Welcome to our All Together Active One Year On newsletter, showcasing a round up of some the achievements and progress to date since the launch of the strategy exactly one year ago today.

Foreword from Professor Ian Ashworth

One year ago we launched the All Together Active physical activity strategy for Cheshire and Merseyside, that will support 150,000 inactive residents in our subregion to become more active by 2026; focusing on those people facing the greatest health inequalities.

I have been delighted to see the progress made to date with All Together Active, in particular with the political support received and inclusion within the ICB’s Joint Forward Plan, the buy-in from our nine Places, collaboration with the Population Health Board and other ICS Transformation programmes, and the execution of a new All Together Active governance structure that builds the solid foundations to see some large-scale implementation in the years to come.

We have seen some really exciting collaborations with clinical teams resulting in transformational outcomes for patients and benefits for the wider NHS system, and I am looking forward to seeing these opportunities grow as we start to innovate and be bold in order to unlock the full potential of physical activity across the subregion.

Professor Ian Ashworth

Director of Population Health for Cheshire and Merseyside

Emerging subregional pilot work

Since its launch, All Together Active has worked alongside its dedicated partners to instigate innovative pilot projects across Cheshire and Merseyside, all focusing on empowering more people facing health inequalities to be physically active as part of their journey within the health and social care system. Those pilot projects have sought to break down barriers and open doors to physical activity.

Exploring opportunities to embed physical activity into patient pathways has been a key area of focus. This commitment has resulted in several exciting pilot projects to support this area, including:

Linking physical activity to alcohol support services

All Together Active has collaborated with partners in Liverpool, Knowsley and Warrington to redesign referral pathways for individuals on the path to recovery from alcohol dependency, incorporating the therapeutic properties of regular physical activity to support their recovery. Pilot programmes have been run, with promising data emerging such as 69% of patients who were previously inactive now taking part in regular physical activity, and we’re working with partners to scale-up the interventions.

One participant told us, “I was initially terrified and so scared to come to the gym – my personal trainer made me feel so comfortable, and I feel like my body has been woken up again after being asleep for so many years. If I didn’t have this now, I don’t know what I would have done, it’s helped me to gain more clarity.”

Using physical activity as a tool to improve outcomes for secondary care

All Together Active have linked up with the NHS Prevention Pledge to support all 17 NHS Trusts who work in Cheshire and Merseyside to increase physical activity opportunities for staff and patients. Examples of work include developing physical activity statements/policies, expanding the range of on-site/virtual classes for colleagues and facilitating partnership opportunities between neighbouring Trusts. Trusts have also been embedding physical activity within patient pathways, one such example being Warrington and Halton Teaching Hospitals NHS Trust’s ‘Active Hospitals’ programme, that has recently been commended at the 2023 HSJ Awards; The programme encourages patients to remain physically active during their hospital stay, preventing the risk of hospital associated deconditioning. Since starting, Active Hospitals has achieved a 22% reduction in inpatient falls has been observed and its success has resulted in the programme’s inclusion in clinical induction and mandatory training for hospital staff.

“The NHS Prevention Pledge has worked in partnership with All Together Active partners from Cheshire and Merseyside over the last two years to maximise opportunities to embed physical activity in the operations of NHS Provider Trusts for patients, visitors and our NHS workforce. Promotion of physical activity and development of active environments flows through many of the NHS Prevention Pledge’s core commitments, and connecting All Together Active colleagues with all of the 17 Trusts in Cheshire and Merseyside has been invaluable in furthering the ambitions of the NHS Prevention Pledge, and has enabled many innovative new projects and partnerships.”

Matthew Philpott, NHS Prevention Pledge Lead, and Executive Director of Health Equalities Group

Embedding physical activity within serious mental illness services

Working alongside the Mental Health Intensive Support Team (MhIST) at Cheshire and Wirral Partnership NHS Trust, we have played a key strategic role in embedding three Healthy Lifestyle Coaches within the community rehabilitation pathway. The coaches will be on hand to support community patients diagnosed with a serious mental illness in their recovery, using physical activity delivered in the community to support the transition into community discharge. The service will be fully operational by December 2023, with a focus on two key outcomes: a reduction in readmission rates and an increase in levels of physical activity.

