Importance of being active
The benefits of regular physical activity are clearly articulated:
• for adults, achieving 150 minutes (2 ½ hours) of at least
moderate intensity physical activity over a week
• Comparable benefits can be achieved through 75 minutes
of vigorous exercise throughout the week
• helps prevent and manage over 20 chronic conditions
including coronary heart disease, stroke, type 2 diabetes,
cancer, obesity, mental health problems and
musculoskeletal conditions
What does this look like?
• Only 39% of men and 29% of women are currently meeting the CMO
recommendations for physical activity
• That’s 27 million people in England alone who are not active enough to
benefit their health
• The NHS spends £3,000 every minute on combating illness, which
could be prevented by increased physical activity
• A modest increase in physical activity amongst older people could cut
hip fractures by one per cent, saving the NHS more than £200 million a
year.
• A 20 per cent increase in cycling would save the NHS more than £50
million in treatments.
Why commission Let’s
Get Moving?
Making the case
• NICE fully endorses the importance of physical activity as a
means to promote good health and prevent disease (NICE 2006 PH2)
• NICE endorses brief interventions in physical activity as being
both clinically and cost-effective for delivery by the NHS in primary
care. (NICE 2006 PH2)
• Around one in four people in England say they would be more
active if they were advised to do so by a GP or nurse. (HSE 2007)
• 54 per cent of patients said that their GP had not provided advice
on diet and exercise. (Lord Darzi's NHS Next Stage Review Final Report)
The Evidence
According to NICE PH guidance 2, primary care practitioners
should:
• using a validated tool (GPPAQ), identify inactive adults
• advise them to aim for the amount of activity outlined in the
guidelines
• take into account the individual’s needs, preferences and
circumstances
• agree goals with them
• provide written information about the benefits of activity
and the local opportunities to be active
Brief interventions
Following a review of the extensive evidence on lifestyle change,
NICE recommended the delivery of brief interventions that help
people to:
•
•
•
•
•
•
understand the likely impact of their behavior on their health
feel positive / optimistic about changing their behaviour
make a personal commitment to change
set goals to undertake specific actions over a specified time
plan changes in terms of easy steps
plan for events or situations that might get in they way of
change
• share their behaviour change goals with others
Lets Get Moving
Introducing ‘Lets Get Moving’
• a behaviour change programme that incorporates a
Physical Activity Care Pathway based on
recommendations of the NICE Public Health Guidance 2
&6
• LGM is designed to assist practitioners in guiding inactive
adults aged 16-74 towards gradually become more active,
for the prevention and management of chronic disease
• has proven feasible for delivery by practitioners working in
primary care settings.
Local priorities
LGM presents important commissioning opportunities for
a new Public Health Service
LGM will help to drive public health outcome indicators and
reduce health inequalities caused by physical inactivity
LGM supports delivery of public health initiatives, such as:
• NHS Health Check
• Long term conditions
Step 1. Recruit
1. Recruitment methodology decided at a local level
2. Flexible entry route:
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•
•
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New Patient Registration
Health Check
Diabetes Clinic
Disease Registers
Step 2. Screen
Assess physical activity levels using the GPPAQ
This classifies people into one of four categories:
• Inactive
• Moderately inactive
• Moderately active
• Active
Step 3. Intervene
The spirit of the approach
• Telling people what to do can sometimes be helpful
• However, in health behaviour change, a telling
approach can sometimes get in the way
• Evidence suggests that adopting a “guiding style” can
be more effective and helpful in motivating people to
think about, start and persist with lifestyle change
• Lets Get Moving takes a motivational interviewing
approach
Step 3. Intervene cont’d
3. The practitioner, skilled in the use of motivational interviewing
principles follow initial steps to guide the patient towards one
of the following options:
a. Patient decides to do nothing further and so leaving the
pathway
b. Patient chooses to become more active and sets a
personal physical activity goal
c. Patient chooses to have a more in-depth motivational
interview about physical activity with a trained MI
practitioner.
LGM patient support pack
Intervene options b or c.
Patient is provided with a Let’s Get Moving
patient support pack, which includes:
 Motivational interviewing exercises
 Goal setting sheet
 Customised insert featuring local physical activity
opportunities
Step 4. Active participation
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Following a brief intervention there is about a 12 week
period where the patient gradually becomes active on their
own
Patients may need to be followed up more regularly than
this
Some patients may benefit from extra support during this
time, for example by a health trainer
Step 5. Review

It is recommended that the patient is followed up at regular
intervals, for example 3,6 and 12 months

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The NICE guidance says patients should be followed up at
regular intervals over 3 and 6 months
The GPPAQ requires annual completion
Feasibility pilot
Summary of findings
• 526 adults were screened, of which 86% were found to be less
than active and 83% were interested in becoming more active
• 315 attended the LGM brief intervention, of those, 54% were
from black and ethnic minority groups
• The LGM brief intervention took between 3 to 21 minutes to
complete
• Patients who attended the follow up intervention, 62% self
reported an increase in their physical activity levels
• Also at the follow up intervention, 59% of adults reported
undertaking self-directed outdoor activities e.g. walking.
Commissioning
Let’s Get Moving
Commissioning Let’s Get Moving
• It is up to each commissioner to decide whether they want
to commission LGM to meet their:
– communities’ health needs (JSNA) and
– Local priorities including those identified through the public
health outcomes framework
• In commissioning LGM, commissioners will stipulate the
model used, who will provide the service, and who the
service is open to and then how they plan to monitor the
service
Commissioning Let’s Get Moving
cont…
To commission LGM, the commissioner should ensure the
following:
• Appropriate service provider commissioned to target specific
population
• Service providers are appropriately trained to deliver Lets Get
Moving
• The patient pack is available with local activity inserts completed
for the service provider to give to patients
• The service provider is the appropriately supported and
monitored
Partner opportunities for LGM
• LGM offers a real opportunity for partnership working to
ensure that appropriate physical activity opportunities are
available.
• The patient pack should include a wide variety of physical
activity and sport opportunities for people new to physical
activity
– Such as walking groups, led cycle rides, dance, swimming,
leisure centre based classes
Further information on delivery
For further information about Let’s Get Moving, visit:
www.dh.gov.uk and search for Let’s Get Moving
You will find details of:
• LGM commissioning guidance
• LGM patient support pack
• GPPAQ
• LGM feasibility study
• LGM training information
• NHS choices physical activity search tool for local opportunities
• Email queries to: letsgetmoving@dh.gsi.gov.uk
Questions
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the person delivering
presentation