Public leisure

Public leisure in many parts of the UK is failing. It is unaffordable and fails to serve those who need it most: inactive people, people with long term health conditions and people from deprived communities.

What's needed is for leisure to pivot to active wellbeing. This means high quality, targeted interventions for people with the greatest health needs and a universal offer for all. The principle is supported by Sport England in its report 'The Future of Public Sector Leisure'. But Get Active, the government's strategy for sport and physical activity, has failed to recognise the opportunity. This is a mistake. The next UK government needs to recognise this and shift its policies and resources to support the pivot to active wellbeing.

Public leisure was first introduced in the 1960s, with a rapid programme of building leisure centres and a 'sport for all' ethos. But the cracks started to appear in the 1990s – literally and metaphorically – as the ageing leisure stock needed significant investment. These problems have worsened over the last two decades despite investment from primarily local authorities and the National Lottery via Sport England. But the most significant issue is not the state of the buildings themselves, it's the failure of many leisure services to reach the people who need them most. We used to talk of open door policies, a warm welcome for all and improving access to target groups but these concepts have proved insufficient.

The conversation has rightly moved on to tackling inactivity and reducing stubborn inequalities but fundamentally, the traditional leisure centre model can't address this.

A new approach for public sector leisure is needed. It has become known as the pivot to active wellbeing. This means high quality, targeted interventions for people with the greatest health needs as well as a universal offer for all. The principle is supported by Sport England in its report 'The Future of Public Sector Leisure'. It is being adopted by a number of local authorities.

So, what does an active wellbeing service look like? First of all, it is not simply a contract or service specification let by a council and delivered by an operator.

It forms an integral part of a whole system and place-based approach involving the local authority, public health, the Integrated Care Partnership, adult social care, the voluntary sector, sports clubs, charities, residents and local companies.

It identifies what is needed in places by talking to the people who live there and involving them in the creation of solutions that are right for their communities. It uses movement, physical activity and sport to help get people moving more often. It brings organisations and services together so that residents can access health services in a relaxed, non-clinical setting and in the same space, move, stretch, relax, walk, swim or dance with other people.

It normalises the culture of movement in a neighbourhood/community- a normal part of life for everyone (not just something for the elite and sporty). It brings out the magic that happens when organisations and professionals in a place work together, collaboratively. It removes the artificial distinction between a customer of a leisure centre, a patient of a clinician, a member of a gym and a resident of a community. It uses local assets – both human and physical – to best effect by backing what's trusted and what works.

Leisure centres are being transformed into Active Wellbeing Hubs – integrated facilities that deliver significant social value and are better value than individual services on multiple sites.

But the journey to active wellbeing is not easy. It takes time, commitment, political will, re-direction of budgets, tough decisions, re-skilling of staff and a significant shift of mindset. It does not necessarily need big capital investment, but it certainly helps, particularly where traditional leisure facilities are tired or neglected.

We have seen recent active wellbeing partnerships between a Council and its service provider deliver significant added value and investment into addressing inequalities. This is through pricing concessions, targeted programmes and service redesign to meet the needs of less active communities. But much more can be achieved by working together.

So far, this all appears to be in the hands of councils and their communities. If it's happening without specific government policy, then why change anything? There are three reasons:

1. The health problems related to physical inactivity are getting worse, not better

2. Inequalities are increasing and are inextricably linked to wider economic and social inequalities

3. A pivot to active wellbeing is currently too difficult to implement in many places due to lack of knowledge and awareness of the benefits

So, this is what we believe the next government should do to accelerate the pivot to active wellbeing.

A local ecosystem for active wellbeing

First, integrated care partnerships (ICPs) should be strongly encouraged or directed to collaborate with local authorities on physical inactivity. At present, integrated care partnerships include the NHS integrated care board and all upper-tier local authorities that fall within the integrated care system area.

But district councils, who have responsibility for leisure in two tier authorities, are not necessarily part of the ICP. Arguably, they have more responsibility and impact on the determinants of public health, including physical activity, than upper-tier authorities. ICPs that put a social model of health at the heart of their strategies need to be fully integrated with local authorities and their VCSE infrastructure. Furthermore, the focus on health conditions in an area means that broad, quality of life solutions like physical activity may not be on the agenda.

Second, local authorities' discretionary wellbeing powers should be backed by mandatory obligations. The wellbeing powers currently enable eligible councils to do anything which they consider is likely to achieve the promotion or improvement of the economic, social or environmental wellbeing of their area. Mandatory obligations could require, for example, councils to lead the preparation of a wellbeing plan for their communities, based on local needs with costed proposals for implementation. Even if there was no additional funding, the wellbeing plan would encourage collaboration, pooling of budgets and refocusing of existing wellbeing activities towards clear and agreed objectives. There is however a need for additional resources to do this - as mandatory obligations are hard to deliver with ever reducing resources.

Third, physical activity should be introduced as a measure in the Quality Outcomes Framework (QOF) for GP practices. The QOF contains five main components: Clinical; Public Health; Public Health – Additional Services; Public Health – Vaccination and Immunisation; and Quality Improvement. If physical activity were added, perhaps as one of the additional public health services, then primary care would immediately have an interest in making communities more physically active.

There are numerous organisational, political and policy barriers that make this work really tough. But that doesn't reduce its importance, nor does it mean that government should shy away from its implementation. In fact, the converse is true: government should tackle these issues head on with bold policy implementation. They should enable those local councils and their partners who have the desire - to pivot leisure into an active wellbeing offer to benefit the whole of their communities.

When councils have to close old leisure centres that they can no longer afford to run, people protest and local politicians have to defend the indefensible. Replacing the old leisure centre with a new one does not address the health inequalities faced by that community. Pivoting the active wellbeing as part of a wider whole system and place-based approach will have the material impact we all want to see.

Our policy recommendations to support the pivot to active wellbeing:

• Funding local government to enable it to invest properly into its active environments.
• Stop charging VAT on community leisure and active wellbeing.
• Creation of a social model of health with an increasing % of spend over time in early intervention/prevention.
• Prioritising the leisure workforce's upskilling to support building capability in active wellbeing to take pressure off the NHS.