“Our collaboration with All Together Active to embed the focus on physical activity within Mental Health community rehabilitation pathways has been an enriching experience for all involved and is starting to show some fantastic results”

Dr Amrith Shetty Consultant Psychiatrist (MhIST) and Associate Medical Director, Cheshire and Wirral Partnership NHS Foundation Trust

Upskilling the health and social care workforce

Equipping Cheshire and Merseyside’s health and social care workforce with the knowledge, confidence and resources to encourage physical activity in their roles is essential for the strategy to realise its goals. All Together Active has partnered with the Royal Society for Public Health and Health Education England to pilot a MECC (Making Every Contact Count) for Physical Activity conversations training programme. The pilot was conducted in March and April 2023 with 56 participants over three online and one face to face programme. The subsequent evaluation found a 43% increase in delegates self-reported confidence navigating conversations about physical activity with patients. Making Every Contact Count for Physical Activity training was launched nationally in September 2023, and forms part of the wider workforce offer for health, social care and community professionals available across Cheshire and Merseyside.

Taking a whole-system approach to tackling inactivity

We are pleased to showcase All Together Active’s governance structure, the launch of which marked a significant milestone for the strategy’s future implementation.

This structure enables better collaboration, accountability and efficiency to maximise the strategy’s life-course approach and key opportunities through a series of thematic and working groups. To date, these groups encompass 135 dedicated stakeholders from 77 diverse organisations across the subregion, ensuring the strategy takes a comprehensive, whole-system approach; we deeply value the commitment and diversity of expertise each stakeholder has brought to All Together Active since its launch, and we would like to take this opportunity to encourage strategic stakeholders who are interested in being a part of these groups to contact info@alltogetheractive.co.uk for more information.

Check out the brand new All Together Active website and Resource Hub

One year on from the All Together Active strategy launch, we’re delighted to share with you a link to the brand new All Together Active website that includes a refreshed and updated Resource Hub; a one stop shop of information, resources and signposting designed for anybody working in health and social care in Cheshire and Merseyside to find out more about physical activity.

The new website and Resource Hub is now live via www.AllTogetherActive.org.uk

Please share this link with your colleagues to help spread the word. We’d love to hear what they think about the new website and Resource Hub too; any feedback can be directed to info@alltogetheractive.co.uk

Place Spotlight

Cheshire East

A Cheshire East Place Physical Activity Plan implementation group has been established with membership from partners across the Council, the ICB, the Community and Voluntary Sector and Provider Trusts. This group is working to develop the Physical Activity Plan for Cheshire East. A piece of mapping work has been undertaken to identify current provision. Workshops are planned for the autumn to bring people together to discuss gaps, duplication and aspirations for investment and innovation based on the mapping work. Work to system map and achieve the same engagement re: Supporting Healthy Weight will also run concurrently, as part of a joint approach to both agendas. A public ‘lifestyle’ survey is being undertaken and this will also inform the Plan. We aim to have the Plan signed off and ready to launch by April 2024.

We are also linked into the commissioner and provider of the leisure provision in the borough and are participating in the strategic review of leisure facilities that is underway.

Cheshire West and Chester

Professor Helen Bromley, Director of Public Health at Cheshire West and Chester Council, said “there have been some exciting developments in Cheshire West and Chester over the past year. We’ve redesigned our Eat Well Be Active partnership programme to include a new physical activity sub-group, which leads on the All Together Active Strategy locally. As Eat Well Be Active reports directly to the Health and Wellbeing Board, physical activity is kept firmly on local agendas.

Colleagues from the local authority and health sector have been building on the findings from the ActiveCHILD research project. The project explored physical activity in very young children and included many Cheshire West families. Using the research findings, an action plan has been developed to inform local policy and practice. Women and girls have also been a big focus for us. We recently held two events, bringing partners and residents together to explore how we can work together to increase participation in physical activity, starting with getting the basics right. Some great work is already happening in our schools, grassroot sports and leisure opportunities and we want to build on this. To that end we’re developing a communications campaign to raise awareness and support this great work.

