Active Dorset is pleased to be able to share some of the progress from year one of our systems change approach to embed Physical Activity.

Supported by Sport England, Active Dorset are working with partners across Dorset's Integrated Care System to drive increased physical activity which forms part of the prevention at scale agenda. Our approach to increasing activity levels of people aged 55+ is to embed physical activity as business as usual throughout primary and secondary care, in localities and with public sector workforce.

The delivery phase of our system change project began in October 2018. Below are some key highlights and learning from the project from October 2018 to October 2019.

Impact in numbers

Total number of Dorset residents engaged = 12,527

Number of inactive* people engaged aged 55+ = 3,198 *inactive refers to someone doing less than 30 minutes of activity a week.

Number of health professionals trained in physical activity awareness and promotion = 110

Number of volunteers trained to support increased physical activity = 316

Highlight System Impacts

Workforce: We have been working with NHS Acute trusts, Academy Trusts and our 2 local authorities to embed physical activity promotion into pre-retirement workshops, appraisals, occupational health processes and staff wellbeing policies. Partnering with Public Health Dorset to deliver the #JoinMe campaign.

Primary Care: In conjunction with colleagues in primary care to increase skills, knowledge and confidence of healthcare professionals to support patients to move more. This includes promotion of the Chief Medical Officer's guidelines for physical activity, moving medicine tools, and delivery of training courses such as Physical Activity Clinical Champions Training, supporting behaviour change and encouraging physical activity. In 2020 we look forward to working with Help and Care to train their staff in these course, including social prescribing link workers. At a system level we have been working to embed physical activity education and support into programmes such as NHS Health Checks and Diabetes Prevention.

Secondary Care: We are working with our acute trusts and a number of clinical pathways to discover opportunities to embed physical activity in patient pathways. In year one much of our work has been with the following pathways; cancer, musculoskeletal and physiotherapy, falls and outpatient services. Changes include, adding physical activity information and advice onto clinical websites, amending patient letters, contributing to new strategies for pathways and pathway redesign, supporting better self-management through increased activity and providing wellbeing events for specific patient groups.

Localities: Together with key partner organisations (Stepping into Nature, Natural Choices) as well as LiveWell Dorset and locality representatives to deliver 6 Picnic in the Park events, reaching over 2900 people.

LiveWell Dorset: Working with LiveWell Dorset we have been developing the physical activity pathway so that we provide the best possible support for people in Dorset to move more and find an activity right for them. Between October 2018 and October 2019, on average 75% of all people registering with LiveWell Dorset accessed support to increase their physical activity levels, compared to 35% in the previous 12 month period.

Our learning

Our evaluation partner, Bournemouth University, have been carrying out an evaluation study to understand how systems are changing in Dorset, improving our understanding of the barriers to embedding physical activity as business as usual. Learning will be available throughout first phase of our systems change project (to September 2021) and will be published annually. Our findings from year one and analysis of the system at baseline are below.

'Pre Active Ageing' themes from system analysis at baseline

Theme 1: Ad-hoc physical activity signposting/referral and provision of physical activity dependent on personal interest and access to funding

Theme 2: Physical activity pathway not prioritised in healthcare settings due to; Time constraints, a focus on established practices, funding streams focussed on other priorities

Theme 3: Low participation in physical activity in Dorset due to;

1. Poor promotion of physical activity
2. Limited knowledge or understanding of professionals about the role of physical activity in prevention and management of long term health conditions
3. Limited infrastructure to enable participants to find physical activity

Theme 4: Disjointed approach;

a) Driven by independent objectives

b) Lacking coherent focus across system

c) Benefits not recognised by referring organisation

Themes from system analysis at end of year 1

Theme 1: Changes in working practices

• Cross-fertilisation of knowledge and understanding of the physical activity pathway
• Shared ownership of the Active Ageing project and joint promotion of whole person health packages to potential partners
• Enhanced working relationships resulting from training of collaborator and deliverer organisations
• Consultation with healthcare professionals, such as consultants, about the benefits of physical activity which led to better promotion to the healthcare teams
• Logistical and communication efficiencies resulting from joined-up working that also facilitated improved interpersonal relationships between partners.

Theme 2: Process changes

• The Active Ageing team have connected with all healthcare policy organisations and networked with strategic health and social care experts
• Healthcare policy teams have engaged with the Active Ageing team about physical activity interventions
• A social movement that helps people with their health prevention by encouraging better lifestyle choices has been activated
• New efficiencies have emerged as healthcare teams are aware of physical activity which has led to better embedding of the pathway in policies and planning

Theme 3: Summary

• Trust and building relationships to implement change takes time
• Physical activity is not consistently considered or embedded when designing services or pathways and when commissioning programmes or projects
• Inconsistent understanding of physical activity and the key messages to engage the most inactive groups in 'moving more'

For more information

The two short videos below give a simple summary of the Active Ageing project and our key objectives. For more information on Active Ageing and our progress contact Charlie, ccoward@activedorset.org