The recent 10-year NHS Long-Term Plan highlighted some interesting insights, including a keen focus on preventative healthcare and encouraging people to "take control of their own health."
Whilst there were definite ‘positives’, there were also some concerns. For physical activity to be part of prevention, we need to focus on an environment that’s conducive for activity, making everyday movement a possibility.
Even so, as a population we simply don’t place enough importance on physical activity; a study by the British Heart Foundation in Bristol indicated that even the promise of an increased life span wasn’t enough to inspire individuals to become more active! So what do we do?
As an industry we attract three main types of people:
- ‘Want tos’: the regular HIIT and Spin class participants who return week after week to group sessions and rebook regularly.
- ‘Need tos’: these individuals have fallen out of love with us. They’re keen to get back to exercise but struggle to book classes (which are always booked by the ‘want tos’). They’re nagged by both their conscience and their families to return.
- ‘Have tos’: what the ‘need tos’ who don’t return become, and where specialist services such as Exercise on Referral (EOR) schemes come in. At this stage we are moving towards rehabilitation rather than prehabilitation!
I passionately believe we need to focus on the ‘need tos’, because the ‘want tos’ will come anyway. The ‘need tos’ are essential for the prevention model and advertising still relates to committed gym goers. The role of physical activity is changing; it isn’t about marketing to our regular class goers anymore. We need to inspire these reluctant users when they’re still in prehab, rather than when they get to rehab (EOR).
The lack of mention of physical activity within the 10-year plan is a clear indication that we aren’t focusing on this group enough. Concentrating on a single lifestyle behaviour alone to target obesity is simply not adequate.
On a positive note, we’ve already taken up the mantle for the ‘have tos’. As an industry we understand the benefits of EOR and condition-specific programmes, like the British Lung Foundation’s ‘Breathe Easy’. Some facilities are offering these hugely beneficial rehabilitation programmes to great effect and many of our customers are picking up this type of work. But are we missing the point?
The difficulty with rehab programmes, whether EOR or condition-specific, is the cost to deliver them is three or four times more than a ‘need to’/preventative programme. So, if we miss out the ‘need tos’ and simply focus on those who want to exercise and those who ‘have to be’ there, the economics simply don’t stack up.
Wouldn’t it be wonderful if facilities looked at the opportunities for everyone coming in (want/need and have tos), joining it up to create a consistent journey throughout? Imagine a seamless entry point where each individual’s needs are assessed. But for this to be achievable we would need to market this diversity of options outside our facilities’ four walls.
I sometimes worry we’ve been here before. The NHS took money from public health and has been charged with creating a preventative model. In my opinion the NHS needs to pump money back into public health so they can do their job. This is key. Social prescribing is a case in point: The report states over 1,000 people will be employed for social prescribing, but we have witnessed the decommissioning of many health trainer services. What’s the difference between the old health trainers and the new social prescribers? And in terms of funding, are we simply missing the point?
Overall, I welcome any plan involving preventative healthcare. As health promoter, if I don’t have a job then my job is done. Isn’t this what we are all working towards?