Our leisure, health and wellbeing provider Brio Leisure, is doing fantastic work, rolling out services that encourage local residents in priority areas to take part. We’ve listened to what our communities want, and designed services on the back of that. Our Inclusive Leisure Manager is part of the Public Health Team and he supports some of the great work taking place. He also makes sure that access to leisure services is central to our local area development plans.

We are incredibly proud of our local walking networks, many of which support people back into gentle exercise. Over 300 people per week take part in these volunteer-led walks. The volunteers, who give up their time to help others each and every week were rewarded with a celebratory event earlier this month.

Whilst we have really strong partnership working across our borough there is always more to do, and over the next year we are looking forward to building on the great work already happening.”

Halton

Over the last 12 months Halton have created a place-based steering group that will work towards the development of a physical activity action plan. This group is currently working on mapping of facilities and provision locally and gaining insights and viewpoints of the public to develop a cohesive offer to support the community to become more active. Some of these projects include: a digital weight management app, a bespoke Men’s weight Management programme, training front-line professionals, the expansion of an exercise prescription prehab programme and the commencement of a transformation project within the leisure services.

Knowsley

Cllr Shelley Powell, Cabinet Member for Communities and Neighbourhoods at Knowsley Council, said “To underpin the Knowsley 2030 offer and improve health and wellbeing opportunities throughout the borough, during a cost-of-living crisis, it’s been fantastic to see colleagues within our Leisure Centres, Environmental Sustainability and Communities, Cultural Services and Public Health come together to work towards this.

More than 83 events were delivered over the summer period in our parks and green spaces providing free activities that included physical sports, crafting and nature-based activities to help our communities’ mental and physical health and reduce social isolation. Our Leisure Centres have supported those on low incomes to access swimming lessons and provide essential life skills and encourage an active lifestyle. Public Health has supported cycling activity through partnership working with the charity Wheels for All and other initiatives. One Knowsley, through the Sport and Nutrition Active Play (SNAP) programme, provided opportunities for eligible children to eat, move, learn, create and connect. We’re proud of the approach that we’ve taken, that enables our networks to support more people become more active, healthy and less isolated.

Liverpool

Matt Ashton, Director of Public Health at Liverpool City Council, said “On the back of our Navigating Local Systems pilot (that’s resulted in some exciting place-based collaborations and conversations in our L8 area to tackle inequalities) and Strategic Outcomes Planning Model work, we have established a Liverpool Physical Activity Group that is currently developing a new strategy for Liverpool; engagement for this will start in October 2023 with a view to launching the strategy in Spring/Summer 2024, and it’s been fantastic to see colleagues within physical activity, sport, leisure, culture and public health all come together to work towards this.

As well as embarking on a new Leisure Transformation Programme, we’re proud of the approach that we’ve taken towards learning, that enables our networks to support more people to move more. To get involved or find out any more about this work please contact pasdev@liverpool.gov.uk”

Sefton

Cllr Ian Moncur, Cabinet Member for Health & Wellbeing at Sefton Council, said “Over the past 12 months we have been carrying out consultation and engagement for our new Physical Activity for Sefton as a place, both with partner organisations and our local communities. The development is now the final stages, with the implementation of the strategy looking at activity levels across a life course, working with neighbourhoods, and through the Sefton system to develop a network responding to issues and challenges around physical activity. The new strategy is also planned to align with existing strategies across Sefton, including the Health & Wellbeing strategy, Children & Young People’s Emotional Health and Wellbeing strategy, and Sefton’s Older People strategy, and create and establish a network to build on the work of All Together Active.

The launch and the implementation of the strategy will commence in early 2024, for further information or to get involved in physical activity networks across of Sefton, please contact: Active.Sports@sefton.gov.uk.

St Helens

As St Helens moves into the second year of their Active Lives Strategy, we look back on the success of year one. The overarching goal of the strategy is to work in partnership to increase levels of physical activity across the whole population of the St Helens borough, whilst maximising opportunities for people experiencing inequality to participate in activities. Physical Activity & Mental Health promotion programmes have been delivered by Saints Rugby League Foundation and we move into year two of delivery. Leisure Services have delivered an accessible open day aimed at residents who have neurological conditions. We have also delivered four mass participations event, one of which being an accessible Football Tournament, aimed at adults with additional needs or disabilities; this attracted clubs throughout Merseyside, and has seen a St Helens team form on the back of it. St Helens also took part in the BuddyBoost challenge; a workplace engagement programme to encourage physical activity in businesses across the borough. We look forward to progressing into Year two of our Active Lives Strategy alongside All Together Active.

