandemic and cost of living crisis.

Sport has given me a place to participate and a group of friends who support me not just on the field, but off it as well.

Many activities are free or low cost so it’s a great way to meet people without breaking the bank.

I encourage you to get out there and give a new activity a go, if it’s not the one for you, move onto another one.

There are loads out there and you’ll find someone who inspires you to be the best version of you. You might even make some friends and find a new social life!

Believe me you’ll be surprised.

As for me, my goal for 2023 is to try 12 new sports. Next up is cycling and I plan to take part in the Superheroes half-triathlon for people with disabilities in August – something you’d never hear me say 18 months ago!
 

“[Climate change] is the defining issue of our age and the central challenge of our century” – António Guterres, Secretary-General of the United Nations.

In 2022, two global conferences (COP27 on climate change and COP15 on biodiversity loss) provided profound moments of reflection for world leaders.

Discussions around the knock-on effects of political unrest, increasing living costs, the reintroduction of coal-fired energy suppliers, and declines in wildlife populations sparked further powerful reminders for immediate action.

Wanting to change that perception, I stood against these barriers and focussed on helping fight health inequalities for the other women around me. 

This is when I came across the Dream Big programme, so I started as a volunteer supporting other women lead cricket sessions for the local community. Now in my role, I have been fortunate to be a part of leading the change within the national organisation and bringing even more women into Dream Big.

Challenges and key learnings

Dream Big Desi Women has been a hugely successful initiative, but it is even more powerful considering the two years of disruption and uncertainty due to the Covid-19 pandemic.

This is also set against a wider landscape of falling volunteer numbers within sport and physical activity, with over 3 million fewer volunteers giving their time in November 2020-21 than during the previous 12 months.

Recent data shows that volunteers remain under-pressure and at risk of burnout, so what has made Dream Big so inspiring for women to get involved?

A defining moment for me in the programme was the design and creation of hijabs and modest apparel for volunteers.

Having designed a modest fitness wear line previously, I knew the value this brings.

This addition helped to not only broaden the reach of the programme, but also to increase its inclusivity and create a new sense of belonging for volunteers within the game.

Insight shows the experience of volunteering is key, so it’s important to create a volunteering journey that is accessible.

By adapting the training and its environment, and by providing opportunities for development, volunteers can be motivated to come back and spread the news about the programme.

This then allows this volunteer opportunity to become community-led and an engine for positive social change.

The three key lessons from the programme for me have been:

1. Understanding the true value behind listening and implementing change. Taking the time to understand the barriers, challenges and initiatives that volunteers want to see will help you reach more people.
    
2. Adapt, adapt and adapt! Never stop innovating, and don’t be afraid to try something new. For instance: modest apparel, virtual coffee mornings and training events and festivals celebrating the diversity of your volunteer base.
    
3. Celebrate your volunteers – reward and recognition has been the key tenet behind the success of keeping our volunteers engaged in the game. 

Dream Big is a great example of the work Sport England is doing in its partnership with Vision for Volunteering - a movement of volunteer-involving organisations and volunteers, working together to create and support amazing volunteer experiences.

So all I can say is here's to many more years or working together and making each other - and those around us - better.  
 

For the past five Invictus Games, Help for Heroes has been responsible for training and delivering Team UK to the largest international adaptive sporting competition for disabled veterans.

The Games help shine a spotlight on those with a disability and demonstrate that sporting achievements are still possible. They also generate a wider understanding and respect for wounded, injured and sick servicemen and women.

But it's not just about the elite athletes, the ones who want to make the Paralympics or Invictus Games - though we have seen many of our veterans we support reach these heights.

Everyone has their own idea of success, their own idea of what a personal best looks like and this focus is crucial for a recovery journey.

No matter your injury, disability or illness, sport must be accessible to all, a vision shared with Sport England and its Uniting the Movement strategy to transform lives and communities through sport and physical activity.

Having fitness goals and aspirations, no matter how big or small, helps you rediscover your motivation and gives you a renewed sense of focus and purpose.

When somebody is first injured or becomes sick, it can be daunting and cause a real identity crisis.

It can be hard coming to terms with who you are and what you are able to achieve, but sport is an easily accessible way of providing something you can throw yourself into at whatever level.

It's about getting out, getting confidence back and that self-belief.

Sport is also something which can be done with teammates, allowing somebody with a disability to be active and socialise with like-minded individuals.

For our veterans, it enables them to rediscover the camaraderie they enjoyed when they were part of the Armed Forces.

Sport services at Help for Heroes offer a broad range of activities out in the community and at all ability levels, from recreational to competitive, helping to maintain an active, healthy and independent life.

Our adaptive sports activities make sport inclusive and allow veterans and their families to reconnect with who they were before they were injured or sick.

This increases their confidence when they realise they need not be defined by their new circumstance, and that they can still do or play something they previously loved.

These activities are delivered day-by-day in communities across the four home nations. They help reduce social isolation, build connections in communities, and offer opportunities for veterans and their families to give back via volunteering. 

In collaboration with UK Coaching, we have also recently delivered a Coaching Academy, which gives veterans the chance to train for a sport coaching qualification and build on their skills in civilian life.
 

Recent research from Professor Brendon Stubbs and ASICS has highlighted that the ‘sweet spot’ to feel the benefits of physical activity, including increased mood, could involve moving for just 15 minutes a day.

While we strive to reach the CMO guidelines for 150 minutes of moderate physical activity per week, knowing that a short walk at lunchtime can help increase our mood, or counter the stresses from work and daily life, is a game-changer.

It reinforces the messages of campaigns such as We Are Undefeatable, which is aimed at getting people with long-term health conditions to move in their own way.

It also helps for people just starting out in their journey and those of us who are time-poor due to work, home or caring commitments.

Fifteen minutes is a start and it’s good enough, giving tangible evidence to the rhetoric that something is better than nothing.

Exercise balance

We have worked with experts to explore what a healthy relationship with physical activity looks like and we're calling on all providers of physical activity to carefully consider their messaging around physical activity, and to focus on the mental health benefits such as how it makes you feel rather than the time, distance or speed - and we've developed new resources to help.

This is reinforced by the findings from Professor Brendon Stubbs, who said: “Taking time to rest is very important. This study shows that people’s wellbeing bounces back very quickly after a period of rest when people resume regular exercise again.”

Introducing the benefits of rest days and importance of varying types of exercise early in a person’s physical activity journey will also set the foundations for a healthy long-term relationship with physical activity, that supports both body and mind.

We are currently working with industry bodies such as ukactive to share our learning and ensure that policies and practices are informed by insight and experts.

The future is bright, the message is getting out there that physical activity has a role to play, but there is still much more to do.

We look forward to seeing more focus on physical activity in the forthcoming guidelines from the National Institute for Health and Care Excellence (NICE) on depression and supporting the cross-governmental plan for mental health - ensuring that the important role of physical activity is recognised.

We all have a role to play in creating sport and physical activity settings, and a society where people can thrive.

And our Mind physical activity team is here to support you to embed good mental health practices, including balanced messaging, training and support in your organisation.