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The NHS at 75 – a time to celebrate and collaborate

Following last week's 75th anniversary of the NHS, our lead for health and wellbeing policy highlights the projects we've developed, and those ongoing, to support a service that's part of who we are as a nation.

12th July 2023

by Tom Burton
Interim health and wellbeing policy lead, Sport England

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. 

An old lady and an old gentleman perform stretching exercises while sitting on a chair indoors

The complexity and severity of health needs are also increasing for some groups. 

According to research by Harvard Medical School professor R.C. Kessler (et al), 50% of all mental health problems are established by the time we’re 14, and 75% by 24.

On this subject, an analysis by The Health Foundation has shown that people living in the most deprived parts of the country typically have two or more LTHCs a decade earlier in their life than those in more affluent areas.

Add in a pandemic, significant staff shortages (both of which have contributed to 7.4m of us waiting for treatment) and record NHS staff sickness rates (primarily due to mental health challenges), and it all makes for a truly complex situation. 

Can physical activity be part of the solution?

In short: yes. The transformational effects of physical activity are well established.

From helping to prevent, delay and manage many health conditions, to averting and reducing loneliness through social interaction, being active helps us lead happier, more mobile and independent lives.

We know that the greatest health gains are achieved by supporting those most likely to be inactive to move more. 

Insight from the We Are Undefeatable campaign highlights that, whilst 59% of people with LTHCs would like to be more active, many say they lack the motivation to act on it, or that they fear activity will make their health condition or symptoms worse.

This is despite evidence suggesting the benefits of being active far outweigh the risks.

From helping to prevent, delay and manage many health conditions, to averting and reducing loneliness through social interaction, being active helps us lead happier, more mobile and independent lives.

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.


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. 

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