Access to exercise for people with long-term conditions

Healthwatch Barnet regularly receives feedback from people with long-term health conditions about the challenges they face in relation to physical activity and exercise. They wanted to find out what would help people in Barnet with long-term conditions, especially those experiencing health inequalities, to exercise more. They surveyed 113 people and carried out interviews with 12 people, most of whom were older adults, Disabled people, and individuals living with multiple long‑term conditions such as diabetes, heart disease, chronic kidney disease, and respiratory illnesses. Over half of respondents reported having little or no disposable income, highlighting the interaction between low income, poor health, and access to exercise.

The findings show that levels of physical activity varied widely. While 42% of respondents reported doing several hours of exercise each week, 26% said they did very little exercise. Walking was by far the most common form of physical activity, particularly brisk walking, although many participants found even short walks difficult due to pain, fatigue, breathlessness, or mobility issues. Some people were effectively housebound because of their health conditions.

Physical ill health was the most frequently reported barrier to exercise, affecting nearly two‑thirds of respondents. Other major barriers included cost, low motivation, lack of confidence exercising in public, time pressures from work or caring responsibilities, and difficulties accessing healthcare such as physiotherapy or surgery. Long waiting times for NHS treatment meant that some participants felt unable to safely increase their activity levels while waiting for medical interventions.

The report highlights the importance of social support and collective exercise in helping people to be active. Group activities such as walking groups, community‑based exercise classes, and peer‑led sessions were described as motivating, confidence‑building, and socially beneficial. However, many participants said they were unaware of what activities were available locally and felt that information about opportunities in Barnet was poorly promoted.

Gyms and structured exercise programmes played an important role for some residents, particularly GLL Better Gyms and the Healthwise referral scheme. However, the report found that awareness of these services was low, referrals from GP surgeries were inconsistent, and many people did not take up referrals because they could not be contacted or did not fully understand what support was available. Cost, travel distance, and uncertainty about receiving appropriate supervision were further barriers to gym use.

Parks and outdoor spaces were generally well regarded, with many residents appreciating Barnet’s green spaces. Nevertheless, accessibility issues limited use, including uneven paths, inadequate lighting, insufficient benches, and a lack of public toilets. The absence of nearby or reliable toilet facilities was a significant deterrent for people with conditions requiring frequent toilet use, such as chronic kidney disease.

Support from GP surgeries was seen as crucial but inconsistent. While participants valued routine health checks, very few reported receiving personalised advice about safe and appropriate exercise, and none recalled being signposted to local physical activity opportunities. There was widespread confusion about Long Term Conditions Locally Commissioned Service (LTC LCS) appointments, and interview data could not confirm whether exercise was being meaningfully addressed within these consultations.

The report concludes that many barriers to exercise arise from systemic and environmental factors rather than individuals’ health conditions themselves. Using the Social Model of Disability, it argues that improvements to information, coordination, accessibility, and professional support could significantly increase physical activity among people with long‑term conditions.

The report makes a series of recommendations for Barnet’s Neighbourhood Health Service, Barnet Council, GP surgeries, the NHS Integrated Care Board, and GLL Better Gyms. These include improving communication about free and low‑cost activities, expanding community‑based and peer‑led exercise opportunities, increasing physiotherapy access and awareness of self‑referral, improving park facilities and toilet access, strengthening GP signposting and advice on exercise, and simplifying information about gym discounts and referral pathways.

Overall, the report finds that with better coordination, clearer information, and more accessible and socially supportive exercise options, many people in Barnet with long‑term health conditions could be supported to be more physically active and improve their health and wellbeing.