Written by Suzanne Gardner and Hannah McDonald, National Partnership Leads (Health & Wellbeing) at Sport England
Our bodies are designed to move, yet movement has largely been designed out of our daily lives. As a society we need to design it back into the fabric of our communities and systems so that we can thrive and flourish as individuals, communities and a population. Re-embedding physical activity into neighbourhood health and community centred care is essential if we are to improve health outcomes, reduce inequalities and support NHS sustainability.
The evidence is clear. Physical activity plays a vital role in preventing and managing long term conditions and associated symptoms, yet 25% of adults are inactive[i], and 28.4% of children and young people do less than 30 minutes of activity a day[ii]. Positioning tackling inactivity at the heart of neighbourhood health would be transformational.
Importantly, this is what people want. 64% of people living with a long‑term condition and 77% of disabled people want to be more active[iii],[iv], and the NHS remains the most trusted source of physical activity advice. Current levels of activity already prevent over 3 million chronic conditions and save the health system more than £8 billion each year[v]. With better integration and collaboration across systems and sectors, the benefits could be far greater.
If physical activity was leveraged to its full potential, it could offer a further £19.6 billion in social value, including £2.4 billion in additional healthcare savings[vi].
Physical activity as prevention and treatment
Physical activity is not only preventative; it is a highly cost-effective way to treat and manage existing conditions. Neighbourhood health models offer the scale and accessibility to embed these approaches into routine care, supporting NHS priorities such as reducing avoidable admissions, managing complexity and preventing complications.
Physical activity is recommended across more than 100 NICE guidelines and quality standards, including for conditions driving hospital demand such as:
Falls: Physical activity can reduce hip fracture risk by 68%[vii]. Falls prevention programmes are effective in decreasing the risk of falls for older adults and are recommended in NICE guideline 249, for example the Otago Exercise Program have shown 35% to 40% reductions.
Cardiovascular Disease: NICE highlights the role of personalised physical activity in cardiac rehabilitation, with outcomes including reducing hospital admissions and readmissions by up to 25% in those with coronary heart disease, including patients with recurrent MI, repeat revascularisation, or heart failure[viii], [ix], [x].
Stroke: Physical activity after stroke improves function, strength, balance, independence, and reduces the risk of further stroke[xi]. NICE recommends incorporating strength, balance, and movement into stroke rehabilitation, as a cost-effective component of long‑term recovery[xii].
The prevention and treatment of depression, with Neighbourhood health offering the opportunity to capitalise on this as part of integrated services and holistic approaches to care.
Opportunities to accelerate impact
Despite this strong evidence base, physical activity has historically been underused across the health and care system. Time pressures, fragmented pathways, workforce capacity, and low confidence have meant it is often seen as a “nice to have” rather than a core intervention. However, cross-sector momentum is building and delivering results…
NHS England’s Four Ways Forward for Physical Activity, alongside programmes such as Moving Medicine, Physical Activity Clinical Champions, and the RCGP Active Practice Charter, has supported tens of thousands of healthcare professionals to embed physical activity into routine practice.
Sport England’s place-based investment of over £250 million across more than 90 communities with the greatest need, put relationships, trust and local leadership at the centre to create lasting change. Two thirds of the 43 locations where NNHIP wave 1 work is focused will also be receiving place-based investment from Sport England -creating opportunity for focused collaboration.
The sport and physical activity sector offers deep expertise in place-based working, co design, and systems change. Learning from Sport England’s place-based working with partners, highlights the conditions for change that could accelerate success in neighbourhood health. These include strong leadership, collaboration, workforce capability, supportive cultures, and community led action.
The network of Active Partnerships play a pivotal role, with 85% already engaging with local integrated neighbourhood teams, embedding evidence-based physical activity into prevention and treatment pathways such as falls prevention, MSK services and cardiac rehabilitation and wider physical activity opportunities that support people to be active in ways that work for them.
There are positive and impactful examples to build upon from across the country, including a growing number of public health, social care, health services and leisure facilities being co-located to better support people’s holistic needs in a way that increases capacity, reduces hospital demand and delivers long-term savings. For example, Sands Leisure Centre (Carlisle) which incorporated MSK services that have freed up acute bed space and increased local MSK capacity by 50%, reducing pressure on physiotherapy, trauma, orthopaedics and mental health services and delivering savings.
What works: examples from practice
Falls prevention: Move2Independence led by Somerset Activity and Sports Partnership supports people recovering at home after hospital discharge through guidance, resources and movement sessions in the home and community. The service, commissioned by Adult Social Care and NHS Somerset, forms an integral part of the intermediate care pathway from healthcare referral into the voluntary and community sector. Among 641 participants, inactivity fell by over half, fear of falling reduced by 32%, and 88% experienced no falls during the programme.
