What’s Nuffield Health’s mission?
We’re clear on what our purpose is. We’re the UK’s largest healthcare charity and that flows through our DNA and into all of our decision-making.

We encapsulate this in a simple mission statement: ‘Nuffield Health exists to build a healthier nation’. I know that sounds like a cliché, but it genuinely is the thing that drives all of our activity, the work we do and the way we’re moving the business forward.

Sitting beneath that, we have our three guiding principles. Firstly, if we want to build a healthier nation, we need to extend our reach to improve the health not only of the patients and members who use us, but also those who live near our facilities – and even beyond.

We impacted 1.5 million lives last year and every year we challenge ourselves to go further.

Second is our concept of connected health, which Martin will tell you more about. In brief, connected health means that – no matter where you are on your healthcare and wellbeing journey – as soon as you touch any part of Nuffield Health, we’re there with the support and advice you need.

There’s a whole loop of getting you fit, maintaining your wellbeing, then – if you do end up requiring treatment, whether that be physio or hospital treatment – putting you back together again and getting you back to fitness.

In this respect, our hospitals, clinics and gyms aren’t currently as well-connected as we would ideally like. We’re integrated as an organisation – our regional directors now look after the hospitals, gyms and clinics in their areas – and there are already some connected pathways in place, but there’s still more work to be done in this area.

Our vision is for there to be a totally integrated, seamless journey available for all our members and patients across the full breadth of our organisation.

Third, whether through our hospitals, clinical services or gyms, we strive to achieve the highest level of quality and outcomes for the patients and members who use us.

Our bigger vision is to then become an all-encompassing health and wellbeing provider catering to all stages of the healthcare journey, and to do so in a way that extends our reach beyond our members.

How will you extend your reach?
We currently have 31 hospitals, 200 corporate clinics and 112 gyms, and we’re looking to grow that number.

From a physical estate perspective, there are currently areas of the UK where we have white spaces: hospitals where there are no gyms or gyms where there are no hospitals.

For 75 per cent of our estate, there’s already a gym or hospital nearby, but we’re keen to fill in the gaps; connecting our whole estate geographically will allow us to provide a seamless member experience in all locations.

A big one will be the opening of our first London hospital in 2021, but I think it’s realistic to say that, in 10 years’ time, 85-90 per cent of the population could be served by a Nuffield Health hospital or gym within an hour’s drive.

We’ll also extend our reach digitally and we’re already working hard on that side of our offering.

Over the years, as our business has grown, we’ve ended up with numerous repositories of data. The 2025 vision is to bring all of that together into a single customer view.

In turn, this will enable us to support people with whatever health services they need, measure the outcomes of those interactions and then provide an even more personalised service on the back of that.

Even if you don’t live near a physical building that belongs to Nuffield, you’ll still be able to access our services digitally. You can still have a digital health assessment, interact with a virtual clinician and get the support you need.

We expect digital will mostly be used as an add-on to our physical facilities, but if we ultimately achieve our ambition – to stop being such a well-kept secret, and instead become the UK’s most trusted health and wellbeing brand by 2025 – then there’s no reason why people wouldn’t make us their first port of call digitally too.

Quite aside from the triage capability of AI, there’s a whole plethora of self-help areas where we can help, and where online is actually an appealing way for people to start.

So, that’s the long-term digital vision, but we have to start somewhere, and the starting point is that single customer view. This is the foundation that will allow us to build strong, personalised relationships with members and patients across our full physical and digital network.

What about your flagship programmes?
We’ll continue to grow our flagship programmes. These involve us going out into the community to deliver either free or highly subsidised health programmes for those might most benefit from this help, but who can’t necessarily afford or who don’t have access to our services.

This comes back to our charity status, whereby rather than just looking at things through a purely financial lens, we also measure the value of our initiatives on the basis of social return on investment. We then know where we’re having the greatest impact, whether that’s assisting those with joint pain to the point that they’re able to go back to work, working with those dealing with cancer, or helping children in schools to lead a healthier life.

It’s been a huge drive for us to extend these flagship programmes and initiatives over the last 18 months, and we’ll continue to build and build them.

We’re a charity, so we do look at things through a different lens. Our hospital business is driven by episodic revenue, but if we can get patients through physio to the point where they don’t require an operation or other such intervention, then that’s a good outcome for us.

Ours is absolutely a health and prevention agenda rather than a hospital-based agenda. People are getting older, so I can’t imagine us ever getting to the point where our hospitals aren’t required, but our focus is on keeping people healthy and out of hospital as much as possible.

Are the standalone clinics also part of your growth plans?
These are pretty much all corporate driven: we’re the largest provider of corporate wellbeing services in the UK, with 100,000 members who use corporate gyms within their places of work. Alongside this are our clinics, but again these are created on behalf of our corporate clients.

I don’t see the standalone clinic model being used to fill gaps in our consumer-facing estate. We will still be focusing on creating full-scale hospitals and, at a gym level, using a format that goes no smaller than our existing Fitness & Wellbeing Clubs. However, within that, we’re shifting our clinics out of our hospitals and into our gyms, so hospital patients will now use our gyms for their rehab and clinical activity. Ultimately, we want to use our clubs to improve the outcomes of our clinical services, which all comes back to our core concept of connected health.

