Physical Activity

Physical activity has been described as ‘the miracle cure’. Being active has enormous health and wellbeing benefits for us all – regular exercise can prevent dementia, type 2 diabetes, some cancers, depression, heart disease and other common serious conditions – reducing the risk of each by at least 30% (Source: Academy of Medical Royal Colleges). 

Regular physical activity, in combination with standard medical care, has an important role in the prevention and management of many long-term conditions including mental ill health. The consensus statement released by health experts in November 2021 states that physical activity benefits outweigh risks for people with long-term health conditions, and determines that physical activity is safe, even for people with multiple conditions. One in four people in England live with long-term health conditions and, according to the national Active Lives survey, this group is twice as likely to be inactive compared to those without a long-term condition. Furthermore, the likelihood of being inactive increases for people with multiple conditions. 

Physical activity is defined as movement and force upon the body that results in raised heartbeat and energy expenditure. The Office for Health Improvement & Disparities recognises four main categories of physical activity: 

• Active Living: housework, gardening, walking and play. 
• Active Travel: walking, cycling and running. 
• Recreation: exercise, dance and swimming. 
• Sport: informal sport, organised sport, structured competition, elite and professional sport. 

Physical inactivity is both a determinant and a product of complex and interacting environmental, physical, economic and socio-cultural factors. Uptake of physical activity is known to be greater in groups with more resource (such as physical health, finance and leisure time) and, consequently, higher levels of inactivity typically correlate with areas of higher deprivation, ill-health, unemployment, lower social and community cohesion.  Physical activity is therefore an important causative factor for the significant health inequalities seen across Lincolnshire. It is associated with 1 in 6 deaths in the UK and is estimated to cost the UK £7.4bn annually. It has significant benefits for both physical and mental health. For every £1 invested in community sport and physical activity £4.38 is generated for economy and society (2024). (Source: Sport England, the social value of sport and physical activity in England).

The Chief Medical Officers’ (CMO) physical activity guidelines recommend that, for good physical and mental health: 

• Adults undertake at least 150 minutes of moderate intensity, or 75 minutes of vigorous activity, per week. 
• Under-fives should do 180 minutes of any intensity per day, spread across the day. 
• Those aged 5-18 years should average at least 60 minutes per day across a week. 
• Children and young people with a disability should do 20 minutes exercise per day, as well as strength and balance activity 3 times a week.

Get Active is the government strategy for the future of sport and physical activity focused on building a healthier nation by tackling high levels of inactivity and making sure that sport and physical activity sector thrives for future generations.  

The 10-year health plan for England is part of the government’s mission to build a health service fit for the future and reduce health inequalities, through community-based services and provisions, a focus on prevention and innovating service delivery, such as use of technology. Embedding physical activity into the health and care system will support the scale of change set out in this plan, particularly in the shift from hospital to community and from sickness to prevention.  

Sport England are responsible for developing and growing grassroots sport, getting more people active across England. Uniting the Movement (2021-31), is a 10-year vision to transform lives and communities through physical activity and sport as the country adapts and rebuilds following the pandemic. The strategy focuses on five big issues: 

1. Recover and Reinvent: Supporting the physical activity sector to recover from the pandemic and adapt as a relevant and sustainable network of organisations. 
2. Connecting Communities: Utilising physical activity’s ability to make better places to live. 
3. Positive experiences for children and young people: Creating the foundations for a lifelong positive relationship with physical activity. 
4. Connecting with health and wellbeing: Strengthening connections between physical activity and the health and wellbeing sector. 
5. Active Environments: Creating the places and spaces for people to be active. 

 
Let’s Move Lincolnshire is the local strategy for physical activity that aligns with Uniting the Movement and includes the development of agile systems across sectors. It is led by Active Lincolnshire (the Sport England funded Active Partnership) and delivered as a countywide movement of stakeholder and resident collaboration across sectors and systems.  

Activity levels of Lincolnshire residents are collated in the adults, children and young people Active Lives surveys. In Lincolnshire, just less than a third of adult residents are inactive (doing less than 30 minutes activity a week) and just over 10% are fairly active (doing 30-149 minutes a week) and therefore not meeting CMO physical activity guidelines (Source: Active Lives data 2023-2024). This has remained relatively consistent since 2015 and is worse than the national and regional averages. 

In Lincolnshire there is a difference in adult inactivity rates across the 7 districts, with lowest activity recorded in South Holland and highest activity levels in West Lindsey.  

Within the districts, there is variation between communities, influenced by factors including prevalence of deprivation and socio-economic status, access to facilities and activities, long-term health conditions and disabilities all of which are determinants of inactivity. Environmental factors, policies, infrastructure, and access also play a part. (Source: Active Lives data 2023-2024) 

Evidence suggests that social isolation is greater in rural areas and that those who are less socially connected tend to engage less with preventative services (Source: Lancet Public Health). If individuals feel lonely or isolated, they may be less engaged in physical activities, despite the physical, mental and social benefits that this could bring. Loneliness can affect people of all ages and is more likely following major life events, such as leaving school or becoming a parent. These are also transitions that are sometimes associated with a reduction in physical activity levels therefor are a key opportunity for targeted interventions.  

As seen across the country, inactivity in adults in Lincolnshire increases with age, being more prevalent in lower socio-economic groups, the unemployed, retired and people with long-term health conditions, and for people with disabilities, (increasing with each additional impairment). Nationally and across Lincolnshire more males than females meet the CMO recommended levels of physical activity (Source: Active Lives).

