More on Active People: Promoting Healthy Life Expectancy (APPHLE)


The Active People: Promoting Healthy Life Expectancy (APPHLE) Health Integration Team (HIT) is a team of academics, clinicians, commissioners and older people, working together to improve activity and health in later life.

Less than a third of 65-74 year olds and less than 1 in 8 adults aged 75 years and over have done physical activity lasting at least 10 minutes in the previous four weeks

Physical activity has the potential to improve health and wellbeing throughout an individual's life. In middle-aged and older people, physical activity helps individuals maintain their physical and mental function and reduces their risk of physical and mental diseases. Sedentary behaviour dramatically increases health risk in older people and disproportionately affects people with low socio-economic status, leading to health inequalities. The number of steps per day in those with cardio-vascular diseases is associated with a reduced risk of cardiovascular events and diabetes in adults. This HIT will focus on adults aged 55 years and over, with particular emphasis on older age groups.

Exercise continues to have benefits at older ages, and the Chief Medical Officer has produced evidence-based guidelines for physical activity specifically for adults aged 65 and over. These recommend at least 150 minutes per week of moderate physical activity, muscle strengthening and balance exercises.

However, there is evidence that middle aged and older adults are exercising less than is desirable in terms of maintaining health. For example, less than 30 per cent of 65-74 year olds and 15 per cent of adults aged 75 years and over report any physical activity lasting at least 10 minutes in the previous four weeks. This is despite the emerging body of evidence that physical activity in older people can have a major impact on an individual's capacity to remain independent, and to maintain mental, social and physical health in older age.

Current levels of physical activity in adults and older people are not conducive to maximising health or to preventing ill-health and disability in the future. Indeed, the level of physical activity in older people is likely to adversely impact on function and lead to an increase in future demand for health and social care.

Aims and objectives

The overall aim of the APPHLE HIT is to encourage the adoption of physical activity and other health behaviours amongst older age groups in order to improve their overall health during their later years.

Through reviewing current provision, data analysis and collaborative studies, the HIT aims to:

  • Increase the percentage of people aged 65 and over meeting the Chief Medical Officer's physical activity recommendations from 32 per cent (Bristol City Council Quality of Life Survey) to 35 per cent by 2017
  • Increase the number of older people taking any exercise lasting at least 10 minutes during the past four weeks from the current 30 per cent to 33 per cent of 65-74 year-olds, and from the current 15 per cent to 20 per cent of adults aged 75 and over by 2017
  • Ensure key public health outcomes indicators in Bristol and Bath and North East Somerset, such as hip fractures in older people, risk of type 2 diabetes, social isolation, percentage of active and inactive adults and injuries due to falls, will be statistically lower than the national average and will be decreasing

Who's involved

Some of the leading experts in health in later life in Bristol and Bath are involved in the team. The HIT Directors are Professor Selena Gray, Professor of Public Health, UWE Bristol, and Karen Lloyd-Pyrke Manager of Active Ageing Bristol. The HIT's leadership team includes Sue Milner, interim Director of Public Health and Claire Lowman, Active Bristol Lead, both from Bristol City Council, Professor Yoav Ben Shlomo, University of Bristol. The team has a lay member to represent a service user's perspective.

Find out more about who's involved.

How patients and the public are involved

The leadership team includes a lay representative, who brings the perspective of service users both during meetings and across projects.

APPHLE HIT is exploring the potential to work with the existing Community Advisory Panel established by the SHINE HIT. The team has good links with a number of voluntary third sector and community organisations in the area, developed from the former Avon Network (AVONet) for the Promotion of Active Ageing in the Community, including Link Age, Life Cycle, University of the Third Age, Retired and Senior Volunteer Programme (RSVP), Sirona and Golden Oldies. APPHLE will offer an open invitation to a wider group of stakeholders from relevant third sector and community groups at its six-monthly collaborators meetings.

Projects and activities

APPHLE HIT's research includes looking at current interventions to encourage older people to exercise, what data is currently available and which interventions work both locally and elsewhere.

Key outputs for the team include:

  • South Gloucestershire Diabetes Prevention Pilot Project, led by SGlos Public Health, in collaboration with SGlos CCG, Sirona Health, and Leap Valley Surgery. The pilot was delivered between January and November 2016 through Leap Valley Surgery, offered to patients aged 35-75 years-old and at risk of type 2 diabetes. Evaluation examined the impact, implementation, and costs of delivery. Following the pilot, South Glos and Bristol successfully bid to be part of NHS England Diabetes Prevention Project Wave 2.
  • Two analyses of the Bristol City Council Quality of Life (QoL) surveys (2011-2013) have been carried out on behalf of APPHLE HIT. The first of these sought to examine: levels of physical activity, potential enablers and barriers to older people being active and important health outcomes that are associated with physical activity. The second report, published June 2016, explores the use of the QoL surveys to measure levels of life satisfaction in Bristol’s population aged 55 and over, and looks at the association between life satisfaction and physical activity.
  • Development of a guide for local decision makers on promoting physical activity in older adults
  • Submission of collaborative research proposals to the National Institute of Health Research
  • Development of implementation and monitoring plan for key interventions
  • Identification of key interventions with commissioners and partner organisations
  • Partnerships with third sector and commercial organisations to address emerging issues and uncertainties in the field
  • A review of existing local data sources, for example local government quality of life surveys
  • A critical review of the evidence base for the existing provision
  • A comprehensive review of the existing provision of educational programmes targeting public and community groups
  • A comprehensive review of the existing provision for promoting physical activity in older people


To find out more, please contact:

APPHLE at the HIT conference

APPHLE presented this poster (PDF) at the 2018 Bristol Health Partners Health Integration Team conference.

View the 2015 video here

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