Whole Systems Approach to Physical Activity Oxfordshire

Whole Systems Approach to Physical Activity is jointly funded by Buckinghamshire, Oxfordshire and Berkshire West Integrated Care Board, Oxfordshire County Council Public Health and City and District councils and coordinated by Active Oxfordshire in partnership with local authorities. 

This holistic approach to tackling health inequality, improving health and wellbeing and increasing physical activity in Oxfordshire is through the delivery and management of three countywide programmes – Move Together, YouMove and the Physical Activity Clinical Champions Programme. 

The Whole Systems Approach to Physical Activity’ (WSAPA) is a system wide collaboration to tackle physical inactivity and improve health across Oxfordshire, with a specific focus on targeting populations facing the biggest inequalities. See examples below: 

• inactive adults (over 16 years) living with or at risk of a Long Term Health Conditions (LTHC)
• adults with disabilities
• eligible children and their families, including those on benefits related free school meals or Universal Credit and children supported by early help services or otherwise vulnerable.
• pregnant and postnatal women.
• residents from Oxfordshire’s priority neighbourhoods. 

Active Oxfordshire’s role in partnership with district councils is to support these target groups to overcome the challenges of being physically active and improving health, both structural and personal, working alongside a wide range of partners across the county. 

Our flagship physical activity programmes, Move Together and YouMove, are designed to remove barriers and provide the best opportunities for target populations to increase and sustain physical activity levels, with behaviour change and being person centered core to our approach. 

The solution provided by the WSAPA demonstrates a joint vision, commitment and understanding of the important role physical activity can play, and a suite of interventions to decrease physical inactivity and tackle inequalities in Oxfordshire.

The work is funded by Oxfordshire County Council Public Health, the Buckinghamshire, Oxfordshire and Berkshire West (BOB), Integrated Care Board and Oxfordshire city and district councils and coordinated by Active Oxfordshire in partnership with local authorities. In 2024-25 the programmes extended their reach to both Early Years and Maternity demonstrating how the WSAPA is supporting the full life course through physical activity.

Move Togetheris a physical activity pathway that provides support to inactive adults who face barriers to being active. This includes individuals living with, or at risk of long-term physical or mental health conditions, adults with disabilities, and those who are pregnant or post-natal.

The pathway includes a referral or self-referral route to get started and a Move Together coordinator assesses the participant’s needs and preferences and provides physical activity advice, behavioural support, and signposting to an appropriate physical activity offer as required. The ‘offer’ is a menu-based approach which includes home activity support, digital options, community activity, and specialist exercise interventions.

YouMove provides free or low-cost activities for eligible families and children (0-17) in Oxfordshire who may not have opportunities to be active together. By signing up to YouMove, local families benefit from low-cost or free fun activities including swimming, badminton, tennis, and a wide range of community activities near to where they live.

As well as being able to enjoy being active together, families are also supported by local Activators in each district who provide advice, support and guidance about what's on offer.

Physical Activity Clinical Champions (PACC)offers free peer-led training and practical resources to all healthcare professionals (HCPs), ranging from hospital consultants to community practitioners. The training focuses on helping HCPs have more effective conversations with patients about physical activity.

Oxfordshire is one of four pilot sites selected to adopt a place-based physical activity clinical champion with the aim of integrating and increasing PACC training across the Oxfordshire healthcare system and improving clinical pathways between the NHS and the physical activity sector.

The impact (including cost savings/income generated if applicable)

Move Together

In 2024-25, Move Together made a significant impact in supporting adults with long-term health conditions to prevent and manage health conditions and improve their health and wellbeing through increased activity.

Overall summary of Move Together’ s impact in 2024-25:

• Move Together is supporting people to become physically active and to live a healthy lifestyle. 91 per cent of people who completed a 3-month review (over 700 people) have made positive lifestyle changes as a result of being part of Move Together. These include healthier eating choices, building physical activity into their daily routine, losing weight, better management of their long-term health conditions, making friends or enjoying nature.
• 75 per cent of participants reported that the overall perception of their health either remained the same or improved. 63 per cent of participants reported that the perception of their health had improved.
• 36 per cent of participants reported improvements in their ability to undertake their usual activities. 32 per cent of participants reported improvements in pain levels.
• 60 per cent of participants with symptoms of anxiety and 55 per cent with symptoms of depression demonstrated improvement by the three-month review.

In addition, Move Together represents excellent value for money and plays a critical role in reducing pressure on health services:

I was able to get fit enough to have surgery which will prolong my life - without it I only had a year to live. Victoria helped me get fitter and stronger and be able to pass the tests I failed before starting with her. Passing this test meant I was then eligible for surgery which has saved my life.

I’ve been made to feel like I am worthy. I have multiple mental illnesses and physical health issues, and the Move Together (MT) team made me feel like I counted.

I feel like I can stand up straighter, my blood tests have improved, I have lost three stone, and I have more confidence, and I feel happier in myself.

