Physical activity improvement in practice staff

St James' Surgery – Bath
Highly commended Bright Idea for England

The problem

Lifestyle and environmental factors are leading causes of non-communicable diseases, including diabetes, cardiovascular disease, obesity, and liver disease, which could be prevented or better treated through addressing diet, physical inactivity, smoking, alcohol consumption and psychosocial factors. Physical activity levels in practice staff were low. This makes it difficult for staff to provide guidance and support to patients.

The bright idea

The surgery organised a "Movement is Medicine" Steps challenge, hoping to increase staff members knowledge of physical activity benefits and guidelines and in doing so encourage more conversations with patients around increasing physical activity levels. Members of staff were split into three teams to compete over a four-week period. Initially, data was collected from those already measuring their step count and found the average number of steps a day was 5,874. Pedometers were bought for those who didn't have them. A member of the practice team collected the number of steps from each person each week and added up individual and team totals. Each week period was treated as a PDSA cycle, changing different things each time. These things included:

  • arranging practice walks with staff
  • discussions at the monthly patient practice walk
  • emails discussing benefits of physical activity 
  • posters in waiting room and in staff room

At the end of the four weeks there was an awards ceremony to announce: the best walker, the most improved and the best team award. Questionnaires were completed by participants to assess if they enjoyed the project and to assess if it increased their interaction with patients regarding physical activity.

The impact


All clinicians discussed physical activity more with their patients as a result of the study. The waiting room posters increased awareness of guidelines and opportunities.


Before the study the average number of steps a day was 5,875, this increased to an average of 9,197 a day – an increase of 56.4%. 71% of clinicians correctly identified the physical activity guidelines for adults compared to 0% before a presentation on benefits go physical activity at the awards ceremony. The practice staff set up their own walking group before work most morning. Many staff members still monitor their step count and aim for 10,000 steps a day whenever possible.


There has been increased team work across the practice as the study got all staff members interacting with each other. Although it wasn't formally assessed, many staff members commented on how much they enjoyed the increased interactions.

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