​Move More statement – NHS Western Isles

Health improvement, rehabilitation and recovery are key priorities for NHS Western Isles. Remaining active and mobile is beneficial to our health and wellbeing.

The Move More physical activity programme was a positive project for the proportion of the population that has completed it. This particular project came to an end of its Service Level Agreement period in April 2024. As stated in all previous press responses from NHS Western Isles, the NHS now intends to undertake a full assessment of how a physical activity scheme could be delivered to ensure maximum benefit and uptake. This important commitment was unfortunately not included in the recent Comhairle nan Eilean Siar Press Release (21 May 2024).

As a public body with significant financial requirements to meet and with a responsibility for ensuring the best and most effective use of public money, it is important that all services funded or part-funded by NHS Western Isles are regularly and fully evaluated and assessed to ensure the services being offered are appropriate, and as inclusive, accessible, effective and equitable as possible. All public sector budgets remain under significant pressure at present – with unprecedented additional financial demands and statutory requirements.

For the last financial year of Move More, 136 individuals completed the programme, which equates to less than three people a week on average. The aims of any future programme of this type would be to ensure maximum benefit and uptake; as high as possible a completion rate (45% of participants that were referred did not complete Move More last year); that there is a clear pathway for more permanent health improvement benefits after an individual has completed a programme; and to ensure any scheme is as accessible as possible to adults over the age of 18 across the Western Isles population.

It’s important also to point out that it is extremely unusual for programmes of this sort to be fully funded by public bodies. It may be that any future programmes should include consideration as to whether participants should pay a contribution towards classes, sports centre membership, one-to-one sessions, or gym inductions. This is common in many other similar programmes, and the Slàinte Mhath scheme provides very reasonably priced access.

To address some points made in the Comhairle nan Eilean Siar Press Release on 21 May 2024:

• NHS Western Isles did not quote a completion rate of 45% as implied. As stated in the above NHS release, NHS Western Isles confirmed that 45% of participants that were referred did not complete Move More last year, which is correct.
• NHS Western Isles took the decision not to renew the Service Level Agreement for this particular programme. We have, from the outset, remained committed to undertaking a full assessment of how a future physical activity scheme of this nature could be developed to ensure maximum benefit. This important point was missed from the Comhairle’s recent Press Release.
• NHS Western Isles would wish to understand the range of different service users that currently use or could potentially make use of a physical activity programme, as this data has not been presented to date for consideration.
• Availability of funding and effective use of public money is always an important issue, as we have detailed in all our media responses that related to Move More to date. In an initial email to the Comhairle on April 12 2024, the Director of Public Health did indicate that the Health Board ‘could not renegotiate a renewal of the Move More service level agreement in its current form’. He then offered a meeting to explore how the delivery of programmes could be achieved going forward. Despite pressing from the NHS side and various meeting dates offered by the DPH, this meeting did not take place until May 17 2024.

It is also important to point out that all public sector budgets are under significant pressure at present – with unprecedented additional financial demands and statutory requirements resulting from a number of pressures, including:

• Ongoing system pressures in terms of demand in terms of healthcare.
• The NHS Western Isles cash releasing efficiency target for 2024/25 is £5.572million. The current remaining gap to achieve that is £1.942million. To meet our statutory requirement to break even and operate within our budget, all services, without exception, are under scrutiny.
• The notional cost to NHS Western Isles of delayed discharges of £1.786million for the calendar year to January 2024 (approximately 30% of individuals in staffed acute beds have been assessed at fit for discharge to a care home, or with home care arrangements).
• Significant ongoing costs (as well as disruption and difficulties for members of the public and patients in accessing healthcare) associated with the new Stornoway to Benbecula flight arrangements.