By Professor Rob Copeland, director of the Advanced Wellbeing Research Centre, and Dr Anna Lowe, programme manager at the National Centre for Sports and Exercise Medicine

Wednesday 3 November • Viewing time: 1 minute

A new model for referring patients with long-term health conditions developed as part of the London 2012 Olympic Legacy is providing answers to one of the biggest health challenges across the world — how to get us all to move more.

One of the biggest pressures faced by our health and social care system today is the increase in long-term conditions such as cardiovascular disease, type 2 diabetes, obesity, arthritis, cancer and depression. 

Inactivity due to ill health costs the UK economy £15 billion a year. And existing inequalities mean that people living in disadvantaged areas are more likely to become ill.

We know that helping people maintain an active lifestyle leads to better health, particularly among those with long-term conditions. But the failure of successive NHS strategies has proved that getting people to move more is harder than it sounds.

As partners with the National Centre for Sport and Exercise Medicine, we have helped Sheffield rise to the challenge — by pioneering a world-first new model for health services. 

By moving clinical appointments out of hospitals and doctors’ surgeries and into specially designed community leisure centres, we’ve played a key role in helping thousands of people to become more active — and allowing NHS staff to work more closely together.

How the idea developed

It all started with the London 2012 Olympic Games. As part of the tournament’s legacy, the government set up the National Centre for Sport and Exercise Medicine (NCSEM), with one of its three hubs located in Sheffield. 

Its aim was to improve health and wellbeing services by bringing together people from different sectors, including council bodies, NHS trusts and academics — including us here at the Advanced Wellbeing Research Centre.

At the same time, local NHS managers were reviewing how they provide their musculoskeletal services. Through the new centre, we were brought in to discuss how they might deliver services differently. After consulting patients we found many wanted to be supported to be more mobile and active, rather than having an operation.

At the same time, we found that physiotherapists were often working on their own in GP surgeries. They didn't have the opportunity to speak to other colleagues and share ideas for treatment. 

We thought about how to tackle both challenges — helping people stay active, and enabling more collaboration between clinicians. Our answer was to move hospital and GP appointments into the community. And that’s how we came up with Move More centres.

So what is a Move More centre?

Through the NCSEM, we have created three Move More centres in Sheffield, all based in leisure centres which were already embedded in the communities they serve. 

Walk into one and at first glance it looks like a regular leisure centre, with a gym, swimming pool and a cafe. But look closer and you’ll see crutches, wheelchairs and other signs of limited mobility. 

That’s because it’s also used as an NHS waiting room for appointments for people with long-term conditions such as musculoskeletal problems or diabetes, and for those recovering from neurological events like strokes. 

Once called up, patients are taken to one of 20 large clinical rooms and assessed. They are often put on a 12-week supported programme of physical activity. Often, you’ll see physiotherapists taking their patient straight into the gym next door to get them started.

Why does it work so well?

The three Move More centres deliver around 100,000 NHS appointments a year. And each year, more than 1,000 people are referred for physical activity support — significantly more than NHS facilities in traditional settings. 

What’s more, the evidence shows that those people referred for physical activity are much more likely to sustain that activity, leading to better health outcomes. But why?

One answer is that holding appointments in a leisure centre, rather than a hospital or a GP surgery, has a powerful psychological effect on patients. 

Attending a hospital can give you the mindset that you are there to be “fixed” by a doctor. By contrast, the leisure centre changes what you see as possible. You see other people with limited mobility like you going to the gym and being active. Our research shows that this makes physical activity less intimidating and empowers people to move more.

As for the healthcare professionals, being based in the same location means they’re able to collaborate more and improve the care they provide. 

Being based in the leisure centre makes it as easy as possible for them to do their jobs, and as easy as possible for the patients to follow through on their activity programme.

A bright future for the model

The success of the Move More centres was highlighted again during the Covid-19 pandemic, when they were able to continue delivering services throughout the lockdowns. Patients who were anxious about visiting a hospital were happier to attend an appointment at the leisure centre. And by continuing to see patients, clinicians were able to reduce the backlog for the NHS.

Now word is spreading far and wide about our healthcare model. Both of us are regularly contacted by wellbeing industry bodies in the UK and health services and universities around the world, as they seek to replicate our success.

We are also working with Yorkshire Cancer Research to develop a programme to support people with a cancer diagnosis into physical activity — before, during and after their cancer treatment.

Ultimately our research is about a culture change in physical activity, bringing together healthcare and wellbeing. We know it works, and we know it draws people in who previously wouldn't have set foot in a leisure centre. 

And for healthcare staff, not only does it deliver services in a better way, but it also helps create brand new services.

With the new working environment that has been created, the NCSEM partnership has changed what’s possible, and led the way in tackling one of the world’s biggest challenges — how to help people move more.