A sustainable health service for the future

Helen Birtwhistle explains why health and sport organisations need to cooperate.

As director of the Welsh NHS Confederation – the organisation which represents the seven Health Boards and three NHS Trusts that make up NHS Wales – I am well aware of the challenges faced by our health service.

An increasingly ageing population, which also suffers from high levels of inactivity, serves to increase demand for our services at a time when finances are extremely constrained. Of course, some of these trends are not preventable, and the fact more people are living longer is something to celebrate. But a significant amount of the pressures currently faced by NHS Wales could be eased if more people took responsibility for their own wellbeing.

The way people live their lives has enormous reverberations for the health service and for other public services. It is proven that an active lifestyle decreases the likelihood of a number of illnesses and chronic conditions. I believe that we all, as citizens first and service users second, have a responsibility to look after ourselves and not pile up pressure on the NHS because of the lifestyle choices we make.

Unfortunately, the evidence shows that many are continuing to live unhealthy lifestyles. Wales has the highest obesity rates for both adults and children of all the countries in the UK, with 58% of adults classified as overweight or obese. For children, the figure sits at 35%.

We also have the highest rate of long-term limiting illness in the UK – the sole most expensive aspect of NHS care. Many of these conditions are linked to unhealthy (and often inactive) lifestyles choices, and these trends in obesity and chronic conditions look set to continue to rise in the future, unless there is a drastic change in how welive our lives.

That’s why today, the Welsh NHS Confederation and Sport Wales are announcing a new memorandum of understanding (MOU) between the two organisations. Never before have sport and health joined forces in this way and we feel this is major step towards tackling the tide of inactivity that we face.

The MOU – which will initially cover the next three years – sets out six areas of cooperation, including working together to support people to enjoy more active, more equal and healthier lives and encouraging people to take more responsibility for their health for future generations. We hope to drive a mass shift in public thinking about the way people view their lifestyles and the impact this has on their health and wellbeing.

We realise we have work to do, and through partnerships like these we can create lasting change.The wellbeing of the population is not just down to the NHS. Other services, organisations and third sector groups have roles to play, and, importantly, so do citizens themselves.

Thepotential benefits of becoming more physically activeare well documented; reducing the risk of many chronic conditions, including coronary heart disease, stroke, type 2 diabetes, mental illness and cancer. Alongside these risk reductions, it is argued that regularly participating in sport and physical activity also benefits an individual’s self esteem, promotes social inclusion, counters anti social behaviour and plays a part in integrating people into the community around them(Sport England 2013, WHO 2014.) It is worth noting that people do not have to be dedicated sportspeople to reap these benefits, just taking part in a small amount of physical activity a few days a week can have lasting positive effects.

As Dr Brian Johnson, GP and Honorary Medical Advisor to Public Health Wales, says: “Sport can enrich our lives in so many ways; through social enjoyment, feelings of well-being and benefits to both our physical and mental health. There is a very strong proven relationship between activity and our health status and physical activity is considered to be as powerful as many drugs. Regular exercise significantly reduces hospital admissions for many conditions and even the critically ill, if regular exercisers, can reduce their length of stay and time in critical care.

“As a GP, I encourage my patients to be more active, in whatever way they can. For those who take up their responsibility, I have seen them avoid the need for medication or reduce their drug requirements and indeed avoid both hospital referrals and surgery.

“If exercise through sport can be melded into our lives, it has the potential to radically change our experience of life both in quality and longevity. I welcome this cooperation in the urgent need to reduce the pandemic of inactivity.”

Partnerships have already been built between the health service and our colleagues in sport, such as the work of BetsiCadwaladrUniversity Health Board with Disability Sport Wales which has provided a new service for disabled people to increase their level of physical activity and involvement in sport. We hope to build on projects such as these as part of the memorandum.

Sport is an area where we can capitalise on opportunities to improve the health of the people of Wales, and alongside this, reduce the number of people relying on the health care system and other public services. We have a big job ahead of us, and change will not be realised overnight. Nonetheless I and my colleagues at the Welsh NHS Confederation are excited for the future and we look forward to working with Sport Wales and seeing what we can achieve together.

Helen Birtwhistle is the director of the Welsh NHS Confederation.

12 thoughts on “A sustainable health service for the future

  1. A brilliant article Helen and a nice change from the dreary politics usually found on IWA pages and from my perspective an issue that should be one of the highest priorities for any society and those who govern us.

    Even as I’m writing this it’s impossible not to bring ‘politics’ into it as at this very time Local Governments throughout Wales and perhaps elsewhere too are cutting back on their support for leisure centres and sport and certainly evident in North Wales (Betsi Cadwaladr University Health Board territory).

    At Bangor University we have an excellent Sports Science faculty which trains and produces Fitness Instructors and sports experts who once leave the University find it difficult to find a meaningful job and most often end up stacking shelves in the local Tesco’s and similar jobs elsewhere.

    Then we have ‘politically correct’ Local Education Authorities again in North Wales who encourage English medium primary schools only to offer after school extra curricula activities including the sports to kids whose parents enrol them through the Urdd membership – Many parents are simply not impressed and do not enrol their children.

    Not sure what the answer is but in my case I dismiss the petty politics of ‘North Wales Political Establishment’ and do a great deal for my kids to embrace sports and be active and healthy which often means taking them to England where they can enjoy sports free of political indoctrination!

