Shared learning database

Natural England
Published date:
September 2008

Development of a unique, robust, longtitudinal evaluation instrument to demonstrate that Health Walks and broader green exercise are an effective intervention for health professionals to recommend to inactive patients. This is a 'world first'- between 1 - 5 million data entries per year are expected at current levels.

Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?


Aims and objectives

We understand that commissioning within the health sector and allocation of resources for any physical activity intervention depends largely on the evidence to support whether or not it is effective and represents value for money. Demonstrating that Health Walks and broader green exercise are an effective intervention for health professionals to recommend to inactive patients. 1) Meeting NICE Guidance to provide a robust evidence base 2) Providing a cost effective off the shelf database for health walk schemes to monitor walkers and their activity levels. Activity levels will be monitored using a unique, single physical activity question validated by BHFNC, Loughborough University. 3) Giving health professionals and partners access to a national network of proven health walk schemes

Reasons for implementing your project

Launched in 2000, WHI supports more than 500 health walking schemes across the country. Core services include insurance, training for walk leaders, a scheme accreditation system and support through networks and regional Natural England staff. Despite a mounting body of qualitative evidence on the benefits of Health Walks, few studies and evaluations of local schemes had yielded significant positive results. This was because of the limitations of sample sizes and lack of resources for in-depth research. WHI had no mechanism for estimating the number of people who benefited from the services it provided. Coupled with this, NICE Guidance March 2006, made it imperative that we developed a system that could capture who we were reaching and the impact of outdoor physical activity. As the need for such physical activity becomes increasingly evident, WHI was aware that: the burden on the NHS of physical inactivity continues to grow; health inequalities continue to be a serious issue; health walks can help to address these problems and save the NHS money. However, to prove this, WHI needed to upgrade its data so that policy makers, funders, health professionals and public alike knew exactly what health walks offered and what they were achieving. We decided to do this via an Outdoor Health Questionnaire (OHQ). This is a simple 2-sided form which includes a 'single item physical activity metric' It combines a health walk screening questionnaire and participant contact details form with a few data collection questions. Each walker simply has to fill in this one, straightforward form at the start of their first walk. Phase 2 of this development was an online database allowing us to capture and interrogate this information. The single item physical activity metric enables us to collect population scale data of walkers' levels of physical activity and learn about changes to these levels of activity after joining a healthy walking scheme.

How did you implement the project

1)The single-item physical activity question is currently being validated by Loughborough University and the academic analysis will be completed in October 2008. 2)An online database launched in July 2008. This allows health walk schemes to input data directly following training provided by Natural England staff. This database was created originally by British Trust for Conservation Volunteers (BTCV) and has been adapted to our needs keeping costs low. This will provide statistical reports for participants by gender, age, ethnicity, disability, health condition and post code. Additionally the database will enable reporting on baseline activity levels and monitor changes over time linked to frequency of participation. By only holding data from the OHQs the database will regularly update and collate information thereby tracking and correlating participation against health outcomes. Uptake to date has been very positive with currently 2700 walkers registered, across 100 schemes with potentially tens of thousands of walkers on the system in the near future. Between 1 - 5 million data entries per year are expected at current levels. 3)It will be used in Scotland and Wales as well as England. The BIG Lottery, Sustrans, BTCV and many other groups/organisations have expressed interested in using it - e.g. universities and Primary Care Trusts, for their research and exercise referral schemes respectively.

Key findings

Progress monitored by Science and Evidence Team within Natural England liaising with other stakeholders including NICE.

Key learning points

Establishing clear objectives from outset Close partnership working (Developed with NICE and the BHF and now used by WHI, Sustrans, BIG Lottery Scotland and Wales.) Involving stakeholders in product development through focus groups Make the system 'scalable' and flexible to accommodate future development and expansion e.g. monitoring other green exercise activities. Adapting an existing (BTCV's)database - it was already successfully 'up and running', secure and robust. Taking this approach has cost a fraction of the time and funding required if it had been developed from 'scratch'. Offer guidance ref;|0|3CB9715613341|p|971|0&parentkey=2537|0|3CB9715613341|p|971|0

Contact details

Stella Goddard
Healthy Walking Project Manager
Natural England

Is the example industry-sponsored in any way?