Physical Activity Really is Medicine.

With Health Secretary Wes Streeting calling for health interventions in non-NHS settings, the question is, how could it work? This study from GM Active could be part of the answer.

Delivering physical activity as a health intervention via exercise referral programmes in leisure centres, community venues, and green spaces is potentially very cost-effective, providing over £20,000 of social value per person using the HM Treasury-endorsed WELLBY, and £5,600 worth of health improvements using the NHS QALY.

The independent study was commissioned to economists, State of Life (named advisors on the 2021 HM Treasury Green Book supplementary guidance on wellbeing for appraisal) and who provide robust evidence on the social value of physical activity using Treasury-endorsed methods. This study builds on State of Life’s work on a new model of social value for Sport England.

The biggest boosts to life satisfaction were seen among those with a lower baseline wellbeing, such as being physically inactive, having a disability or a long-term health condition, or those living in more deprived communities. Specifically, it was found that the greatest wellbeing gains came from those who participated at least 4-6 times a week, attended supervised sessions, attended specialist classes and stayed in the programme for at least 4-6 weeks. The report also shows that benefits were still high among people who started in a programme up to two years ago.

Wellbeing value is up to eight times higher when working with those participating in exercise referral schemes compared to the average adult.

Using HM Treasury-approved well-being valuation methods, this converts into a social value of £21,800 per person per year.

As a comparison, through State of Life’s work with Sport England, they found that a member of the general population being physically active is worth £2,500 of social value. Participation in a GM Active programme is, therefore, worth eight times more, highlighting the expertise the collective organisations have in supporting those with the most health benefits to gain.

NHS QALY value and reduced service use.

The survey also included the EQ-5D-5L questionnaire to measure health-related quality of life. The EQ-5D index was used to calculate QALYs (Quality-adjusted Life Years), a standard used by NICE and the NHS to assess whether health interventions, including drugs and services, offer good value for public money.

Findings suggest that participation in GM Active’s exercise referral programmes is associated with an average health improvement equivalent to £5,600 per person in QALY terms.

Based on a conservative NHS production cost benchmark of £15,000 per QALY, this implies the programmes would represent value for money if delivered at a cost under £1,200 per participant per year – early estimates in the GM Active study suggest the costs could be less than a quarter of this figure. Exactly what Wes Streeting wants to hear.

Participants also reported 19% fewer GP appointments over 28 days compared to those on the waiting list, suggesting that these programmes not only improve health-related quality of life but also reduce pressure on frontline NHS services.

Long term, it is likely this reduction is the tip of the iceberg for NHS savings – and looking at a longitudinal study of these sorts of inventions at a national scale is almost certainly worthwhile.

These findings make the compelling case for expanding and embedding exercise referral as a critical component in the shift from treatment to prevention. They also support GM’s wider ambition to create a population health system that reduces inequality, boosts wellbeing, and reduces pressure on public services.

Andy King, Chair of GM Active, said, “The results of this study are significant. We were determined to properly understand the effect that physical activity could have when used as an intervention to improve a person’s health and well-being. We were prepared to be disappointed with the results – that’s the risk we took – but we were confident that physical activity really is medicine. The impact upon people’s lives is clear; at a time when central government is looking for transformational changes in its approach to health services and across Greater Manchester and the UK, there is an unequivocal commitment to the Live Well initiative.

This study gives ample evidence of the role that physical activity can play.”

Read More - GM Active