Memorandum by the Fitness Industry Association
(WP 48)
INTRODUCTION
The Fitness Industry Association (FIA) was formed
in 1991 in response to the need to professionalise the practices
of the health club and leisure centre sector. This is a sector
that employs approximately 150,000 staff, engaging over 6 million
members within 1,982 private clubs and 2,043 public fitness facilities.
The FIA is a non-profit making trade association
with just over 1,600 facility operator members. It is run by a
democratically elected board of directors representing multi-site
and single-site facilities across the private and public sectors.
The mission of the FIA is to improve the health
of the UK population by helping to increase the number of regularly
physically active individuals. This increase in physical activity
does not have to be entirely based within the health club or leisure
centre setting, as our case studies will show, but rather using
the site as a resource for expert coaching, advice and exercise
programming.
Recent initiatives designed to professionalise
delivery have included the FIA Code of Practice, the Register
of Exercise Professionals (REPs) and the Fitness Charter.
There is a perception within certain circles
of government, and certainly the media, that private health and
fitness clubs only cater for socio-economic groups A and B in
terms of access and that they are solely gym equipment focused.
On the first point, many of the FIA private
facility operators actually recruit across all socio-economic
groups. In fact, Fitness First, who have 150+ clubs in the UK,
recruit their largest percentage of members from socio-economic
group E. 27.99% of members come from E as compared to 18% from
B and 25% from A.
On the second point, hopefully the case studies
of innovative practice will show that FIA members extend their
provision beyond gym-based activities.
FIA General Comment on the Public Health White
Paper
Whilst the FIA is of the opinion that the White
Paper will go a considerable way towards achieving the government's
public health agenda we feel that the focus on physical activity
is disappointingly limited. Sir Derek Wanless's second report
and the Chief Medical Officer's report, both in 2004, clearly
evidenced that lack of regular physical activity is detrimental
to health. The FIA submitted a number of proposals during the
consultation to the white paper and would have hoped for a clearer
recognition of the benefits of regular physical activity in its
recommendations.
I. ACTIVITY IN
EDUCATION (A) (i) The
government has set itself the goal of supporting all children
to attain good physical and mental health. The White Paper talks
of "new initiatives to promote physical activity and sport
inside and outside school" and states that "the components
of good health will be a core part of children's experience in
schools through a co-ordinated `whole school' approach to health".
(ii) Many of the proposed targets, for example
for active travel plans, child poverty, the provision of school
nurses, curriculum PE levels and reducing the spread of obesity
in under 11s have a 2010 focus.
(iii) The FIA and its members are currently
involved in two significant projects with regard to the implementation
of the government's proposals. Both "Adopt a School"
[Annex 1, not printed] and the Solihull College of Further Education
[Annex 2, not printed] offer evidence of models for how the government's
public health goals, with regard to activity, might potentially
be achieved.
(iv) "Adopt a School" is an FIA
and Youth Sport Trust initiative and a great example of a private/public
partnership involving the health and fitness industry, the government,
independent agencies and commercial partners in the creative use
of health club facilities in order to offer physical activity
opportunities to young people. It forms part of "On the move
to 2010", a health and fitness campaign initiated by the
FIA.
(v) The FIA's "Adopt a School"
has been jointly funded by Sport England, through the Youth Sport
Trust (£40,000 per annum for 2003-04 and 2004-05) and Norwich
Union (£25,000 for 2004).
(vi) "Adopt a School" fits
many of the government's proposals as put forward in "Choosing
Health":
— For those who have taken part
it has successfully increased children's awareness of the values
of a physically active lifestyle.
— Through a broad range of activities
it has encouraged young people, who are not normally attracted
to traditional sports, that exercise can be fun—a breakfast
skipping club was organised at Dorothy Stringer High School in
Brighton; Moberly Sports and Education Centre in Westminster provided
street dance sessions.
— Children from schools located
within walking distance to the clubs have benefited from walking
to and from exercise sessions. This fits with government proposals
on active travel plans and has been used to educate children that
exercise does not need to take place only in a formal setting.
— The development of long term
links between health clubs and local schools—building healthy
communities.
(vii) Activity does not just take place in
the health clubs and leisure centre. In Birmingham, instructors
from the local Living well club ran aerobics and circuit training
classes at Calthorpe School.
(viii) The government has expressed concern
over the drop-off in activity levels for teenagers. The FIA has
recently received funding from the Department for Culture, Media
and Sport to run a trial of its "Active Girls" initiative.
This is based on the successful "Adopt a School" but
focused on teenage girls, a demographic associated with worryingly
low physical activity levels.
(ix) In 2002 an innovative partnership was
formed between Holmes Place Health Clubs (an FIA member) and Solihull
College of Further Education [Annex 2, not printed]. The collaboration
led to the opening of the 02 health and fitness club situated
at the heart of the college campus. The project is an excellent
example of the private sector health and fitness industry bringing
its expertise to colleges. In this instance the project helped
to attract and retain students. This example of a private/public
sector partnership is a model of good practice that should be
extended to include schools and universities as well as FE colleges.
