Integrating Physical Activity into Health and Care Pathways: The Role of Physical Literacy

By Olivia Flemons, IPLA Secretary, Doctoral Researcher at the University of Bedfordshire

The IPLA had the pleasure of attending yesterday’s (4th April 2025) event on integrating physical activity into health and care systems, hosted by Active Partnerships, in collaboration with Sport England, and NHS HORIZONS. As discussions spanned from policy-level interventions to grassroots partnerships, a consistent theme emerged: the need for collaborative and integrated systems to support sustainable change.

Understanding the Current Landscape

The case studies presented, including the work of Wiltshire and Swindon Sport (WASP), Wessex Water, and Active Sussex, underscored the wider societal implications of inactivity. The discussion extended beyond health outcomes to the environmental and economic consequences of inactivity, such as increased medication in water supplies due to higher prescriptions (resulting from inactive behaviours), and the associated costs passed on through poverty.

At the policy level, Sport England’s shifting priorities and the evolving governmental landscape signal a need for adaptable and responsive approaches. The delay of the 2025-2028 implementation plan, alongside the broader governmental health mission, reflects the challenge of integrating physical activity within existing systems. The conversation reinforced the importance of collaborative leadership, devolution strategies, and system-wide alignment to drive change.

The event also provided invaluable opportunities for discussion and reflection, enhancing our understanding of best practices. The success stories shared were particularly inspiring, showcasing real-world impact and innovation. The insights from CIMSPA’s work and the learning from a Primary Care Network-based programme in the Midlands offered a powerful lens into how these initiatives can be scaled nationally and locally. Importantly, the event highlighted a crucial element often overlooked—physical literacy.

Physical Literacy: A Foundation for Sustainable Behaviour Change

A compelling insight highlighted from a local perspective, was the recognition that physical literacy is essential for fostering sustainable physical activity participation, particularly among inactive populations.

Without a focus on physical literacy, efforts to increase physical activity risk being short-lived or exclusionary. The stigma around ‘tackling inactivity’ often places responsibility solely on individuals rather than addressing the systemic barriers they face. By embedding physical literacy principles, we shift from a deficit model of intervention to an empowerment model that equips individuals with the tools they need for long-term engagement.

Embedding Physical Literacy into Health and Care Systems

The NHS’s ‘Four Ways Forward’ strategy for embedding physical activity into clinical pathways is an excellent starting point. However, the challenge remains: how do we empower health and care professionals to embed physical literacy into their practice?

Here are some considerations arising from yesterdays emerging themes:

• Medical professionals as movement advocates: There is a need to reframe the role of healthcare professionals as facilitators of movement, ensuring they understand and can communicate the value of physical activity in ways that align with patients’ capabilities and lived experiences. Training programmes should focus on developing healthcare professionals’ understanding of physical literacy, equipping them to build patients’ motivation and confidence alongside prescribing movement. Nevertheless embedding physical literacy in workplace wellness programmes can create a culture where NHS staff model and promote active lifestyles, reinforcing the importance of movement in healthcare settings.
• Moving from mandated medical clearance to medical guidance: Shifting the narrative from risk management to benefits-based guidance encourages positive reinforcement of movement as a fundamental aspect of well-being. Incorporating physical literacy principles into patient interactions will ensure that interventions are tailored to individuals’ capabilities, thereby reducing fear and stigma around movement, and embracing positive embodied movement experiences.
• Addressing digital divides and access inequalities: Ensuring equitable access to physical activity interventions requires targeted methodologies that bridge gaps in digital literacy and socioeconomic barriers. Digital and in-person physical activity interventions should be designed with diverse communities in mind, considering linguistic, cultural, and socioeconomic factors. By integrating physical literacy into digital engagement strategies, we could create accessible, user-friendly resources and provide in-person alternatives to ensure inclusivity. Nevertheless, ensuring that physical activity opportunities are not limited to those with financial means is crucial. Embedding physical literacy within social prescribing pathways and community-based initiatives can create supportive environments where everyone, regardless of background, can develop the confidence and skills needed to be active.
• Storytelling and evidence-based advocacy: The need for stronger impact storytelling and data-sharing across sectors to drive investment and policy alignment is crucial. Future research and programme evaluation should measure not only participation levels but also improvements in motivation, confidence, and knowledge related to physical activity, ensuring long-term engagement rather than short-term compliance.

A Collaborative Future

Overall, this insightful and engaging event underscored the necessity of moving from fragmented interventions to an interconnected system; physical literacy may be the underpinning framework to support the life course of the health and care journey. As seen in the ‘Path to Park Run’ initiative and South Leamington GP Practice’s lifestyle group clinics, embedding physical activity into patient pathways requires a shift in resourcing, training, and community partnerships.

By aligning the principles of physical literacy with health and social care strategies, we can create a sustainable ecosystem where movement is not an afterthought but an integral part of life. Rather than viewing exercise purely as medicine, we should recognise movement as an innate human behaviour, shaped by our evolutionary need for physical activity and essential for our overall well-being.

The challenge now is to ensure that these conversations translate into action—through collaboration, advocacy, and a shared commitment to rethinking how we engage people in physical activity for the long term.

If you are looking for guidance on how to shape health and care systems using physical literacy, or if you want support in making this happen, we encourage you to reach out to us: support@physical-literacy.org.uk