The FSEM responds to government and other related consultations on public health, wellbeing, physical activity, sport and exercise on behalf of its members.
Our aim in engaging with policy is to ensure the medical specialty of Sport and Exercise Medicine is recognised as a means to prevent and manage many common diseases, improve public health and ensure standards in the medical care of athletes at all levels.
Scottish Parliament Health and Sport Committee - Preventative Agenda
The FSEM responded to the Scottish Parliament's Preventative Agenda Inquiry on the 28 February 2017, key points included:
- An outline of the role of physical activity in population health and the impact a more active nation would have on the health of a nation.
- Clear guidance and support for prevention strategies focussed on the role of physical activity in a community.
- The known benefits and the role that a structured Sport and Exercise Medicine Consultant (SEM) would bring to the wider clinical and social structure in the Scottish Healthboards i.e.
- A “Physical Activity Champion”and a Sports & Exercise Medicine Consultant to facilitate understanding of the impact of inactivity on disease and population health, who can lead the wider integrated healthcare team and influence local and national governmental bodies.
- Sport and Exercise Medicine can advise on prevention strategies that are researched and impactful (eg: ischaemic heart disease, stroke, certain cancers, diabetes, mental health), providing clinical support for complex rehabilitation cases or areas such as concussion where supervision of return to work / return to play is becoming increasingly important.
- There are also additional skills that can be utilised in the musculoskeletal pathway, reducing referrals to secondary care, reducing radiology burdens, improving patient outcomes and access to the right person at the right time.
- Setting up an Muscluoskeletal Medicine service to offload traditional Orthopaedic referrals is already known to save £62 - £85 per consultation.
- Physical activity interventions are cost effective and we know that leading a more active life reduces your overall risk of many common conditions for example diabetes by 30%. Applying this to 600000 Scots at risk of diabetes, 180000 would be spared the illness by a simple intervention.
Work, Health and Disability Green Paper: Improving Lives
The FSEM responded to the Work,Health and Disability Consultation on the 17 February 2017, key points included:
- Musculoskeletal (MSK) conditions are a leading cause of inability to work and working days lost.[i] Physician led workplace wellness schemes are highly cost effective[ii]
- Sport and Exercise Medicine has the skills and knowledge to lead clinical vocational multi-disciplinary teams which can improve health and employment outcomes in the community.
- Early assessment for musculoskeletal (MSK) conditions is key via a community-based Sport and Exercise Medicine (SEM) team who can provide functional analysis of limitations and abilities and decide on the optimal care pathway in order to meet health and employment needs.
- NHS Commissioners need to see exemplar service-delivery models drawn from existing instances of best practice, this exists within Sport and Exercise Medicine MSK models of care.
- There is a need to develop integration between Clinical Vocational multi-disciplinary teams and Jobcentres to integrate healthcare, social care and the department of Work and Pensions.
- There needs to be a broader understanding of the nature of specific disabilities in order to identify opportunities and mitigate limitations within the workplace.
- Where medical issues arise and are identified by clinicians, adaptations should be made swiftly with funding from Social Services or Department of Work and Pensions to enable continued employment.
- Access to employment support can be improved via different avenues of referral including Exercise Medicine and physical activity referral schemes.
- Graduated return-to-work (GroW) programmes are effective. Learning can be taken from sport and team medical care where a prescriptive period of appropriate goal-based rehab and a graduated return to performance/work is already being used.
[i] Arthritis Research UK (2016). Working with arthritis.