(B) (x) The government is committed to making
schools the focus for delivering its healthy lifestyle message
to children and their parents. This is evident from the proposals
to extend the role of school nurses and the government's PE targets.
Such a focus makes sense given that school provides a key time
when the attention of all children is assured. However, the implementation
of the proposals will have to be bold and innovative in order
to be effective and represent value for money. The FIA's "Adopt
a School" initiative is evidence of the success that innovation
and variety in PE classes can have in enthusing children with
the desire to get more active. Such continuing private/public
sector partnerships, as mentioned above, are vital if the government
is to achieve its targets for PE in schools (for which it has
pledged £1billion).
(xi) If the focus and impetus of a campaign
to get young people active should be centred on schools, there
is also a role for sports clubs. "Choosing Health" states
that "the Government's national strategy for PE School Sport
Club Links is the keystone for a bridge being built from PE to
lifelong learning, inter-school sport and school-club links".
It seems important that resources should be shared within communities,
for example school sport being focused on a local sports college.
The FIA's proposed family of "Adopt a . . ." schemes
helps to provide this centring.
(xii) The FIA's "Active Girls"
has received DCMS funding for a pilot and the Scottish Executive
has welcomed a suggested proposal for "Adopt a Youth Club"
in Scotland. The successful outreach element of "Adopt a
School" shows how the pooling of local resources, across
public and private sectors, can effectively deliver improved physical
activity opportunities for young people.
(xiii) Encouraging walking to school through
such schemes as "walking buses", where all the children
wear bibs, was an element in some of the "Adopt a School"
projects. In some case the time spent walking to and from the
gym was used for mental arithmetic and language games. Such ideas,
which are simple and effective, are key for the success of the
Government's proposals for schools to develop active travel plans.
Providing schemes that engage those involved is more likely to
produce successful results than just a campaign marketing healthy
lifestyles, although this clearly has a role to play.
(C) (xiv) Considerable work needs to be done
in order to achieve the necessary public health infrastructure
to achieve the "Activity in Education" goals. A cross
government departmental approach is essential to create links
between school, community and club, links which the Department
for Education and Skills initiative (PESCL) has been excellent
at initiating. The success of the FIA's "Adopt a School"
is based on the role of local Partnership Development Managers
(PDMs) in co-ordinating links between leisure centres and primary
schools. The successful delivery of the government's proposed
targets for activity in education is reliant on the effective
management of local partnership resources. The infrastructure
at local level needs to be expanded and developed for continued
and increased success.
II. ACTIVITY
IN THE
WORKPLACE (A) (i) "Choosing
Health" stresses the importance of people's work environment
in influencing health choices and its potential to be a force
for improving health. Recognising that we spend an average of
7 hours and 50 minutes a day at work and that a great deal of
this time is probably sedentary reinforces the need to promote
physical activity to both employers and employees.
(ii) Many of the FIA's members invest in
the health and wellbeing of their staff, DC Leisure Management
and David Lloyd Leisure being two examples. [Annexes 3 and 4,
neither printed]. These two companies offer free membership to
all their staff, their partners, parents and offspring. Across
the two companies this involves 11,300 employees and their relatives.
However, currently, employer-provided gym membership is taxed
as a benefit in kind. The FIA would like to see an initiative
that pushes for fiscal incentives for gym membership, particularly
through employer schemes. It would be helpful if the Inland Revenue
did not tax those employees who take advantage of employer schemes,
such as off-site gym membership, for using that benefit [see Annex
5, not printed, for the FIA's current proposals in partnership
with BISL for tax incentives for physical activity].
(iii) The existing tax-efficient bike-purchase
scheme, which the White Paper suggests needs greater advertisement,
shows that the Government is willing to make tax concessions to
increase opportunities for physical activity.
(iv) Employer health club membership schemes
are naturally more available to large enterprises and government
departments. Therefore, to build a healthy nation through workplace
activity, there need to be schemes that focus specifically on
small and medium enterprises (SMEs).
(B) (v) In "Choosing Health"
the Government pledges to "establish pilots to develop the
evidence base for effectiveness on promoting health and well-being
through the workplace".
(vi) The FIA is currently planning an initiative
called "Adopt a Business" in collaboration with Sport
England (East), the local Primary Care Trusts, Business Link and
six FIA health club members with facilities in the region. The
initiative will be based on the "Adopt a School" project
where health clubs would offer their staff expertise by sending
qualified exercise professionals into workplaces to run activity
sessions. These sessions can take place out of doors and simply
be walking/jogging in order to fit easily into a lunch break.
