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Why the NHS needs to get its approach to exercise ‘match fit’

Helen Greenough, a freelance writer for health and wellbeing discusses physical activity ‘a significant untapped resource’ for the NHS. Helen is also a mother to 2 children (and a dog!) and since becoming a parent has become even more passionate about key healthcare issues that impact the state of healthcare provision both now and for the future.

Health policy topped the list of most important election issues among ordinary voters before May the 7th, therefore it was no surprise that Jeremy Hunt set out his stall quickly providing a 25 year vision for the NHS. Facing unprecedented budgetary pressures coupled with ever increasing demand and a new proposal for a 24/7 health service, it is widely acknowledged that the NHS and those who work in it are under immense strain. It is clear that the NHS needs a major injection of wellbeing if it is to avoid the organizational equivalent of a cardiac arrest. The vast majority of policymakers agree that the answer to this mammoth challenge is not just more money. A fresh approach would appear to be,’ what the doctor has ordered,’ if real results are to be achieved. Perhaps then the solution is staring us all in the face? What if to get the NHS moving again what we really need to do is just that- get moving? While many health professionals agree that the benefits of physical activity represent a significant untapped resource, there has been limited progress in terms of introducing this fundamental principle into NHS practices. Let’s take a closer look at how embedding physical activity into public health policies could get patients and practitioners moving towards enhanced wellbeing.

Why exercise is good for our health

Exercise generates a variety of physical and psychological benefits. Research has proven the link between regular sessions of physical activity and reduction in risk levels of serious illnesses such as cancer and heart disease, as well as boosting mood and improving energy levels. Studies have also found strong connections between physical activity and the prevention as well as treatment of mental health conditions such as depression. So physical activity can help in a general sense in terms of protecting our wellbeing and keeping us healthier, but what about its use in direct treatment? Can regular bouts of exercise ever be a substitute for drug treatments? The World Health Organisation (WHO) certainly believes so. At a special event held by the European Network for Health-Enhancing Physical Activity late last year, the WHO revealed that approximately ten percent of deaths in Europe each year are attributed to physical inactivity. Integrating physical activity into healing strategies delivered in healthcare settings was seen to be central to addressing this problem.

Physical activity and coronary care

Widely recognised as a powerful primary and secondary preventer of cardiovascular disease, regular physical activity is frequently cited as a top to-do for better heart health. Patients who have already suffered a heart attack or have heart disease may be concerned about the strain which exercise may place on their heart function. The British Heart Foundation believe that inactivity can be as damaging as too much activity and thus advocate a structured programme of cardiac rehabilitation. This measured, informed approach helps the patient understand more about their condition and make changes to their lifestyle to reduce the likelihood of re-occurrence. While cardiac rehabilitation services are available in a number of hospitals, as with much healthcare provision the jam is spread rather thin. Travelling to a cardiac rehabilitation centre may be an option for some patients but for others distance acts as a barrier to this effective form of treatment.

Physical activity and cancer

Keeping active is seen as an integral part of recovery for the majority of cancer patients. Clinicians believe that although recuperative rest is important this needs to be balanced with exercise in order to regain and support bodily functionality. Although pockets of good practice exist across the country in terms of implementing this approach, the facts remain that physical activity plays only a limited role in the recovery process for many cancer patients. Earlier this year a Cancer Research UK Health Behaviour Research Centre survey reported that more than two-thirds of bowel cancer patients they interviewed had not been advised to undertake regular exercise. This was despite the fact that a Cancer Research UK study published in the British Medical Journal had previously demonstrated strong linkages between brisk physical activity and better survival in bowel cancer. Research from the Netherlands Cancer Institute has also established that moderate and even low intensity exercise can prove beneficial for women receiving chemotherapy treatment. Their study found that physical activity could lead to a reduced decline in cardio-respiratory function, lower levels of tiredness and less likelihood of chemotherapy dose reduction.

Physical activity and dementia

With an ageing population one of the biggest health challenges facing the UK is Alzheimer’s disease and other forms of dementia. The Alzheimer’s Society strongly believes that exercise can improve the quality of life for people at all stages of their dementia journey. From walking to gardening to dancing, physical activity is considered an essential part of improving cognition and maintaining independence. Due to the nature of the condition, a large number of dementia patients are unlikely to initiate exercise themselves and require prompting from medical professionals and carers. Positive results have been achieved through home based programmes delivered on a community basis with the support of carers. Significant improvements linked to the exercise included better hand function and greater lower body strength. A £300,000 research study led by the University of Stirling’s Dementia Services Development Centre has recently been launched which will focus on the physical activity needs of dementia patients living in care homes. The aims of the research are to devise, test and evaluate interventions which could easily be integrated into the daily lives of residents.

Putting physical activity at the centre of healthcare

With all these plus points it would be easy to assume that healthcare professionals would be already well on the way to maximising the benefits of physical activity in terms of contributing to better public health. Unfortunately this is an area where in reality much more needs to be done. Although the NHS Five Year Forward View planning strategy does recognise the potential of prevention as a key tool in terms of improving the nation’s health there is insufficient focus on physical activity and indeed inactivity as part of this. One simple step, which has been strongly advocated by the Faculty of Sport and Exercise Medicine, would be to introduce a physical activity assessment tool into the dialogue between GPs and their patients. This would mean that as well as questioning patients about issues such as smoking and alcohol consumption, GPs would also ask them about their levels of physical activity. By opening up a discussion on the impact of physical activity in relation to health, GPs could become a powerful force for good in terms of increasing the amount of physical exercise being undertaken across the nation. They could then truly become drivers of what the Academy of Medical Royal Colleges believes is, “a miracle cure too often overlooked by doctors and the people they care for.” Prolific English 17th century author Thomas Fuller once observed,

“He who cures a disease may be the skillfullest, but he that prevents it is the safest physician.”

By taking the reins of a proactive strategy to integrate physical activity into day to day healthcare processes, today’s Healthcare Professionals have the opportunity to apply this lesson of the past and make it work for now and the future.

Citations:

http://www.bbc.co.uk/news/uk-politics-30980022

http://www.psychguides.com/guides/depressive-disorder-in-older-patients/

http://www.euro.who.int/en/health-topics/environment-and-health/pages/news/news/2014/09/physical-activity-must-be-promoted-more-in-health-care-settings

https://www.bhf.org.uk/heart-health/living-with-a-heart-condition/cardiac-rehabilitation

http://medicalxpress.com/news/2015-04-two-thirds-bowel-cancer-patients-health.html

http://www.pharmaceutical-journal.com/news-and-analysis/research-briefing/exercise-programmes-benefit-women-on-chemotherapy/20068485.article

https://www.gmjournal.co.uk/exercise_in_the_management_of_dementia_25769816499.aspx

http://www.careappointments.co.uk/care-news/scotland/item/37068-300k-study-explores-physical-activity-for-people-with-dementia

http://www.goodreads.com/quotes/807951-he-who-cures-a-disease-may-be-the-skillfullest-but

http://www.aomrc.org.uk/doc_download/9821-exercise-the-miracle-cure-february-2015.html

Written by Helen Greenough at 04:30