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Everyone's talking about...: CCGs not PCTs
Clinical Commissioning Groups (CCGs) have – as of 1 April – replaced PCTs, placing the responsibility for health with local authorities. How will this impact the fitness industry?
Local authorities are now charged with the responsibility for public health, with decisions about the commissioning of services being made locally by GPs and the directors of public health (see p26 for a full briefing).
Physical activity is one of the 66 indicators of the public health outcomes framework, so there’s now structural recognition of the importance of physical activity in the role of public health. However, ukactive CEO David Stalker says we must still be cautious about what these changes mean: physical activity and leisure are not currently statutory requirements, despite their inclusion in the outcomes framework, so they will not necessarily be protected.
The wider determinants of health will also now be tackled for the first time, so housing, roads and other local authority services will be assessed to see how they impact the health of the local population. This could mean, for example, funding being found for mass participation initiatives, such as the provision of cycle trails for children to get to school.
The fact that local authorities will be charged with getting people more physically active is great news for the health and fitness industry, as is the £2.7bn ringfenced budget. But how easy will it be to get a slice of the money – particularly for the private sector, which may not be as well-versed in the language of local government? And how much of this money has been allocated already?
On paper this looks like a good opportunity for the health and fitness industry, but what should be the first moves? Building relationships with the local decision-makers who will be commissioning services? Training staff and developing programmes to ensure facilities are equipped to deal with new audiences – people who are nervously embarking on a lifestyle change and who may be wary of gyms? We ask the experts...
David Stalker,
CEO,
ukactive
“This is such a great opportunity: a whole new workstream of opportunity, with a £2.7bn yearly ringfenced public health budget in the hands of local authorities.
Clubs will have to be proactive in order to get a share of the funding and will need to work with other community service providers. Services will be commissioned based on the health needs of the local population, so clubs will have to find out the key statistics influencing the decisions being made locally. Providing a strong evidence base for cost-effectiveness of physical activity interventions is also important, as GPs make their decisions based on evidence. We’re already getting more focused on this, with ukactive’s Research Institute due to start publishing its findings in June this year. Clubs will also need to both speak and understand the language of local government.
If we’re to get beyond 12 per cent penetration, we need to welcome people who require support. Historically our sector has focused on a member pathway, which doesn’t necessarily align with a patient’s care pathway. Helping people improve their health through physical activity means starting from the beginning and counselling them on how to think about being more active, before they even set foot in a fitness facility.”
Steve Bedser,
Member of Community Wellbeing Board,
LGA
“These changes potentially give the fitness industry access to a new customer base and new funding opportunities, but there is no quick buck. To access public health funding, any initiative must demonstrate the likelihood of improved health outcomes.
Much of the public health focus is on encouraging currently inactive people to adopt healthier lifestyles. As research into Birmingham’s ‘Be Active’ initiative shows, one of the biggest barriers to regular exercise is poverty. Not only that, but inactive people are also far more likely to take the plunge if there is no initial cost. However, once people get the fitness bug, they are more likely to spend on further activities.
If the fitness industry is going to grab the opportunity to tap into this new market, it must take a more holistic approach. Adopting a healthier lifestyle is not just about exercise – it’s about a healthier diet, quitting smoking and drinking less.
If the physical activity sector can come up with the right packages, it has the opportunity to be part of the solution. Our focus is on outcomes, so if the fitness industry can provide us with evidence to show it can help us produce a fitter, healthier population, the opportunities will be there.”
Chris Holliday,
Head of leisure & community health,
Walsall Metropolitan Borough Council
“I’m ever optimistic, so I’d say these changes represent an opportunity for a more joined-up approach.
Nationally we want health and fitness and sport professionals to work together to make a real step change. It’s not often that we’ve had an opportunity like this, where public health has been brought into the same room as leisure services, with both sectors aiming for broadly the same outcomes. As a discretionary service, that’s great for our industry.
If a director of public health takes a holistic view and uses budgets imaginatively to create health opportunities, it could be exciting – there’s an opportunity to jointly pull in the same direction. However, given all the public sector cuts and with more to come, I’m not sure how much new funding will be available.
Nevertheless, the health and fitness sector has a great role to play going forward. The agenda in sport, leisure, recreation and fitness will have to align closely with public health’s to help them deliver against their agendas for obesity, smoking, alcohol and diabetes. Operators will need to think outside of the box to come up with innovative ways of drawing the physically inactive into exercise. My advice is to knock on the director of public health’s door and show how you can help.”
Prof Gabriel Scally,
Director of WHO Collaborating Centre for
Healthy Urban Environments,
University of England
“As a result of these changes, I hope local authority leisure services departments will transform themselves into physical activity departments, so they are not just in the business of managing leisure facilities, but are integrating their efforts with other parts of local government – such as parks – to increase levels of physical activity.
There’s an opportunity here for private sector fitness providers to broaden and expand their offer to welcome new audiences, particularly outside of peak times. But there’s also an obligation for all leisure facilities to improve their food and beverage offer. I would like to see all sites taking part in the Food For Life catering mark, to guarantee the food and beverages they provide match up to the exercise opportunities they are offering. The sale of junk food in health clubs currently undermines their efforts to help people live healthier lives.
Each local authority will be in the process of preparing plans on how they will improve the population’s health. The fitness industry needs to engage with local Health and Wellbeing Boards while they are preparing their Joint Strategic Needs Assessments, to make sure they are part of the plan.”