Warrington

In 2023, the Warrington Borough Council (WBC) Public Health team (in partnership with multi-sectoral system partners – ‘Warrington Together’) have begun to work towards achieving the Healthy Weight Declaration (HWD). A key ambition is to, to galvanise cross partner efforts and commitments to improve the health and wellbeing of the people of Warrington and create a healthy weight environment. Physical activity is a huge part of this and associated pledges towards the declaration include Council Planning departments revising the Local Plan and new developments to incorporate healthy weight initiatives such as access to green spaces for physical activity and infrastructure to support active travel, including cycle lanes and walking trails. In November this year, we are also establishing two steering groups to support development of the Active Warrington Strategy and the HWD Strategy involving a range of partners from multiple sectors. These will be launched in Summer 2024.

The WBC Public Health Knowledge & Intelligence team completed a large-scale health and wellbeing survey in summer 2023. This population health survey, which was last conducted in 2013, has generated vital up to date information from nearly 5,000 adult residents on a variety of topics which we know can all influence health and wellbeing. Respondents were asked about the amount of physical activity they do and we will utilise the information to inform both the Active Warrington and HWD strategies in combination with our Joint Strategic Needs Assessment.

WBC Public Health have also this year invested funding into our local ‘Offload’ programme, a men’s mental fitness and wellbeing project run by the Warrington Wolves Foundation which includes education and coping strategies to support mental fitness, along with physical activity sessions.

Wirral

Jason Gooding, Director of Neighbourhood Services at Wirral Council said, “Over the past year Active Wirral has continued to deliver on the strategic ambition to make sport and physical activity part of everyone’s everyday life. We have established a network of community organisations and individuals all who have the same ambition to use sport and physical activity to achieve better health and social outcomes for people who live and work in Wirral. This network is called COLLABOR8.

In partnership with National Governing Bodies of Sport we have invested in new facilities and programmes of activity providing new opportunities and environments for people to be active. Highlights include the redevelopment of Bidston Sports and Activity Centre, new 3G pitches and upgrades to our park’s tennis courts. Along with colleagues in Blackpool we have been part of a pilot to test a System Leadership Programme within a Place, which has provided us with the foundations to further develop this approach across Wirral. We also launched our campaign ‘Be Part Of The Movement’ to drive visibility and awareness of the benefits to leading an active life, provided resources along with a call to action for everyone to get involved. Join us activewirral@wirral.gov.uk or visit www.bepartofthemovement.com “

Subregional opportunities to embed physical activity

All Together Active is able to use physical activity as a tool to unlock the potential of improving population health, and we have been delighted to link up with other ICS Transformation Programmes to start some exciting collaborations about improving elective care, waiting list times and holistic support for patients including:

• Pre-hab: co-production of the Cheshire and Merseyside Prehabilitation Strategy Development Group, which will use physical activity to improve elective care outcomes, recovery time and reduce hospital bed days
• Falls: co-chairing the Cheshire and Merseyside Falls Prevention Collaborative, with opportunities to improve the standard of physical activity within falls prevention services across the subregion
• Talking Therapies: working with providers across the region to support people with mild to moderate mental health problems to be more active to support their recovery

Measuring the difference

The All Together Active Evaluation working group has laid the groundwork for the development of the strategy’s Monitoring and Evaluation Framework over the past 12 months. This group has supported the thematic and working groups through the process of crafting specific logic models; these models will serve as the foundation for ongoing monitoring and evaluation efforts with a commitment to a data-driven methodology, these models will contribute to the realisation of the strategies overarching goal: empowering 150,000 inactive individuals to lead more active lives. Furthermore, this meticulous approach fosters a culture of learning that the entire system can benefit from.

Get in touch

We hope that you have enjoyed reading this short All Together Active One Year on update, but if you have any further questions or want to get involved in the strategy then please contact our team via info@alltogetheractive.co.uk or fill out our contact form.