[ii] Sport and Exercise Medicine A Fresh Approach NHS North West (2011)
Image Courtesy of the Work Health and Disability Green Paper October 2016
Sport Duty of Care Review
The FSEM responded to this consultation in May 2016, key points included:
- Ensuring that the appropriate medical care is available for all athletes and sports participants
- The medical specialty of Sport and Exercise Medicine (SEM) has a large role to play in sport duty of care
- Recognising appropriate medical qualifications and qualified SEM doctors for preventing and managing illness and injury in sport and exercise
- Reducing risk in sport. Every sport should be responsible for collecting appropriate injury data, at junior, recreational and elite level
- Further investment in Sport and Exercise Medicine NHS posts, providing optimal early treatment ensures a participant can continue to take part in sport and exercise
- A strong recommendation that National Governing Bodies use external expert advice when appointing team doctors or chief medical officers
- Support and recognition of approved immediate medical care courses in sport training for doctors and allied health professionals
- Availability of Automatic External Defibrillators (AEDs) in public places
Draft Cycling and Walking Investment Strategy
The FSEM Responded to this consultation by the Department for Transport in May 2016, key points included:
- Promoting cycling and walking as a treatment for chronic diseases and musculoskeletal problems
- Recognition of the role of the NHS in delivering this strategy
- The role of rehabilitation in improving competence to cycle and walk
- A plan to encourage real behaviour change to accompany infrastructure change
- The importance of GP practices and the role they can play
- Involving multidisciplinary teams in planning
A New Strategy for Sport Consultation
The FSEM responded to this Department for Media Culture and Sport consultation in October 2015. The response focuses on the sections of the consultation most relevant to the FSEM's strategic objectives:
Amongst our key points and recommendations were:
- A centrally coordinated campaign to encouraging an increase in physical activity participation, including sport, that unites bodies and people across the UK and encompasses the CMO physical activity guidelines.
- Funding for GP physical activity assessment and education, education of all Health Professionals in physical activity and exercise.
- Deliver long term sustainable change through, value for money, therapeutic sport and exercise medicine services in the NHS.
- The prevention and management of chronic disease - increase access, for those identified as high risk, to physical activity interventions and exercise medicine.
- There is a shared responsibility for the government and the NHS/medical profession to enable further evidence to be created on the benefits and health economies of physical activity.
- The FSEM fully supports the work of the NCSEM to ensure the continued sustainability and growth of this valuable national medical and science resource for Elite Sport.
In November 2015, Sporting Future - A New Strategy for an Active Nation was released by the Department for Culture Media and Sport and Tracey Crouch MP.
The cross-government strategy aims to “tackle head on the flatlining levels of sport participation and high levels of inactivity in this country” and includes a five page section on physical activity in which Sport and Exercise Medicine and “its use within the NHS and wider public health practice” is a key part of its deliverables. Read the Sport and Exercise Medicine deliverable on page 29.
Department for Transport Cycling Delivery Plan
The FSEM with the Royal College of Physicians submitted its response to this consultation in November 2014. Our key points and recommendations were:
- The plan should recognise the role of physical activity and cycling as a treatment, via exercise medicine, in both primary and secondary care, in addition to wider public benefits
- Cycling should be promoted as one of the many ways to easily achieve the recommended levels of physical activity per week
- The plan should encourage real behaviour change which will only be achieved if improved infrastructure is accompanied by removing social/economic barriers to participating in physical activity
More Sport for All - Labour Party Policy Review
The FSEM with the Royal College of Physicians submitted its response to this consultation in September 2014. Our key points and recommendations were:
- Other forms of physical activity should be promoted alongside sport
- Strategies and programmes to promote sport and physical activity must be better coordinated across different government and public bodies
- The quality of PE in schools must improve and be more inclusive to promote wider physical activity rather than just sport
- Greater emphasis on fitness indicators such as cardiorespiratory fitness over BMI will better reflect the health of the nation
All Party Commission on Physical Activity
The FSEM responded to the Parliamentary Commission for Physical Activity open call for evidence in December 2013 calling for a national programme for physical activity health and wellness. Our key points and recommendations were:
- The national plan will set out clear goals and oversee regional delivery. A clearly articulated plan of action is to be established based around three key work streams:
- Children and Adolescents – Grow the National Plan with our children and Youth: but this would be a 10-15 yr plan of social change.
- Workplace Health - 54% of the global population. Key would be lifestyle management programmes: physical activity & nutrition
- Active Ageing-Health Ageing – Partnership for Older People