The Active Hospital pilot embedded a sport and exercise medicine consultant-led physical activity service within Oxford University Hospital Foundation Trust. Hospital in-patients often spend prolonged periods of time sedentary, and this can lead to deconditioning, reduced muscle strength and mass, a decline in functional ability leading to frailty, longer hospital stays and a deterioration in quality of life, particularly in older adults.
The Active Hospital study was carried out by academics at the Advanced Wellbeing Research Centre at Sheffield Hallam University, which is the research hub for the National Centre for Sport and Exercise Medicine in Sheffield. It explored how the pilot was implemented; how it was experienced by sport and exercise medicine consultants, healthcare practitioners and patients; what worked well and what challenges were encountered.
Findings from the study include:
- The importance of leadership that is trusted and embedded within the system: the culture change observed at Oxford University Hospital NHS Foundation Trust did not happen overnight, but was driven by influential individuals with a clear vision for change
- Create the team from a coalition of the willing to drive change: the importance of developing a network of physical activity champions within departments and services so that lines of communication between the delivery teams in each pathway and the central team could easily be maintained
- The importance of governance structures to ensure quality service improvements and sustainability: establish policies and structures that align to making the new behaviours sustainable
- A flexible approach and a willingness to fail: the need to be sensitive to where new opportunities exist whilst at the same time being adaptable to change, and to look for opportunities across the system to intervene
The study found that the Active Hospital pilot was well received by patients, however a lack of dedicated resource and capacity to deliver the intervention was highlighted as a challenge by both patients and healthcare practitioners.
Dr Anna Myers, research fellow at Sheffield Hallam University, said: “Physical activity can play an important role in preventing a decline in health associated with a hospital stay. It can also encourage patients to play an active role in their recovery and longer-term health and wellbeing. This study provides insight into what is required to successfully embed physical activity within secondary care clinical pathways as well as considerations for future practice.”
The Active Hospital pilot was commissioned by Public Health England and Sport England as part of the Moving Healthcare Professionals Programme.
Physical inactivity is the fourth leading cause of death worldwide. It accounts for approximately six per cent of deaths globally and is directly responsible for a huge burden of non-communicable disease. People with chronic health conditions are amongst the least active members of society despite having the most to gain from even small increases in physical activity.