Opportunities to engage health system leaders in whole systems approaches to physical activity in England

Full project title: Opportunities to engage health system leaders in whole systems approaches to physical activity in England

Duration: 2019-2021

Project lead for CPHWB: Emeritus Professor David Evans

Other UWE Bristol researcher: Dr Emma Bird

Funder: Public Health England (now Office for Health Improvement and Disparities)

Aim: The study aimed to identify opportunities for engaging NHS systems leaders in whole systems approaches to physical activity.

Background: Despite health care being one of the top eight best investments for increasing physical activity, there are few published studies that examine how to involve health system leaders in whole systems approaches, and none which address how to involve the NHS in promoting physical activity in particular.

Methodology: Thirty telephone interviews were conducted: eight with national stakeholders (including for example, NHS England and NHS Improvement and the Local Government Association) and 22 with local-level informants from four case study sites. Interviewees were purposively sampled to ensure representation from across England and from different levels of the system. 

Results: Thematic analysis highlighted numerous barriers and enablers to engaging the NHS in whole systems approaches to physical activity. Pockets of good practice exist from which lessons can be learned, but there are systemic issues that discourage and create barriers. Leadership and action are required by governmental, NHS and other interested physical activity and health organisations at all levels. National and regional actors like Sport England, health professional bodies, Active Partnerships, the Local Government Association and the newly established Office for Health Improvement and Disparities can encourage and support the NHS to change policy drivers, culture and practices. At local level, public health, physical activity specialists and other organisations have a key role as champions and facilitators of local whole systems approaches and engagement of local NHS leaderships.

Conclusions: Overall findings indicated a range of possible opportunities for engaging NHS system leaders in action across the system at all levels – from local through to national. It is important to recognise that opportunities will vary, and some flexibility is needed, in accordance with the structures, priorities and roles of the systems at differing levels.

• Opportunities to engage health system leaders in whole systems approaches to physical activity in England.
• Engaging NHS system leaders in whole systems approaches to physical activity (PDF).

For further information about the project, please contact Dr Emma Bird (emma.bird@uwe.ac.uk).