Step up to boost health

A GP who started by going out for walks with his patients is now behind a city-wide game involving 60,000 people. Peter Blackburn speaks to doctors who see physical activity as a way of tackling the negative mental health effects of lockdown

Location: UK
Published: Friday 20 August 2021
andy Douglas 2 on a run

‘Five years ago, I was still that tree-hugging doctor doing strange things.’ Reading GP William Bird is reflecting on how much has changed.

In 1996 Dr Bird became known for ‘health walks’ which initially saw him encouraging patients from his diabetic clinic to get out and about – using social motivation as the driving force and improving physical and mental health.

And just two years later Dr Bird brought ‘green gyms’ to the world – encouraging patients to get to work in the great outdoors on commons and in nature reserves. Those health walks now number 3,500 weekly and there are more than 100 green gyms across the country – but Dr Bird’s latest brainwave might well encourage many more people to get active in their local communities.

The effects of lockdown have led to a huge surge in the number of people feeling down and depressed

Dr Bird

Recently, more than 60,000 Sheffield residents have been playing a game which encourages them to spend time out of their house, getting to know their local area, engaging with other people and – crucially – becoming more active.

The game is simple: ‘Beat Boxes’ – electronic buzzers – are placed across the city and participants are given cards which beep when placed on them and make a record of the distance travelled to the box.

Dr Bird is clear the introduction of technology is part of what makes the project successful. The game gives increasing amounts of points to players and teams to reward walking or cycling to spots further from home.

active go William bird BIRD: ‘We put the Beat Boxes right in the heart of the housing estate’

‘The reason for the success is we take it to them,’ Dr Bird says.

‘We don’t even need them to go to a leisure centre or even a park to start with. We put the Beat Boxes right in the heart of the housing estate.’

He adds: ‘They don’t have to have a phone or download an app and children love the practicality of touching something and it beeping back.

'We use kids as the energy but then they get their parents, grandparents and aunts and uncles involved. We are still looking at mostly young families but over 10 per cent – and 10 per cent of 60,000 is still 6,000 – are over the age of 50. So, we do get the grandparents and the neighbours and the community groups involved as well.’

Activity on prescription

The importance of the idea – particularly in the context of a pandemic where health inequalities have widened and young and old have been left so isolated – could hardly be more clear. And, even prior to COVID-19 many areas of the country have been very much left behind when it comes to wellbeing and health.

Dr Bird says: ‘In the really deprived communities most of them don’t even go out of their estate. We had children in Eastbourne who lived half an hour from the sea who had never been to the sea and they were six years old and had lived there all their life.’

It is a project Dr Bird, and colleagues, have been working on for some time – with the initial idea coming in 2010. For a long time the majority of the work was done with schools but of late Beat the Street has become a more ambitious idea with doctors aiming to involve much wider parts of the community.

And, in Sheffield, where leading doctors are making efforts to involve physical activity in much of their work, patients are even being prescribed the game.

There are more people walking, cycling and rolling around the game area in family or friendship groups

Greg Fell

Sheffield GP Andy Douglas says: ‘My colleagues and I have been speaking to lots of patients who since the pandemic have experienced the effects of lockdown: isolation, inactivity, financial difficulties, and stress.

'These conditions have led to a huge surge in the number of people feeling down and depressed. One of the most effective ways people can improve their mental health is through becoming more physically active.

dr activity Andy Douglas DOUGLAS: Physical activity a great stress reliever (image: Ed Moss)

‘That’s where Beat the Street ticks a lot of boxes. I have heard from people playing that it has got them out of the house, finding areas near them that they had never explored before; often finding themselves chatting with new people over a Beat Box.’

And Sheffield’s director of public health, Greg Fell, adds: ‘Noticeably, there are more people walking, cycling and rolling around the game area in family or friendship groups, and it’s great to see physical activity move up the agenda in this way.’

Broadening horizons

The schemes, which have also recently run in lots of areas across the country, seem to be a success beyond just the numbers of people involved, too.

A recent location for the game, Lanarkshire in Scotland, found a 20 per cent increase in the proportion of children meeting the chief medical officer’s physical activity guideline of 30 minutes of activity a day.

An evaluation also found 7 per cent of adults reported a decrease in inactivity and 5 per cent more travelled in an active manner.

Dr Bird is hopeful those numbers can increase further, too.

He says: ‘We aren’t teaching people to do a new sport as such, we are just widening their world. When the Beat Boxes go the whole idea is the habit continues: the world is bigger, they’ve met lots of people and they’ve got their confidence.’

Given the experience and excellence of the doctors involved who would bet against the worlds of many more people being widened – and, perhaps, the health of a nation being tangibly improved. 

Read the BMA's Social Prescribing: Making it Work for GPs and patients