Tell us more about connected health
Connected health, put simply, is about end-to-end care. It’s about a personalised journey that embraces everything from preventative health – our Fitness & Wellbeing facilities – through a middle ground where you might need some diagnosis or physiotherapy, for example, right through to intervention and cure in our hospitals.

It’s about getting the support and advice you need from us to improve your health and wellbeing. If you just want to come to us for your fitness, fantastic, but we’re seeing more people than ever who want to engage in total wellbeing. Nuffield Health is unique in its ability to support people throughout this entire journey of health and wellbeing.

How are you structured as an organisation to be able to deliver this?
As Chris mentioned, we’re working to create health communities around the UK where our hospitals and fitness clubs are geographically connected. That’s an important starting point: it will ensure the pathways are there to quickly and comprehensively meet the local population’s healthcare needs, all within one organisation.

Then, at a club level, we’ll work with you to achieve your fitness goals, but if at some point you need an intervention, then we can help here too.

By the end of 2021, all of our Fitness & Wellbeing Clubs will have a physiotherapist and CBT therapist on-site, while half of our estate is already on the Wellbeing Centre+ model. This offers more clinical services – health assessments, pathology lab on-site, potentially a GP on-site – and we’ll keep expanding that clinical offering.

And all facets of our offering are linked. If someone is having emotional wellbeing therapy with us, for example, they also get a month’s free gym membership as part of that. Because it’s clinically proven that, by exercising while you’re suffering from anxiety and depression, you’re more likely to reduce your symptoms. I think this is a really important area in which we have a huge opportunity to make a difference to the nation’s wellbeing.

Meanwhile, hospital patients who have a knee or hip replacement will have their physiotherapy in the club, and alongside this they get 12 weeks’ free gym membership as well as some specialist personal training. It means they recover quicker and it gives them a pathway into Fitness & Wellbeing, with many signing up for membership. That’s great. We don’t want someone having an operation and then, six months later, to be knocking on the hospital’s door again.

And, of course, all our members have access to regular Health MOTs. These might highlight a medical challenge, a physical challenge, an emotional challenge, and it’s our opportunity to flag this to the member and offer them access to a free initial consultation. This is the benefit of having Clinical Services within the Fitness & Wellbeing Clubs and of having multiple service lines within our business.

So that’s Connected Health. Once we have our geography sorted, it means we can offer people the opportunity to not only get better, or be cured, but to stay well afterwards.

Are you able to tell us more about the flagship programmes Chris mentioned?
One great example is our cystic fibrosis programme, which has been going for years, working closely with Great Ormond Street Hospital. The research from that programme, demonstrating the benefits of exercise for cystic fibrosis patients, has won awards.

Participants in the programme are offered a free one-to-one personal training session each week at a participating Nuffield Health Fitness & Wellbeing Club – pre-booked to reduce the risk of cross-infection between young people with cystic fibrosis. Each participant works with a specially trained PT, following a tailored training programme to help develop lung capacity, aerobic fitness and general wellbeing.

At the same time, their parents are allowed to come in and also use the club for free. It’s about trying to give them an hour that just makes them feel better.

Our SWAP programme for schools is also fantastic. It’s a six-week behavioural change programme where we go into predominantly primary schools to educate the children about the four main areas of wellbeing: physical activity, diet, sleep and emotional resilience. We have 325 programmes across the UK at the moment and more schools are actively approaching us. We’re now looking at creating a handbook and online tool for schools that aren’t located close to a Nuffield Health, and we’re starting to provide online emotional wellbeing support for the teachers too.

Our Joint Pain programme is relatively new, but it’s already getting great results. Over 60 per cent of those who have taken part are clinically recognised as having significantly improved and are living with less pain. We’ve had letters from consultants to say they’ve taken patients off operation waiting lists after they’ve taken part. Chris received a beautiful letter from a patient with early onset arthritis, who went on our programme and then walked Hadrian’s Wall with her family.

Are these programmes available in your clubs too?
The health piece is very important in terms of differentiating our member experience. We’re working to embrace more health conditions in our gym programmes, and we’re creating a medically-specific portfolio of classes.

Joint Pain is the first: it’s already available in 50 per cent of our clubs and we will continue to roll it out across our estate. We’re also working with Sheffield University and Sheffield Hallam University on a programme for men with prostate cancer; we’re calling it STAMINA. We’re piloting that to see if we can improve quality of life. We’re also exploring options for a breast cancer programme, and we will be looking at diabetes – at what classes we can design to help patients manage their condition, lose weight and so on.

I’m really keen to look at specialities that impact a lot of people. How can Nuffield Health help people living with these conditions to improve their health or improve their quality of life? That’s what our charity is about.

What role does your fitness team play in delivering connected health?
I have to start with the standards and the quality of our team. We’re the largest employer of CIMSPA professionals in the UK – 1,700 people across our business – and that adds a seal of quality and robustness to the fitness professionals themselves. Our medical professionals, be they GPs, occupational therapists, emotional wellbeing practitioners, physiotherapists or consultants, can confidently refer into our fitness teams.