Stroke: A co‑designed community programme for stroke and TIA survivors led by London North-West University Healthcare NHS Trust and Imperial College Healthcare NHS Trust, delivered with football club foundations, community providers and stroke survivors increased activity by 235 minutes per week, with 64% continuing activity post ‑programme. Modelling suggests a conservative 10% reduction in readmissions across 100 patients could deliver a potential annual saving of up to £100k per cohort through improved self-management and reduced NHS dependency
Cardiac rehabilitation: Post, pandemic, the Leicestershire cardiac Phase IV programme redesigned engagement approaches to build trust, address concerns and boost confidence, and co‑produced resources, including a patient booklet featuring participant stories, instructor profiles, programme evidence and FAQs which led to 93% of participants becoming more active and 38% reporting reduced healthcare use.
Physical activity pathways:
Sport for Confidence’s Reconnect Service combines occupational therapy, physical activity expertise and lived experience to reduce barriers and tackle inequalities. Reconnect is a placed based early help and prevention service, within the social care pathway, improving wellbeing and strengthening collaboration across health, care, and community. This model has increased physical activity levels, reduced healthcare service use (saving an estimated £365.23 per participant annually), and delivered significant social and economic value (£22,230 per person per year in life satisfaction).
Oxfordshire’s Move Together supports people with health conditions to increase activity through tailored advice, behavioural support and signposting to a variety of structured and unstructured activity options. Coordinated by Active Oxfordshire partnering with local authorities, Move Together is part of Oxfordshire’s ‘Whole Systems approach to PA and jointly funded by the BOB Integrated Care Board, Oxfordshire County Council Public Health and City and District councils. Of the 1,932 people who joined in 2024-25, 79% were inactive, 64% increased their activity levels and reported significant health improvements. This delivered a 22% reduction in out-of-hours demand, 43% fewer GP appointments delivering a social value of £1.45m, and £3.70 of return for every £1 invested.
What you can do
Connect
Build or deepen relationships across the health and physical activity system to determine and create action around a shared purpose of inactivity and health inequalities that focuses on those that would benefit the most. A key route to achieve this is for Neighbourhood Health partners and Active Partnerships, who play a key connector role in the community, to connect. This could include simplifying referral pathways from healthcare into community activity, which the Moving Together programme is addressing, alongside the use of digital tools, social prescribing, and resources such as Moving Medicine.
Collaborate
Co-ordinate strategic planning, action and investment across sectors to spread and scale proven approaches tailored to the needs of different places and systems, including falls prevention, cardiac rehab and stroke recovery.
Champion
Promote physical activity as a routine, evidence-based ‑intervention and champion action against the NHS Four Ways Forward. Utilise tools such as, Moving Medicine, Physical Activity Clinical Champions Programme and the NHS Four Ways Forward blogs to empower neighbourhood teams to connect people with health conditions to high quality local physical activity provision.
Delivering lasting impact
By embedding physical activity into neighbourhood health, we can shift the dial on inactivity, improve lives and relieve pressure on the health system. Sport England modelling suggests that supporting the one in four people who would be more active if advised by a healthcare professional could lead to 2.8 million fewer inactive adults, 525,000 more active children, and £0.84 billion in additional healthcare savings.
[i] Sport England (2024) Active Lives Adult Survey Nov 2023 – 24 Report
[ii] Sport England (2025) Active Lives Children and Young People Survey Academic Year 2024 – 25 Report
[iii] Richmond Group of Charities (2024) Bridging the Gap Report
[iv] Activity Alliance (2023) Annual Disability and Activity Survey 2022-23
[v] Sport England (2025) Social Value of Sport and Physical Activity in England 2024 - 2025
[vi] Sport England (2025) Social Value of Sport and Physical Activity in England 2024 - 2025
[vii] https://www.gov.uk/government/publications/physical-activity-applying-all-our-health/physical-activity-applying-all-our-health
[viii] Anderson, L, Oldridge, N., Thompson, D., Zwisler, A., Rees, K., Martin, N., and Taylor, R. (2016) Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. Journal of the American College of Cardiology 5 (67) 1-12 doi: 10.1016/j.jacc.2015.10.044
[ix] Dalal, H., Doherty, P., Taylor, R. (2015) Cardiac rehabilitation. British Medical Journal 351 Available at: https://www.bmj.com/content/bmj/351/bmj.h5000.full.pdf
[x] Sagar, V., Davies, E., Briscoe, S., Coats, A., Dalal, H., Lough, F., Rees, K., Singh, S., and Taylor, R.(2015) Exercise-based rehabilitation for heart failure: systematic review and meta-analysis. Open Heart 2 (1) doi: 10.1136/openhrt-2014-000163 Available at: https://pubmed.ncbi.nlm.nih.gov/25685361/
[xi] Moving Medicine Stroke evidence briefing
[xii] https://www.nice.org.uk/guidance/ng236