Children and young people display a similar pattern across the districts, with Boston and East Lindsey having the highest levels of inactivity compared to Lincoln and West Lindsey. However, the pandemic has affected the gender breakdown with inactivity of boys being higher than girls in 2021 for the first time since the survey began in 2017-18. Across the county (data unavailable at district level) inactivity is lower between Years 3-4 and Years 7-8 but increases again for Years 9-11 to levels similar to the adult survey. Inactivity decreases as family affluence increases. There are higher levels of inactivity amongst pupils whose families qualify for free school meals. Children and young people with disabilities and long-term health conditions follow the same trend as adults, being less active the more impairments they have. (Source: Active Lives data 2023-2024). 

• One You Lincolnshire provides a free, integrated service offering health and wellbeing programmes across the county. These programmes help people make small, sustainable lifestyle changes—such as becoming more physically active—to improve their overall health and wellbeing and support them to live longer, happier lives. 
• Let’s Move Lincolnshire is a countywide movement co-ordinated by Active Lincolnshire funded by Sport England, providing the following system wide support: 
  • Investment in priority places identified by Sport England based on levels of inactivity, health inequalities and deprivation, to influence system wide place-based change sharing the learning countywide. 
  • Co-ordination and communication across the physical activity sector in Lincolnshire. 
  • Physical activity providers access and advocacy for skills, education and best practice responding to local need including the Active Skills Hub. 
  • Promotion of the Let’s Move Lincolnshire website a one-stop-shop for residents and stakeholders to find safe, condition-specific activities and access resident stories. This includes a physical activity finder for Lincolnshire.  
  • Cross agency co-ordination of communications for Let’s Move Lincolnshire. 
  • Facilitating and enabling the development, management, and promotion of health condition specific programmes. 
  • Creating an evidence base of case studies, reports and data analysis to strengthen the local narrative between sectors. This includes using Moving Communities data to evidence the value of leisure provision on physical and mental health indicators. 
  • Coordination of funding to support physical activity interventions and access to activity.
  • Advocacy and influence for development of accessible, inclusive activity options.  
• Lincolnshire and district health and wellbeing strategies. Developed collaboratively to ensure alignment and futureproofing, they include a section on physical activity aligned to the Let’s Move Lincolnshire strategy. 
• Leisure operators provide sessions and spaces suitable for different conditions, e.g. dementia friendly leisure centres. Facilities also offer discretionary pricing and subsidised access e.g. free membership for looked-after children. 

The Let’s Move Lincolnshire strategy was refreshed in 2022 using recommendations made following research and consultation undertaken by the University of Lincoln in 2021-22. More than 80 stakeholder agencies contributed via focus groups or surveys and 331 residents via online surveys. The report from this research can be found at Let’s Move Lincolnshire. 

Annual surveys conducted by Active Lincolnshire ensure a comprehensive understanding of the needs of the physical activity sector to enable it to be resilient and respond to local need.

• Physical activity is not consistently embedded in non-sport sector strategies or corporate plans despite its ability to achieve a wide range of health, social, and economic outcomes. 
• The early preventative benefits of physical activity are not considered in terms of investment of the health and care sector, which is more focussed on treatment.  
• There is an inconsistent countywide picture of activities aligned to the health needs of residents. Consistent, detailed data collection would allow for better promotion of existing offers aligned to conditions as well as distribution of resources, training and the establishment of new activities. 
• There is a lack of knowledge of the workforce required to meet future population growth and associated health needs of the county, and the skills gap between the current and future workforce.  
• Physical activity is not consistently embedded in the design and contracts of commissioned services, often needing to retro fit physical activity into the work. 
• Communities are not consistently involved in design and decision making. Co-production is required to be a guiding principle, a new paradigm in the suite of tools for gaining representative involvement. 
• Low use of physical activity specific digital tools for prevention, management and rehabilitation. 
• There has not yet been detailed consideration given to opportunities to address physical activity or agreed standards that span care pathways in primary, secondary or community care. 
• There is a need to develop a greater understanding of the communities facing greatest barriers to participation, enabling improved action plans and to remove all barriers to accessing sport and physical activity. 
• There is an opportunity to increase the messaging and communications targeted at residents, providing them with relevant information, inspiration and ways to be active. 

• Working in identified priority places to understand what the barriers are to residents of Lincolnshire being active, and advocate and influence for change.  
• Support communities and community groups to facilitate local change.  
• To advocate for, and facilitate the inclusion of, physical activity in strategies and processes across multiple sectors and agencies including local authorities and integrated care systems.  
• Embedding cross-sector developed guidance e.g. Active Design into planning policies and practices. 
• Improved collation and dissemination of key messages, resources, tools, case studies for shared learning, growth of opportunities and scalability of successful programmes. 
• Collation and utilisation of data to inform decisions and secure increased investment for physical activity. This includes mapping the current physical activity offer overlaid to health conditions across the county and identifying skills gaps within different workforces. 
• Create equality of access to opportunities through scaling-up condition-specific work to inform other care pathways of the development of their work, focusing resources on areas with limited opportunities available. 
• Train all staff (paid and voluntary) in the Integrated Care System workforce (managerial, front-line, and administrative) to build physical activity into policy, working practices and delivery. 
• Train the physical activity workforce (paid and voluntary) and community voluntary organisations offering physical activity, to better understand and provide positive experiences for residents with health conditions and those facing the greatest barriers to participation. 
• Advocate for and amplify the resident voice in decision making and delivery planning. Building mechanisms that ensure all use of physical activity to achieve outcomes includes better, more representative, resident voice in design, delivery and promotion. 

• Active Lincolnshire Knowledge Hub