There are pathways within our business to facilitate that too. Recovery Plus, for example – that’s the 12-week programme for post-operative patients that Martin mentioned. The physiotherapists work side-by-side with the fitness professionals; there’s some specific training that we put our personal trainers through that allows them to do that.

Then there’s the flip-side of that, where our fitness professionals might be training clients who pick up a sports injury or a medical condition. Our teams all have internal referral pathways, so they can refer their clients to the relevant specialists within Nuffield Health.

It can sometimes be as easy as grabbing the physiotherapist for a few minutes – if they aren’t with a patient, the physio will be on the gym floor – and bringing them into the session to do a quick assessment, offer a bit of advice, maybe suggest a few exercises for the member to do. If they feel the member needs more help, they can make an appointment for them. It works really nicely.

We’ve also been hearing about a digital journey. Where does fitness sit in this?
In fact, the work really started in the fitness area as a result of our partnership with Technogym and its Mywellness platform. Nuffield Health now has its own wellbeing app – My Wellbeing - which allows our members to download workouts, take part in fitness challenges and track their progress over time, both in and outside of the gym.

In the first instance, it’s enabling customers to access content that’s relevant to them, including content designed by our experts: workouts they can do with a specific medical condition, for example, or if they’re recovering from an injury.

But this is just the beginning; we have huge ambitions for our digital channels. So far, we’re only seeing the tip of the iceberg in terms of using these channels to knit our service lines together, but the aspiration is absolutely to use the app as a way for people to connect digitally with all of our services. We’re talking everything from booking a GP or hospital appointment, to tracking their Health MOT data and progress, to following personalised programmes based on their health assessments, their injuries, etc.

I absolutely see our app being the hub of how a customer will engage with Nuffield Health, facilitating personalised care both in and outside of our facilities.

What else has been happening in the fitness space?
We realised a few years ago that our physical gym floor proposition needed a step change: equipment, concepts, layout. We wanted to look at it slightly differently to reflect different demographics, including older users, without alienating our core users; in 2019, our most active members were those aged 70–79 years, with members in this age group visiting on average 26 times a month. For members aged 20–29 that figure was 18, and for those aged 30–39 it was 19.

We’ve therefore been rolling out a gym transformation programme across our estate, creating fantastic gym floors that are accessible to all demographics.

We’ve completed this work in 46 clubs so far, and in the next few years I expect to have transformed all the clubs we intend to transform.

A lot of thought goes in to making our gyms as welcoming as possible, especially for beginners. You come onto the gym floor and you’ll immediately see the less intimidating options, with the more advanced stuff a little further away.

What we’ve created, in collaboration with Technogym, is a zonal approach to the gym floor. This includes signature areas such as our coaching zone – a non-intimidating space where beginners can get support from personal trainers to try out new equipment and exercises. That’s probably my favourite, but there are others too. A mobilisation zone. A self-assessment zone, complete with InBody body composition analysis. A series of small group training zones including our SKILL Zone with Technogym SKILLRUNs and Origin functional equipment for HIIT training with a Nuffield twist. Because even here, we make it approachable and non-intimidating, with beginner sessions and so on.

We’ve also created a new studio cycling concept, NuCycle. This was first trialled in one of our forward-thinking corporate sites, but has now spilled into our wider offering. We’re working with Technogym on this too. We’ve already introduced it at 25 clubs and it’s fast becoming a staple part of our gym transformation programme – we’ve probably done 15 of these studios in the last year and I think we will put them everywhere we possibly can.

"As the UK’s largest healthcare charity, we have a huge role to play in supporting the nation during the Covid-19 pandemic.

"At this unprecedented time, we’re easing the pressure on NHS trusts and teams by making 30 of our hospitals (in England and Wales), our hospital teams, equipment and over 1,000 beds available to the NHS to support patients fighting the coronavirus – as well as people who need urgent elective or cancer care.

"Access to our 14 nurseries is also available for NHS and key workers to relieve the strain on employees and their families. We’re also reviewing how our workforce across its network of fitness and wellbeing clubs and clinics can support NHS hospitals and patients.

"We will be reimbursed at cost, meaning no profit will be made, this will be audited by external auditors.

"In line with guidance from both the government and Public Health England, our fitness and wellbeing clubs are currently closed. Membership fees have been frozen and we won’t be collecting any direct debit payments until we can re-open our clubs.

"We’re keeping members up to date regarding re-opening and alternative ways to stay fit, healthy and active during this time, with advice articles and online workouts, as well as activities to help parents maintain and improve the wellbeing and fitness of their children."

Nuffield’s My Wellbeing app, powered by Technogym, extends support outside the gym, engaging members and providing a full wellbeing service.

Features include weekly workouts such as HIIT, core, family workouts and stretch and mobility; a range of challenges to keep members motivated; access to Nuffield home workout videos on YouTube; activity tracking through integration with Strava, Fitbit and Garmin; outdoor activity tracking through in-app GPS; challenges and activities for kids via the kids’ wellbeing pages and; links to expert content, such as emotional wellbeing, nutrition and physio articles and advice.