  2. In my very humble opinion there is only one answer to the problem of people causing their own poor health by ‘lifestyle’ choices. There is an economic price for any service and the NHS which runs on principle of ‘no charging’ is flying in the face of reality in an ever increasingly ‘selfish’ society.The creation of NHS was in a very different society than today with a massive working class and I mean ‘working’,and small middle class,taken together with very high marginal rates of taxation.The Irish have a form of NHS,but everyone has to pay to see GP and ‘free’ prescriptions are a JOKE,however their society continues working.The system of some form of payment will not happen until the NHS collapses due to contradictions in current policies and distribution of provision of services. Whilst we ‘muddle on’ the revenue funding for sporting facilities in working class/poor areas is being cut to the bone so reducing opportunity for people to get ‘fitter’ and reduce their need for services from the NHS.The converse to ‘cuts’ for working class people is the growth of people using private health clubs at circa £50-£60 per month and many of them having excellent pensions from public sector, so there is a clear class difference in our nationalist/socialist society.

  3. A promising alliance: it might also be of benefit to children (and young people such as students) who travel by car to school and college/university. Cutting car travel where and when reasonable (such as in cities, with the exception of emergency vehicles, delivery vehicles, and transport for public and disabled use) and prioritising pedestrian and cycle movement only (or mostly) in these areas could make a huge difference to well-being and health. Working adults will also benefit from these pedestrian/cycling prioritised areas if they are assured one to two hour lunch breaks in which they csn stretch their legs, get fresh air, and have time to eatvand digest

  4. Sorry – text posted inadvertently – I meant to write, “..lunch breaks in which they can stretch their legs, get fresh air, and have time to eat and digest a pleasant midday meal”.

  5. The real answer is walking not organised sport. It also has the advantage of being free and doesn’t cost the taxpayers a bean. How do you get people walking? You start when they are young. You see the crisis in local government finance as an opportunity. No child in my valley needs a bus to go to school. Parents also need to understand that they are not doing their child any favours by using the car to take them to school. I passed a local primary school yesterday and counted 30 cars outside the school. The grand parents of the children in that school in the 1950s and 1960s would all have walked to school. The Assembly is also not doing older people any favours by a free bus pass scheme that starts at 60. No one at 60 is old. The scheme should start at the retirement age as it does in England. Except for registered disabled the scheme should also not apply for the first mile of a journey.

  6. In other words, it would mean restricting or banning car travel from greater areas than the current ‘pedestrian zones’ in city/town centres. It would involve much more use of out of town park-and-ride facilities, fewer in-town and close to town car parks, better regulated high traffic roads where drivers are travelling past expanded towns on highways that bisect old town from new supermarket developments, and no car parks right beside shopping retail parks! Instead, public transport mini buses, which could link with park-and-ride schemes, plus lovely walking and cycling highways, could link town and city centres to the newer larger scale retail stores and supermarkets? This is not difficult to envisage.

  7. You might wonder what we could do with all that space in retail parks devoted to car parking….well we could cut most of it out, and turn much of the rest into relaxing grassy landscaped spaces where people can take picnics and let their toddlers run around. We can employ care takers and gardeners too!

  8. Jeff Jones, Not sure if I agree with your remedies but on the ‘walking issue’ perhaps Welsh NHS should prescribe lively puppy dogs to all obese patients and define minimum walking distance for the pooch and the patient and all monitored electronically (To save money lets use the existing prison service tagged individuals facilities)!?

  9. This looks like a very worthwhile campaign.

    Is one of the partnerships with Local Authorities. I wonder, because in the face of cuts one area they me be considering is sports facilities and this needs to be resisted.

    I know from personal experience the terrible state of recreational football pithes in Cardiff and the effect this can have on kids who are part of the local leagues. There is also a dire lack of all-weather facilities meaning children (and adults) have very options throughout the winter when the grass pitches are off-limits.

    Prevention starts ealry it’s important that children are provided with affordable and accessible facilities to play sport. Hopefully this will be a feature of your campaign.

  10. Perhaps a bit irreverent but it could work to improve fitness and make obesity obsolete in Wales if we adopt the latest trend in slimming and fitness by following in the footsteps of our cousins from across the pond:

    To my understanding some exclusive California based clinics specialising in slimming and fitness often use SEX to achieve their aims of helping their clients shed excess weight and become healthy and fit in the process.

    These treatments are not cheap but seem to be popular and cater for both sexes – Not quite sure how they do it for women, but In case of men they will arrange decorative, fit and beautiful young ladies to be chased through secluded and manicured lawns of the ‘Health Centres’.

    As I understand it it’s a kind of a race where girls get a 20 yard head start and just before the whistle goes they strip stark naked and carry a label ‘If you catch me – You can have me’ or words to that affect!!

    Have no information of any cardiac arrests on the part of men taking this treatment – Perhaps we can come up with a Welsh version of this approach on Welsh NHS and do it under strict Health and Safety rules bilingually!?

  11. Oh come on Helen this is MOU is meaningless … Nothing to do with. Action and everything to do with people like the former health SPAD who also worked for the confed and the Chair of Sports Wales and you collectively packing yourselves on the back for something that makes no material difference to anyone

  12. I agree with Jeff Jones; surely, many children could walk to school – during school holiday periods I notice that the roads are much less congested during morning commuting time, making it safer for walking anyway. Also, If many more children walked instead, there might be fewer regular trips to MacDonalds for meals, as parents wouldn’t be there to pay for them. Alas, of course this would not be the situation for all. No doubt lots of parents work part time so that they can collect children after school, and this practice includes car use, and eating fast food out (tired and hungry parents and children). I agree that bus passes don’t need to be given to all 60 year olds.

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