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FIA update: Prevention over medication
The physical activity sector must be ready to present a compelling case for exercise interventions in local healthcare delivery, says the FIA’s David Stalker
Historically there has been limited discussion and co-operation between the medical profession and fitness professionals who deliver exercise – one of the core reasons why exercise is not currently a routine part of healthcare. However, over the past few years the FIA has been putting the structures in place to make a step change and engage with the medical community.
Partnership work
The Joint Consultative Forum (JCF) was set up by the FIA as a channel of communication with the medical sector.
The JCF quickly determined the need to produce standards for exercise referral that will define the role of exercise referral schemes, assist the evaluation of exercise referral services, and most of all improve the quality of care for patients. The standards have been put out to consultation and are now at the drafting stage. They will be published later this year.
Providing evidence
The FIA Research Institute was launched at the University of Greenwich last year to build an evidence base for the effectiveness of exercise in delivering health outcomes.
The institute’s first 12-week pilot study, delivered with Impulse Leisure, enrolled 100 people – some of whom were inactive gym members. It assigned them to three levels of exercise engagement: physical activity counselling and activity monitoring with a MyWellness Key; free use of the gym facilities; or a structured exercise programme at the gym three times a week.
A full set of results will be published in academic journals later this year. However, all participants showed improvements across the board, with lower weight, BMI, body fat and blood pressure, as well as higher levels of cardio and respiratory fitness, muscular strength and flexibility.
focus group research
A high level focus group – the GP Clinical Commissioning Consortia Focus Group – met at the end of January to determine how members of the physical activity sector can best place themselves to offer their services to the health service.
Dr Paynton, national clinical commissioning champion at the Royal College of General Practitioners, led the focus group. He explained that he is looking to the physical activity sector, as a potential NHS provider, to develop a “different combined approach” to demonstrate that it can offer long-term solutions to the costs and pressures on the NHS created by long-term medical conditions. The fitness sector must, he explained, also be prepared to take on the risk and responsibility associated with joint commissioning.
The discussion summarised that, to have the greatest impact, exercise interventions must form part of a greater programme of behaviour change.
So we now have three key elements needed to move forward:
• Communication and regular contact with key members of the medical community
• Standardised procedure for physical activity referral schemes
• Evidence
The scene is set for the sector to present our offering to healthcare commissioners and show that exercise really is the answer.
Around 15 million people in England have at least one long-term health condition – a condition that cannot be cured but that can be managed. This accounts for the majority of NHS spending on clinical care.
The NHS has to find £20bn in efficiency savings in the next five years – yet it is estimated that only 50 per cent of these savings can actually be found through quality, innovation and productivity (QIPP). To stop its costs rising further, the NHS must look at investing in prevention.
At the same time, major structural changes to the health service will see the introduction of Clinical Commissioning Group (CCGs), which will drive a shift in focus towards community-based treatment and lifestyle interventions. This will bring with it a number of key changes to the role of GPs in decision-making and the commissioning of care, and has particular relevance for the delivery of exercise referral schemes.
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