8th Report – Healthy Ageing: physical activity in an ageing society

Key findings

• 44% of people aged 75+ are physically inactive (less than 30 minutes moderate activity per week), rising to 38.2% in deprived areas versus 17.8% in least deprived; physical inactivity causes one in six deaths and costs £7.4 billion annually.
• Physical activity is recommended in 98 NICE clinical guidelines and has been described as 'as good as or better' than many drug treatments, yet only 33% of adults with long-term conditions discuss it with health professionals despite 68% seeing a professional monthly.
• Only 5% of ICBs and 15% of local authorities have commissioned the Falls Management Exercise (FaME) programme; evaluation shows £1 invested in FaME yields £2.36 in health savings and £50.59 in social return.
• Frailty is not inevitable and can be reversed through evidence-based exercise programmes, particularly resistance training, which can prevent or delay dementia onset; early intervention offers significant opportunity but approaches remain inconsistent across the country.
• Current funding structures and short-term evaluation timeframes undermine prevention services; ICBs report prevention funding is 'still one of the first things to go' despite NHS England's stated commitment to prevention.

Recommendations

• The Department should require ICBs to embed physical activity as a core preventive intervention within population health strategies, with clear accountability for demonstrating integration into healthy ageing, long-term condition management and health inequalities frameworks.
• The Department work with ICBs to develop a national roll-out of existing best-practice models (such as Moving Medicine and Moving Healthcare Professionals) to support clinicians to have conversations about physical activity with patients, including a communication strategy and resources for managers.
• ICBs explore methods for increasing investment in the prescription of physical activity as part of a broader shift towards prevention, ensuring patients benefit from evidence-based interventions alongside appropriate clinical treatments.
• As part of the Modern Service Framework for frailty and dementia, the government identify and set clear standards for delivering exercise programmes at the duration and intensity necessary to deliver outcomes, with accountability arrangements ensuring consistent uptake among ICBs.
• The government set out how it will judge whether ICBs are successfully moving towards population health delivery models, including how it will ensure standardised monitoring and data collection across ICBs to allow meaningful evaluation.
• Launch a national movement campaign focused on those approaching retirement and the least active that challenges negative assumptions about ageing and starts a multi-generational conversation.
• Embed active design principles into planning guidance to support creation of healthy, active places; act across government to remove policy, funding and accountability barriers that have designed inactivity into daily life, including action on poorly paved streets, unsafe crossings and lack of toilets and seating.

Key actors

Layla Moran, Professor Chris Whitty, NHS England, Integrated Care Boards, Department of Health and Social Care, Wes Streeting, Sport England, Active Norfolk, Age UK