All Move in Erewash

Working with partners and stakeholders, we want to improve health and wellbeing across the community by reducing inequalities in physical activity. In Erewash, around 27,000 adults are inactive - and nearly 10,000 of them are living with a limiting condition or disability. We’re listening, learning, and working together to understand what supports or gets in the way of being active - so we can help make moving every day possible for everyone.

10,000 adults who are inactive in Erewash are living with a long-term condition or disability. There are many factors that influence physical activity behaviour, which exist at different levels within the wider system. Current interventions offered are short-term and led by data rather than insight and community experiences. 

Through combined funding from Erewash Borough Council, Derbyshire County Council Public Health and Active Derbyshire, a Physical Activity Inclusion Officer has been appointed for 18 months (September 24 to March 26) to provide capacity to progress the work of All Move in Erewash (AMiE). The officer has been working on the following areas since being in post.

AMiE prioritised hearing residents’ voices as an important starting point to understand what they want and need. A survey was distributed to obtain insights from people with lived experience - 172 people responded. In addition to this, focus groups were facilitated with a wide range of residents with differing needs to capture a richer understanding of their needs. The themes arising from these insights were: involving people with lived experience in the process, consistent messaging about physical activity, workforce development and resources that can be easily accessed. 

What we have heard from residents is key to ensure that future interventions are designed with their needs in mind. A real concern from residents is the support they have received since their diagnosis has been minimal and unhelpful. Many people have lost trust with healthcare professionals, feeling dismissed, judged and stigmatised. There were some positive experiences shared but unfortunately these were in the minority. Considering this, we identified a need to upskill partners in the system who regularly have conversations with people with longterm health conditions (LTCs) and disabilities. Training resources have been shared with partners to help them access additional learning. A signposting resource for Erewash was co-designed with partners to establish a central place where professionals could signpost clients for further information. We have also delivered Motivational Interviewing at a basic level to help partners feel more confident in empowering patients to take ownership of their physical activity behaviours. Finally, we have provided Physical Activity Clinical Champion (PACC) training through Moving Medicine to clinicians within Erewash Primary Care Network (PCN) to help them embed physical activity into their conversations. We are continuing to listen to residents to ensure that changes made are based on what they tell us.  

From the outset, the work of AMiE has been co-designed with partners from a large number of local and regional organisations. Links were established with professionals from the health, voluntary, community and physical activity sector. This prompted everyone involved to take on a shared vision, learning how we can influence all aspects of the system to increase physical activity behaviour. Through AMiE, greater connections have been formed allowing joint working so resources can be utilised more efficiently. For example, staff from the local leisure centres have better understood the needs of people living with long term conditions, which has enabled a better partnership with the Exercise by Referral co-ordinator so improvements could be made to what is on offer. 

AMiE network meetings are held once per quarter to bring stakeholders together in a space where ideas, learnings and actions can be discussed. Having the space to come together as a diverse group and hear from the experiences of different sectors has been incredibly valuable. To capture the discussion and actions from these meetings a workshop summary document has been created and is updated after each meeting.

The impact of taking a collaborative approach with partners has influenced how they work and has started to bring about interventions that meet clients’ needs and support them to be more active. See examples below: 

• AMiE recognised that the pathways to physical activity in Erewash are messy and complex. Bringing partners on the AMiE journey has helped to connect services so that stakeholders are aware of what is available and how individuals can access this support. Raising awareness of AMiE has also helped partners to consider how these pathways can be developed so that activities are more accessible, inclusive and easy to navigate onto. For example, a social prescriber has connected with the local walk co-ordinator to set up a new accessible walk around a track, which has led to an increased number of walkers on the walk programme. 
• One of the clinicians who attended PACC training commented three months later that she found the training helpful and was actively using the resources provided when having conversations with patients.
• One of the teams who received Motivational Interviewing awareness training were the social prescribers. Since this training was delivered, feedback has been received to show that AMiE has influenced the team on how they support and work with clients through skills that empower clients to feel confident and take accountability for their actions.
• One of our AMiE partners from a social enterprise was able to use the findings from the AMiE survey to secure a bid for funding physical activity. They will be delivering rolling six-week courses of movement for mental health over a 12-month period.
• A close partnership with the Erewash walking co-ordinator and trained walk leaders, has prompted two new accessible walks in the area, which have taken into consideration AMiE insights, for example, including a social element. These new walks have been well attended. 

A recommendations report is being produced, which will be shared in places where it can be seen by stakeholders, partner organisations and professionals working at a strategic level as well as members of the public. 

Stakeholders have commented on the value of connecting through AMiE meetings to strengthen partnerships and utilise resources more efficiently. Meetings will continue to maintain these connections and to bring more stakeholders onto the journey.

Resident insights will remain a key priority to ensure that interventions are developed in partnership with people with long term conditions and disabilities. Through AMiE, we have begun to engage with AMiE champions – ambassadors who advocate for people with long term conditions and disabilities to show that movement is possible and looks different for everyone. Our AMiE champions have shared their story of how they remain active despite the challenges of the conditions they live with. We will continue to work with AMiE champions to inspire and encourage this community through seeing someone ‘like them’ who is active. 

Community-based test & learn pilots are in the pipeline and will provide us with key data around what works and doesn’t work to encourage people with long term conditions and disabilities to move more. This will help partners provide sustainable interventions that truly meet their needs.

System change is hard but is worthwhile. Key lessons have been learnt from how programmes have been delivered in the past. Interventions are usually offered based on assumptions made by the decision makers of those interventions. With AMiE, it was important to challenge those assumptions, to take a different approach and have more meaningful impact. Whilst there are more challenges that come up in joining the system together, and it takes more time, the benefits are greater and longer lasting.

One of the challenges faced, was where to start with this work. Bringing partners together requires unity, so it was important that a shared vision was co-produced and made clear throughout the work. With a shared vision established, it can still be hard to identify key priorities, when so many ideas are formed. It was helpful to focus on actions where partners brought energy and passion to the table. This provided a helpful starting point, which we could then build on over time. 

The relationships that have been built with both professionals and residents are a huge part of the success of AMiE. Trust takes time to develop, so persistence is key. Once awareness of AMiE had reached a wider audience, we found that there was a ripple effect of bringing more partners on the journey who were keen to play a part in it. 

Sarah Knapp, [email protected]