Harnessing the benefits of physical activity

Physical activity is essential to health and wellbeing, yet many people do not receive the support they need to stay active. There is overwhelming evidence that the benefits of physical activity far outweigh any risks, for both adults and children and even for those with health conditions. Embedding physical activity into every aspect of life-long healthcare will benefit patients, NHS staff and the wider population.

The evidence base

The benefits of physical activity for prevention, management and treatment are substantial for conditions currently most associated with economic inactivity, like mental health and musculoskeletal health, but also multi-morbidities. Conversely, physical inactivity, which is associated with inequalities in health outcomes, impacts on the demand on NHS services.

We know that:

  • physical inactivity is estimated to contribute to almost 1 in 10 premature deaths from coronary heart disease (CHD) and 1 in 6 deaths in the UK from any cause.
  • physical inactivity is increasingly recognised as a global health priority that should be the concern of all healthcare systems (WHO, 2024) people with a long-term health condition or disability are twice as likely to be inactive as those without.
  • physical activity is essential for people to live better with long-term conditions.
  • The greatest health and economic gains can be made by supporting those who are physically inactive to participate in some physical activity.
  • physical activity helps to delay the onset and progression of diseases for as long as possible, it also helps people to recover from surgery more quickly and it is beneficial for mental health. 

Yet changes to society have meant that we are increasingly sedentary.

The 2019 CMO guidelines recommend that each week adults should accumulate at least 150 minutes (2.5 hours) of moderate intensity activity (such as brisk walking or cycling); or 75 minutes of vigorous intensity activity (such as running); or even shorter durations of very vigorous intensity activity (such as sprinting or stair climbing); or a combination of moderate, vigorous and very vigorous intensity activity.

However, the latest data shows that:

  • over one-third of adults do not meet the Chief Medical Officers’ guidelines on aerobic physical activity
  • less than half of adults meet the Chief Medical Officers’ guidelines on muscle-strengthening activity
  • over a quarter of the adult population were classified as inactive
  • almost one-third of children and young people (30.2%) in 2023 were inactive, doing less than 30 minutes of activity per day.

There is an economic argument as well:

People who are inactive, for whatever reason, are less able to participate in society, both socially and economically. A report by Sport England and Sheffield Hallam University (2019) into the Social and Economic Value of Community Sport and Physical Activity in England found that physical activity’s role in preventing a number of serious physical and mental health conditions which provided over £9.5 billion in value to the economy. Of this amount,

  • £5.2 billion was in healthcare savings
  • £1.7 billion was in social care savings
  • More than £3.6 billion worth of savings were generated by the prevention of 900,000 cases of diabetes
  • A further £3.5 billion of value was generated in avoided dementia cases and the related care
  • £450 million was saved by preventing 30 million additional GP visits.

Four ways forward

The evidence for the positive impact of regular small amounts of exercise in the prevention and treatment of common conditions is overwhelming.

Unlocking the potential of physical activity will require healthcare leaders to be much more ambitious, incorporating promotion of physical activity into wider plans on prevention and long-term conditions management.

The NHS, in collaboration with national and local partner organisations, can harness the full potential of physical activity to help people live healthier, longer, and more independent lives.

Empowering clinicians and health and care professionals with the skills and confidence to discuss and promote physical activity, integrating it into key clinical pathways, aligning it with Core20PLUS5 for adults, children and young people, and supporting our staff to stay active, the NHS can help to transform patient outcomes and reduce health inequalities.

  1.  Empowering health and care professionals

Evidence shows that 1 in 4 people would be active if a healthcare professional advised it. This would result in 2.9 million less inactive adults in England who would be gaining the benefits of moving more.

All health and care professionals should be equipped with the skills and confidence to discuss the importance of taking up appropriate physical activity with patients who have health conditions. This includes:

  • signposting patients to physical activity opportunities and events
  • promoting rehabilitation
  • highlighting the importance of maintaining activity levels to prevent deconditioning
  • removing myths associated with the risk of physical activity (and the need to seek medical approval)
  • empowering people to make informed choices.

It can involve signposting to digital tools like:

  1. Integrating physical activity into clinical pathways

NICE guidelines recognise the important role of physical activity in managing a range of conditions. Physical activity, exercise or activity related community rehabilitation is recommended in 98 NICE clinical and NICE condition specific guidelines and quality standards including those for cardiovascular conditions, musculoskeletal conditions, mental health conditions, cancers, falls in older people, fertility problems, irritable bowel syndrome, liver disease and ante and post-natal care (Sport England, 2024).

By embedding physical activity into clinical pathways, the NHS can support improvements in patient outcomes and deliver evidence-based care across various conditions. This means fewer complications and less use of NHS resources.

For example, peri-operative care can be enhanced by supporting patients to prepare for surgery and recover more effectively, using and building on resources like: ‘Fitter Better Sooner’ toolkit, the Prep Well programme, or Prehab4cancer.

  1. Supporting the NHS workforce

The health and wellbeing of the NHS workforce can be supported by holistically promoting physical activity both within and outside of work, such as through the NHS health and wellbeing framework. Examples include NHS sites where health and care leaders already champion active working practices, such as through the RCGP active practice charter, promote healthy workplace environments, encourage active travel, seek to offer flexible hours (if possible), which can support engagement in physical activity, and promote the use of local community facilities and assets, such as gym membership discounts and access to the digital weight management programme. NHS leaders may also act as role models for active lifestyles, thus contributing to a healthier and more engaged workforce.

  1. Supporting innovation and evaluation with partners

Collaboration between the NHS and the physical activity sector is essential to embedding physical activity into health and care. Addressing disparities in physical inactivity requires system-level solutions. By supporting collaboration between regions, integrated care systems (ICSs), integrated care boards (ICBs), commissioners (including those in local authorities), and the physical activity sector, the NHS will help to ensure that underserved communities benefit from targeted interventions. Enhanced research and evaluation of interventions that address physical inactivity and their impact will further drive this effort to influence the provision, access to and use of local assets and facilities.