The health care challenge

The health care challenge
 time to stick our necks out
 Slow-motion catastrophe
Our society faces a rising tide of chronic ill health. We are in the midst of what can only be
described as an epidemic, or what the Director General of the World Health Organisation
has called ‘a slow-motion catastrophe’ of chronic noncommunicable diseases.
The health care challenge

This catastrophe has been driven by a number of global trends (e.g. an increasingly
aged population and rapid, often unplanned urbanisation) but perhaps central to it is what has been termed the ‘globalisation of unhealthy lifestyles’ - poor eating habits and decreasing physical activity.
People, are living longer than ever but often in poor health and sustained by a medical profession increasingly skilled in the management of illness.
However, as the waiting rooms and hospital wards fill, NHS funds are depleted and the
financial strain on our economy increases. The cost of physical inactivity through the ill-health it causes is in fact projected to be roughly £8.2bn per year to the UK economy.

Tightening belts
It is with some trepidation that we all face up to an uncertain economic environment – who
knew there was such a thing as a triple dip recession? In keeping with this economic
environment, the government is tightening its belt and has set its course on significant
reductions in public spending.
No government department will remain untouched by the cost cutting process. Despite
the government protecting the NHS budget from the severe cuts faced by other public services, the NHS has to find a means to make £20bn in cost  savings by 2015 (equivalent of
4% of the budget per year).

Fit to burst 
 The health care challenge

 So what are we to do? At a time when the financial burden on the health service from our increasingly sedentary lifestyles has never been greater, those with the power to make such decisions are reducing the budgets previously allocated to deal with our chronic lack  of self care.
An opportunity
Of the £20bn cost savings required of the NHS, only £10bn are projected through efficiency
savings; if the NHS is not to ‘fail’, the remaining £10bn must be identified through the prevention of ill health. So herein lays both the challenge and the opportunity for our industry.
The benefits of physical activity in offsetting the risk of developing many chronic health conditions are well documented.
Regular physical activity, in line with the Chief Medical Officer’s recommendations of 30
minutes of moderate intensity activity on five or more days of the week (60 minutes every
day for children and young people) can reduce their risk of developing major chronic
diseases – such as coronary heart disease, stroke and type 2 diabetes – by up to 50%, and
the risk of premature death by about 20–30%.
So, the rising tide of ill health and the pressures this imposes on the health service means
that over the next 10 years our industry, as the purveyor of physical activity, has a pivotal
role to play in providing preventative activity strategies, thereby containing healthcare demands.

Ready to engage
As the UK government and health service face up to the economic and social consequences of a ‘wellness’ crisis, we are starting to see a greater willingness to engage with our sector.
Perhaps the embodiment of this was the setting up of a Joint Consultative Forum (JCF) in 2010 between the fitness sector, Medical Royal Colleges and Faculties in the United
Kingdom, and the Chartered Society of Physiotherapy.
The JCF identified a limited use of physical activity and exercise programmes as part of preventative medicine and medical treatments. This could be attributed in large to
the current limited interaction between doctors who prescribe them and fitness professionals
who deliver them. As a result of this conclusion, the JCF set out to draw up standards
for the UK in the use of exercise in the management of chronic disease, or as our
industry would refer to it, ‘exercise referral’. These new Professional and Operational
Standards for Exercise Referral are due to be released in the next few months.
The Royal College of Physicians has also published a report, ‘Exercise for Life’, outlining a series of recommendations to establish an exercise as part of the routine prevention and management of chronic disease. This is a ground-breaking document highlighting the importance of exercise and general physical activity. It is also telling that the Royal College have on several occasions highlighted the FIA (now UKActive) as a “key
collaborator” and the JCF as the body to take forward many of the recommendations of the
report. This is a significant step forward for our sector.

Same strategy, same result
The question we must ask ourselves is how can we best assist the government and the health service to reduce the financial pressures it faces through providing the ‘preventative medicine’ that is physical activity in the correct dose and to the widest cross
section of the community. And the starting point has to be examining where we are as an
industry now.
The Department of Health’s Health Survey for England (2006) reported that 60% of
men and 72% of women are insufficiently active to benefit their health. This alarming
statistic is perhaps reflected in the fact that presently only 12.1 per cent of the UK
population are now registered as members of a health and fitness club or publicly-owned
fitness facility (2012 State of the UK Fitness Industry report).
So it would appear that whatever we are doing as an industry is not impacting on the large mass of the general population who it would seem, are not suitably inspired by the
messages we are sending out to become physically active.
It would appear more likely that we are in fact appealing to the percentage of the population
who are already active and simply need somewhere to go to engage in a well-established
pattern of behaviour.
Like the high street store that refuses to adapt its product to the new shopping environment
created by the rise of the internet and tablet devices, if we keep doing the same things
we will keep getting the same, or even diminishing results. So rather than continuing to appeal to the minority we must widen our net and reach out to those individuals and communities who are not currently engaged in physical activity.

The recognition of this fact was recently reflected in the rebranding of our trade body, the Fitness Industry Association, to Ukactive. This rebranding was a clear acknowledgement of the fact that if we are to truly make ‘more people, more active, more often’ we can no longer be seen as the deliverers of ‘fitness’ or the ‘body beautiful’ but of a lifestyle that incorporates physical activity as a necessary and enjoyable aspect of a full and healthy life. In other words, we must stop talking about the gym and trying to lure people into it, like some Orwellian ‘big brother’, and instead get out there into our communities and start offering the sorts of inclusive products and services that will appeal to even the most staunchly inactive. To echo the words of James Bryant Conant, former reformist President of Harvard University, “Behold the turtle. He makes progress only when he sticks his neck out.”

AllFitness ___ The health care challenge
Julian Berriman

Research & Development Director

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