From right to left, Professor Mike Bewick, Former Deputy National Medical Director at NHS England, Lord James Bethell, Former Minister for the Innovation Department of Health and Social Care, Steve Mann, Director at 4Global and Sasha Karakusevic at NHS Horizons.
As part of our Innovating Healthcare series, Professor Mike Bewick, Former Deputy National Medical Director at NHS England, sits down with Sasha Karakusevic at NHS Horizons, Steve Mann, Director at 4Global and Lord James Bethell, Former Minister for the Innovation Department of Health and Social Care to discuss the UK’s obesity roadmap.
The epidemic of obesity
Exploring the management of obesity and the societal element of obesity, Professor Bewick opened the discussion with: “Obesity is one of the largest, if not the largest health problem,” and Lord James Bethell added that he is “really struck by how unhealthy a lot of Briton is”. They noted how recent government cuts would not help matters.
In a bid to tackle the obesity epidemic, Karakusevic is working with the NHS Horizons team to investigate complex change projects within the realm of physical activity. Commenting on the initiative, Karakusevic said: “It was a really interesting project. The challenge was how do you get the NHS to be more interested and involved in physical activity,” adding “their findings suggested that “it’s not just about more guidance,” but early discussions showed that “most of the barriers are at out of the boundary of the NHS.” These barriers include interactions between the NHS and local communities, authorities, and the sports sector.
Lord Bethell expressed his frustration at the Government’s recent U-turn on obesity strategy which already fell far short. Noting that there are still significant smoking contingent, especially in deprived areas of the country despite decades of action to reduce people smoking, he laments that “I just don’t want us to be here in 30 to 40 years time, wondering where the obesity strategy is going to go”.
Breaking down the barriers
To break down the barriers, NHS Horizons has built a partnership with Mann at 4Global, who believes in “harnessing the power of sport and activity to tackle big societal issues.” Commenting on the partnership, Mann said: “It’s been a fascinating process to go through. At 4Global, we work predominately with local authorities and the sports sector. We’ve always been trying to tackle the issue of how we can get into this sector,” adding that he knows “how important physical activity is in treating, managing and preventing chronic conditions.”
The team at 4Global are working towards answers to several questions, how to break through the barriers of the NHS, how to be part of frontline services and how to make services much more accessible for people? “If we’re going to be effective” in the obesity strategy, Lord James Bethell commented: “it means getting education behind us, getting sports behind us, getting housing behind us and getting our food strategy correct.”
Creating an inclusive environment
According to Sasha Karakusevic, “Every community is different, they’ve got different interests and different ways of getting things done,” and that’s why the NHS is working towards “translating a national policy into a local action.”
In doing so, 4Global is working with over 1200 leisure centres that Steve Mann said: “sit at the heart of communities.” Still, data suggests that there are “huge dropouts from the referral point to people actually making the front door.” Mann believes that this is due to the fact that leisure centres are “often quite scary and intimating places for people to get into.”
To tackle this, Mann said: “We need to do much more with healthcare and take referrals in; the advent of social subscribing will help this,” adding that “the thing that people want to do is what’s best for them. We’ve recently developed things like golf referral schemes where, for a 65-year-old man, they probably don’t want to go and do an aerobics class in the leisure centre or sit and stand classes. But would love to play golf and benefit from green exercise, and the social aspect that comes with it.”
What’s more, the pandemic has enabled people to change the environment to suit them. Commenting on the new normal, Mann said: “Now, it’s much easier to take part in an exercise class off of the television or phone, rather than having to cross all of the psychological barriers of getting into a facility like wearing the wrong clothes or being worried that you’ll have to stop after twenty minutes when the class is going for forty.”
From useful interventions such as NHS social prescribing to changing environments for physical activity, there are clear pathways that can help us better understand the psychology of the epidemic and address the alarming rates of obesity.
While exercise is a step in the right direction, overcoming addiction to junk food is ultimately the biggest hurdle to jump.