3. National shift in approach to physical activity
3
National framework domains,
Everybody Active, Every Day
National Strategy outcomes, Sporting
Future 2015
6. How does the UK compare with the
following countries for inactivity?
6
A
USA
France
Netherlands
Germany
Australia
Finland
7. Proportion who are inactive
7 Public Health England (2014) Everybody Active, Every Day; Based on Hallal PC et al. (2012) Global physical activity levels:
surveillance progress, pitfalls, and prospects. The Lancet.
International comparison of physical inactivity (at ages 15 and over)
Note: Comparator = Not meeting any of the following per week: (a) 5 x 30 mins moderate-intensity activity; (b) 3 x 20 mins
vigorous-intensity activity; (c) equivalent combination achieving 600 metabolic equivalent-min.
UK 63.3%
USA 40.5%
Australia 37.9%
Finland 37.8%
France 32.5%
Germany 28.0%
Netherlands 18.2%
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0%
% Inactive
8. Physical activity: Who gains the most?
8 Moore et al. (2012) PLOS Medicine
A
150 Minutes
Biggest gain
in years
9. Physical activity reduces the mortality and
morbidity risk of disease
9
Start Active, Stay Active (2011) based on US Department of Health and
Human Services Physical Activity Guidelines Advisory Committee Report
(2008), Washington DC
A
Disease Risk reduction Strength of evidence
Osteoarthritis disability 22-80% Moderate
Alzheimer’s disease 20-30% Moderate
Hip fracture 36-68% Moderate
Depression 20-30% Moderate
Early death 20-35% Strong
CHD and stroke 20-35% Strong
Type 2 diabetes 35-40% Strong
Colon cancer 30-50% Strong
Breast cancer 20% Strong
Hypertension 33% Strong
Functional limitation, elderly 30% Strong
Prevention of falls 30% Strong
10. Lies, damn lies, and statistics…
• 25% of the UK adult population ‘inactive’
• >40% of the population ‘not active enough for good health’
• Inactivity 4th biggest risk factor for NCD
• 300million GP & patient consultations per annum
• 75% GP discuss lifestyle ‘often/always’
• So… why isn’t the message getting through?
11. Barriers – GP perceptions
• Time - 10 minutes to talk about everything!
• Lack of knowledge
• Fear of offending patients
• Perceived lack of services locally
• Reliability of services - who can I trust?
12. What we learnt…
• Behaviour change takes time – think smoking
• PHE teaching will reach some but not all
• There are HCPs doing great work already
• There is an appetite for this – patients and HCPs
• Genuine concerns re: medicolegal limbo
• One size definitely doesn’t fit all
13. Solutions - knowledge
• RCGP toolkit – ‘motivate to move’ – disease specific
• Podcasts
• Videos
• Events – regional workshops, conferences, media presence
• Moving Medicine
15. Solutions – advocacy and empowerment
• The Active Practice –the power of the med student
• The case for PA –commissioners
• The case for surgeries
• The case for the PA industry
• The case for the voluntary/third sector
• Universal cross sector medicolegal guidance
• Doctors and HCPs as leaders and activists
17. Becoming a local leader
• Look for allies
• Join or start a network
• ‘Lifestyle’ medicine: RCGP, PHE, BSLM, social media
• Grants and bids – charities, CCG, research
• Events - Elevate, UKactive, ISPAH, BSLM conference, FSEM, BASEM
18. Social Prescribing: a solution?
• GPs can’t do it all – but can sew a seed
• For more complex patients
• In-depth knowledge of local services
• Health sec promise for universal access
• Emerging evidence of efficacy
• Are they including PA in their offer?
21. The future
• Surgeries as health/wellness centres
• PA as the norm not just for weirdos in lycra!
• Embedding in other health priorities – PCC; clusters;resilience
• PA recognised as a good value safe ‘medicine’ for all
• Positive partnerships across sectors nationwide
22. Resources
• Motivate to Move gpcpd.walesdeanery.org
• Moving Medicine www.fsem.ac.uk
• RCGP Physical Activity Toolkit www.rcgp.org.uk
• Arthritis UK PILs www.arthritisresearchuk.org
• Disease charities – Richmond Group
• One You app www.nhs.uk/oneyou
• NHS Live Well www.nhs.uk/live-well/exercise/
• Chair based www.bhf.org.uk/heart-matters-magazine/activity/chair-
based-exercises
And many many others…
23. Get in touch
• RCGP Physical Activity & Lifestyle Clinical Priority
andrew.boyd4@nhs.net
• PHE Clinical Champions physicalactivity@phe.gov.uk
• British Society of Lifestyle Medicine bslm.org.uk
Thank you!