YouMove

Overall achievements in 2024-25:

• In 2024-25, the number of participating families increased by over 1,000, bringing the total number of participants to 13,911. This means that almost 30 per cent of children in receipt of free school meals (FSM) in Oxfordshire are now part of YouMove.
• Approximately half of our participants regularly use YouMove and are making changes to how much physical activity they do, as well as how they spend family time.
• There are now 116 partners engaged in YouMove across the county, with offers and opportunities for families ranging from tennis to circus skills, Boogie Bounce and rugby clubs.
• This year, pre-school activities such as Baby Movers, Active Totz, Rugby Tots and Little City have become available and YouMove has also started to increase inclusive offers, with Gosford All Blacks SEND Rugby, Disability Cricket, Abingdon Boccia, along with sensory swims and leisure centre accessible sessions becoming more available.

YouMove helps in lots of ways. Just ask my eight-year-old son who asks me daily ‘how many sleeps until tennis’ and the soft play that my boys went to last half term. Also swimming lessons which is helping their health and fitness and mental health.

We love activities as a family.

It is allowing me to go to the gym, because one of my children is disabled it is a real struggle to do exercise, I was gaining weight and now I am regularly going to the gym to try and put this right.

I have taken my daughter on the crash course swimming lessons in the school holidays, and she has really enjoyed them, it has boosted her confidence in swimming a lot more and gives her more practice in swimming.

Physical Activity Clinical Champion Training (PACC)

• 1066 healthcare professionals trained across Primary Care, Secondary Care, Community Care, and the Education System (Oxford Brookes University), and 56 sessions delivered to date.
• 100 per cent (of those who completed the evaluation form) of participants reported feeling motivated, confident, and equipped to promote physical activity to their patients. .
• Increased awareness and knowledge on physical activity signposting through Move Together provided in every session, including stronger links with DCs.
• A 30 per cent increase in patients registering with Move Together from the practices that have taken part in PACC training in quarter 4.

Christine was incredibly knowledgeable, clearly passionate about physical activity. Great pace of presentation and I loved being given the opportunity to stand up and move numerous time.

Approaching conversations regarding physical activity to patients helped me figure out how without sounding patronising

Christine was really good, everything was concise yet still very informative and very relevant and kept everyone engaged

The Whole Systems Approach to Physical Activity (WSAPA) is not a standalone initiative and has been sustained by being a strategically integrated component of Oxfordshire’s broader prevention and population health agenda. 

Through shared commitment and vision across the Oxfordshire system there is support for the vital role physical activity plays, and the approach operates by leveraging significant aligned funding and in-kind resources from across the local system to deliver targeted, high-impact interventions. This includes annual collaborative commissioning from Oxfordshire County Council (Public Health), Buckinghamshire, Oxfordshire and Berkshire West, Integrated Care Board, District Councils and in-kind contributions from Active Oxfordshire, allowing the programmes and approach to be sustained. 

Supporting the longevity of the WSAPA is the evaluation that continuously demonstrates the impact, social value and learning cycle, allowing the programmes to keep developing. The end of year reports are included in the links below. 

• The work should be systemic and not focused solely on interventions. Creating a shared system wide vision for the role of physical activity was key to the development of the WSAPA and the collaborative commissioning approach for investment. It can take time and involves building relationships, trust and accountability between partners.
• Invest in evaluation from the outset. Securing dedicated evaluation budgets and appointing expertise in the early days helps to make the most of the data and evidence collected. The evaluation will reinforce the approach and demonstrate impact delivered through the physical activity programmes. This involves evidencing the impact to participants, programmes and at a system level, aligning to system priorities. For example, Core 20PLUS5.
• It’s helpful to have a neutral coordinating organisation for this work in Active Oxfordshire. Active Oxfordshire shifted from direct delivery competitor to facilitating intermediary and convener, proving the strategic roles to build partnerships and drive the work forward.
• Through our physical activity programmes, we’re seeing the importance of having a wide range of activity options for signposting. This has moved us towards a mixed leisure and community offer that includes home based, digital, active travel and nature/gardening activities alongside the traditional gym and Exercise Referral schemes. It’s about finding the most suitable activity for individuals’ needs. In addition, this has included an inclusive approach to our work and ensuring we can provide accessible support and activity for individuals, for example, easy read and translated resources and inclusive activities opportunities.
• Adopting a behaviour change and person-centered approach for our physical activity programmes has been key to supporting individuals to increase activity. Participants are supported through personalised conversations that help them overcome barriers and get signposted to activity that is most suitable to their needs. This equips them with the tools to continue being active.
• The risk associated with physical activity for people living with long-term health conditions can put barriers in the way of them being active, especially as the research demonstrates a low risk of adverse events. We need to move away from medical consent being required to more guidance to create a smoother journey for those wanting to be active.
• Our relationships with healthcare have led to opportunities to set up physical activity provision and pathways for condition specific support. We have learned that although most patients benefit from the activities on offer through Move Together, there has been a need to upskill workforces and provide activity suitable for their conditions and build trust onto continued physical activity opportunities in the future. Pilots are currently being setup with Cancer rehab/prehab and Pulmonary.

Richard Claydon, [email protected]. 

• Move Together annual report 2024-25
• YouMove annual report 2024-25
• Active Oxfordshire
• Press Red case study – select Active Oxfordshire link on webpage.