A pilot will hopefully be launched by the summer. If successful
the plan is to roll out this scheme in other regions. The Scottish
Executive have again shown an interest, whilst other Sport England
regional plans list the FIA as a potential partner for similar
projects.
(vii) Physical activity opportunities need
to be considered in the design and build of workplace making sure,
for example, that stairs are accessible, shower and changing facilities
are available and cycle parking is provided.
(viii) Moreover, employers need to be encouraged,
where possible, to look at the length and structure of their working
day and to provide flexibility within this to enable staff to
take physical activity breaks. This might enable employees to
take advantage of downtime in local health clubs, working in partnership
with businesses in their area. Likewise, employers should be encouraged
to provide education/information to employees about the local
opportunities available for physical activity.
(C) (ix) The current public health infrastructure
will not adequately support effective implementation of work-based
health initiatives. Links need to be made with the largest employers
via trade unions, the Confederation of British Industry, the Institute
of Directors and other employee focused organisations. Private
sector employers, as well as public, must be engaged in this process.
Schemes to raise activity levels in the workplace, such as "Adopt
a Business", need a conduit in the local community to fulfil
the role performed by PDMs for "Adopt a School". The
Government's Business Link is an organisation that could offer
a framework for putting businesses in touch with local opportunities
for activity and for health clubs and leisure centres to co-ordinate
activities with local businesses. Business Link's potential in
this regard is being used in setting up the FIA's "Adopt
a Business" pilot and should be developed.
III. AN
ACTIVE HEALTH
SYSTEM (A) (i) The
Government's aim is for a health system that proactively promotes
good health rather than simply treating the symptoms of poor health.
This needs to involve more than just good marketing and place
PCT's into active partnership with other key players in local
communities.
One proposal in the White Paper relates to a
"physical activity promotion fund" which we are lead
to believe will be available from 2006. Criteria for the distribution
of this fund have not yet been made public but the FIA strongly
advised that it is ring-fenced money whichever agency it is given
to for distribution.
(B) (ii) An active healthcare system must
involve the NHS, local government, the private and the voluntary
sectors working more closely together. FIA members complain that
it has been difficult to set up local partnerships with PCT's
which is frustrating as a great deal of professional expertise
and other resources could be shared. There is sometimes a breakdown
in communication between leisure centres and doctors when potential
leisure clients, with known health problems, such as recent cardiac
conditions, are asked to consult their GP over whether a particular
exercise programme is appropriate.
(C) (iii) FIA member's experiences of working
with healthcare professionals have come mainly through exercise
referral schemes. The FIA were a contributory author to The National
Quality Assurance Framework (2001) and set up the Register of
Exercise Professionals [Annex 6, not printed] in response to the
DoH's demand for a system that listed the skill levels and qualifications
of exercise professionals. Exercise instruction as a profession
had been largely unregulated until the development of REP's and
healthcare professionals therefore had little confidence in the
abilities of those working in the fitness industry. This barrier
is now being broken down through the institution of REP's and
other FIA initiatives.
(iv) However, some GPs retain a low opinion
of exercise professionals [Annex 7, not printed]. Much work still
remains to be done, therefore, before a broad-based community
health promotion drive will be truly effective. The FIA is currently
making good progress on the development of an industry-wide PAR-Q,
in partnership with REP's, Skills Active and Dr Nick Webborn of
the RCGP. It is hoped that the PAR-Q will give GPs confidence
in giving medical sign-off to patients wishing to take part in
physical activity.
(v) The Excel to Health Exercise Referral
Scheme [Annex 8, not printed], which has been running in the North
West of England for eight years, offers a useful model for how
partnerships in communities can successfully deliver exercise
opportunities for those who need them. One of the most innovative
aspects is the involvement of both the public and private leisure
sectors. Local Authority gyms in the area charge £1 a session
on a "pay as you go" basis and private health clubs
offer a reduced rate "clinical populations" membership
for patients.
(vi) The Government's proposed Health Trainers
could play a key role in referral schemes, thus not further adding
to GP's workload. However, the White Paper is not clear in its
description of the roles, responsibilities, skills and qualifications
of its proposed "health trainers". The existing public
health networks need to liase closely with the relevant Sector
Skills Councils (ie SkillsActive and Skills for Health) who already
oversee vocational qualifications under the guidance of the Qualifications
and Curriculum Authority. The FIA would strongly recommend a re-assessment
of the National Quality Assurance Framework, which sets out the
guidelines for implementation of referral schemes. The framework
is now rather out-dated and overly bureaucratic causing bottlenecks
to occur as there is a mismatch in current qualifications and
those required on the framework.
(D) (vii) The FIA proposes the development
of a "referral in reverse" system, whereby GPs can respond
back to the fitness industry when a health risk is identified
in a Physical Activity Readiness Questionnaire (PARQ) and the
potential client is requested to visit their GP. Currently GP's
often request a fee for such a response, which, in the FIA's view,
is unacceptable.
January 2005
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