10 Year Health Plan – opportunities for physical activity

by Tom Burton

Strategic lead for health and wellbeing policy, Sport England

It’s been just over a month since the 10 Year Health Plan was published – a key milestone in the government’s commitment to create an NHS fit for the future.

It’s taken me time to navigate the headline ambitions, shifts in language, structural implications and, critically, what this all means for physical activity. There are 160 pages to get through, after all…

There’s lots to unpick and this post from the Medical Consulting Group includes a visual that usefully summarises the key points.

For patients, it’s a positive and empowering tone, underpinned by a digital revolution and receiving care closer to home.

With Neighbourhood Health a cornerstone of the Plan and elected mayors playing a greater role in prevention, combined with Local Government Reorganisation and Devolution, this all presents big opportunities to align with Sport England’s investment into communities that need it most.

To what extent does physical activity play a role?

Well, there were multiple references, including:

The health and economic impact, tackling inequalities through cross-system join-up and recognising poor access to sport and recreation is a root of sickness.
Our £250 million place-based investment; a £400m investment into community sport facilities, new partnerships on school sport; a £616m investment into active travel; and an important reference to local health plans.
A new campaign to motivate millions more to walk and run more every day.
A new annual process, modelled on the UK City of Culture, to name the most physically active community.
Expanding the role of incentives in lifestyle change.
The Department for Culture, Media and Sport providing more information on the strategy for physical activity in due course.

Since publication, much commentary has reflected that the Plan could have gone further in utilising physical activity’s preventative powers.

It’s true: the evidence and opportunity for impact at scale are significant. I have two glass-half-full thoughts on this:

This Plan feels like it goes further on physical activity than any previous national NHS/health strategy. Whilst we can go (much) further, this is progress to build upon.
Rather than considering ‘potential’ purely through physical activity’s reference, there are numerous levers throughout the Plan to capitalise upon. We’ve learned that framing physical activity’s role in supporting wider, shared outcomes is key – whether that be tackling health inequalities, preventing and managing multi-morbidity, falls/frailty or social isolation… the list goes on.

So, what next?

Below are five opportunities that could deliver significant impact, particularly for those who do little or no activity (where health and economic gains are the greatest), those at risk of or living with long-term health conditions and those out of work due to poor health (including the NHS workforce).

As with any emergent thinking, I’m also holding questions...

1. A core part of Neighbourhood Health

An excellent opportunity to connect people with local physical activity that works for their holistic needs.

Whilst finding ways to move is about more than structured or organised activity, there’s a diverse asset and activity offer in almost every neighbourhood to connect with, build trust in and enable frictionless access into.

Work co-led by the Faculty of Sport and Exercise Medicine alongside the Active Partnership National Organisation can help make this a reality.

Additionally, could co-located services, often including leisure provision alongside GP practices, become neighbourhood health centres?

2. Support embedded within the ‘doctor in our pocket’

Physical activity must be embedded within the evolving NHS app – leaning into behavioural science and AI to ensure people get the level of support they need.

There’s lots of great work to build upon – for example, the ORCHA-accredited We Are Undefeatable app.

3. Maximising health and care data systems

Interoperability of data systems can help target the least active, empower decision-making and better understand local opportunities and demonstrate impact.

The Open Data Institute’s recent white paper makes the case for better use of physical activity data.

4. Wraparound provision of obesity and mental health support

Increased use of anti-obesity medicines (such as GLP-1) provide opportunities for physical activity’s complementary role in muscle maintenance/gain, strength and maintaining a sustainable healthy weight.

For mental health, particularly in children and young people, physical activity can intervene and support early, including within expanded school mental health support teams and new Young Futures Hubs.

5. Building upon what’s already working

And much is working, led locally by our network of Active Partnerships alongside wider place, leisure and system partners.

Learning and effective practice must spread and approaches should be rooted in lived experience and considered in the context of community need – underpinned by strong system leadership, applied proportionate universalism and applying consistent impact/return on investment measures (i.e. the WELLBY).

Two women walking in a park with water bottles

Five questions

What does a coordinated physical activity response look and feel like?
How do we ensure we’re coherent and consistent in our narrative, messages and offer? Is more support required for our wonderful frontline activity workforce?
How do we maintain relationships and momentum throughout complex change?
People are at the heart of this change – compassionate and supportive leadership is critical.
How can we capitalise on levers to support NHS England’s ambitions to harness the benefits of physical activity?
A real milestone in our collective ambitions to integrate physical activity into routine healthcare. Perhaps this is an opportunity in itself!
How can we develop healthcare professionals’ confidence to promote activity, when mandated training is being reduced?
The Physical Activity Clinical Champion programme is delivering brilliant impact and evolving the offer to support place-based working.
Are we still missing certain types of evidence?
We’re not short on ‘why’ physical activity, but do we have enough around the ‘how’ we enable it in different contexts?

So, could the Plan have gone further on physical activity? Of course. But are there opportunities throughout the Plan to capitalise on? Absolutely.

Yes, we’re still holding lots of questions, but let’s not dwell on what could have been and instead focus on the collaborative opportunities in front of us.

10 Year Health Plan for England: fit for the future