How should the ‘leisure sector’ support a Major Conditions Strategy?

A Major Conditions Strategy – A Major Opportunity for Leisure

Much has been written across sport and leisure print and social media about the release of the long awaited ‘Sport Strategy’ by the Government.  The ‘Get Active: A Strategy for the Future of Sport and Physical Activity’ sparked a flurry of responses yet hardly any has picked up on a policy paper also released last month about the idea to create a strategy around ‘major conditions’ and the case for doing things differently in future.

I suggest this is because although there is an increasing desire for leisure to work with health and to support the NHS, the relevance of this and other papers like it are not obvious to many. Yet there are clues within the paper as to what we could or even should be doing in the future if we really want to be considered as part of the solution to creaking NHS services.

Summary of strategic framework

So what is the paper proposing?

The paper is laying out that the model of care which has sustained us for the past 75 years must evolve considerably to meet the needs of the public in 75 years’ time. It is simply staring down a barrel as we all live longer but for too many people that life is experienced with many years in poor health.

“This major conditions strategy begins with one question: how should our approach to health and care delivery evolve to improve outcomes and better meet the needs of our population, which is becoming older and living with multimorbidity?

The Government focus is on 6 groups of conditions: cancers, cardiovascular disease (CVD) (including stroke and diabetes), musculoskeletal disorders (MSK), mental ill health, dementia, and chronic respiratory disease (CRD). Excitingly for leisure colleagues they state that prevention will be a key part of this new strategy and this is the first clue to the opportunities that could / should be open to us.

Not just primary prevention (reducing the risk of contracting a disease) but also secondary prevention or reducing the risk of a disease progressing. Another key aspect of the plan is to be better at early diagnosis of conditions through more effective screening – in the community. Not only that, they also state they want to increase treatment options within the community too. Well, by now the opportunities should be screaming at you!

The Age Time Bomb

The ageing population is often now talked about in our sector and the paper demonstrates that the likelihood of having a long-term condition rises significantly for older age groups: most people in the 55-64 age group and older have at least one long-term condition, including 80% of people over 85, and a rapidly increasing proportion of the population is over 65 (projected to be 3 million more people over the next decade and a half).

Figure 3: proportion of age cohorts living with long-term conditions

The Sick Workforce

There are now 8.65 million economically inactive people in the UK (people who are neither working nor available for work), a rise of 281,000 since early 2020, with 50- to 64-year-olds and people with work-limiting health problems largely driving the increase. Long-term sickness is now the most common reason for being economically inactive, with 2.52 million people of working age reporting this as the main reason in March to May 2023.

Empowering people to create healthy lives

As this is a Conservative Secretary of State authored paper, it clearly states that creating healthy lives is not just a matter for government. It also means empowering and enabling people to manage their own health and engage in healthy behaviours across their lives. It talks about behavioural risk factors including smoking but also about poor diet and physical inactivity contributing to obesity and in particular the fact that children’s obesity levels are increasing to epidemic proportions.

It states they have announced a 2-year pilot backed by up to £40 million to explore ways to make the newest and most effective weight loss drugs accessible to more eligible patients living with obesity outside of hospital settings. Pharmacies are increasingly utilised in this way but what is stopping us getting involved? Philosophical objections if some replies to my Linkedin article suggesting such a thing. But do we want to support the NHS or not?

In addition they are investing £645 million over two years into Community Pharmacies, including expanding the provision of blood pressure services this year to increase the number of people diagnosed with hypertension. This could save up to 10 million appointments a year, equivalent to around 3% of all appointments, and give the public more choice in where and how they access care.

Can we help?

Another key plank of the plan is to modernise the NHS Health Check  – about time as it is almost criminal how basic it is with virtually no follow up yet it still saves lives. It consists of the top risk factors for CVD, diabetes, kidney disease and some types of dementia. The check helps people to understand their individual risk and supports them to take action and access treatment. At current rates, estimates show that the NHS Health Check programme could prevent 2,500 heart attacks and strokes every year. A new digital app based check will be launched and yet people will still need to get support for some aspects of the checks. With our ability and incentives to offer follow up services surely we could / should be aligned to this initiative and use our resources to support this change?

Living with major conditions

The paper points out that many of us now and in the future will live with major conditions over many years. Physical activity can help alleviate many conditions such as pain management and MSK plus can be of huge benefit for those suffering with mental health conditions. Social prescribing is noted as being a vital component in this aspect of a modern health service.

‘Pre-habilitation’, rehabilitation and recovery

As someone immersed in the GM Active award winning Prehab4Cancer programme I was delighted and not at all surprised to read the commitment to expanding these types of services.

‘Pre-habilitation’ involves supporting people to prepare for treatment for a major condition. Targeted lifestyle changes while waiting for surgery for an MSK condition or in advance of cancer treatment can greatly improve patient outcomes while also helping people feel more in control of their recovery.

Every leisure operator, Active Partnership and cancer service should work collaboratively to ensure any person diagnosed with cancer can access this type of service, locally in their communities (rather than the clinical model that cannot possibly offer the quality of service a community based approach can)


‘Finally, none of this is deliverable without effective and supportive leadership.’

Clearly this last sentence about leadership was written with the NHS in mind I’m sure. But with the advent of the ICB’s maybe not. What is true is this stands for our sector too. Are we up for the challenge? Can we think differently, act differently and renew our purpose?

Major conditions strategy: case for change and our strategic framework – GOV.UK (

Andy King

Director, Miova