MPs told ministers to force the NHS and the care regulator to prove they are acting on physical activity for older people. The government's own reply softens 'require' into 'consider', skips the care home question, and credits children's sports funding instead.
Estimated reading time: 7 minutes
In short. The House of Commons Health and Social Care Committee asked the government to require NHS integrated care boards to embed physical activity with "clear accountability for delivery", to have the Care Quality Commission set new national standards for physical activity in social care and inspect for them, and to fund a cross-government plan through pooled budgets with their own accountability measures [1]. The government's own written response agrees with all three asks, then answers each with something smaller: "require" becomes "should consider", the CQC half of the social care ask goes unmentioned while the new-standards half is declined outright, and the cross-government funding claimed to do "exactly" what was asked is evidenced mainly by a children's school sport programme [1]. Three documented mistakes: four stars.
A report built on a wide gap
The committee's inquiry, chaired by Layla Moran MP, concluded that physical activity "can be more effective than medication" for keeping older people well, and pressed for the system to treat it that way [3]. The government's own written response does not dispute the scale of the problem. It records that 44% of people aged 75 and over do the recommended 150 minutes of activity a week, against 64% of those aged 55 to 74; that only 10% of over-75s meet the UK Chief Medical Officers' combined aerobic-and-strength guidelines, against 43% of 16 to 24 year olds; and that Sport England values the social return on physical activity participation at £122.9 billion a year, including £15.9 billion in healthcare savings [1]. Published as Command Paper CP 1688 and presented to Parliament by the Secretary of State for Health and Social Care in October 2026, the response answers the committee's 15 recommendations one by one. None is rejected. Three of the firmest are, on inspection, hollowed out.
"Require" becomes "should consider"
Recommendation 1 of the committee's report asked for a duty, not an aspiration: "the department should require ICBs to embed physical activity as a core preventive intervention within population health strategies," with ICBs expected to "demonstrate how physical activity is being integrated into healthy ageing, long-term condition management and health inequalities frameworks, with clear accountability for delivery" [1].
The government's response opens: "The government agrees with the committee that ICBs should consider how population health measures, including physical activity, are integrated into care" [1]. "Require" has become "should consider" in the space of one sentence. What follows is a pointer to work that already existed before the committee reported: the Neighbourhood health framework, published by DHSC in March 2026, which sets general expectations for integrated care boards on population health management. Nothing in the response names a physical-activity-specific metric, target or accountability mechanism; the "clear accountability for delivery" the committee asked for is not addressed.
The CQC half of the ask goes unanswered
Recommendation 12 had two parts: new national standards, and tougher inspection. "The department should work with the CQC to set national standards for the delivery of physical activity in social care settings, with physical activity being provided in line with the CMOs' guidance," the committee wrote, adding: "We also recommend that CQC places a greater emphasis on physical activity in its assessment framework and inspections of social care provision" [1].
The response states plainly: "While, at this point, DHSC is not actively considering setting additional national standards specifically for social care settings, NICE has published quality standards [QS183] on Physical activity: encouraging activity in the community, and [QS84] on Physical activity for NHS staff, patients and carers" [1]. QS183, the standard doing the work of answering a 2026 recommendation, was published on 6 June 2019, confirmed directly on NICE's own page for the standard [2], more than six years before the committee reported. The second half of the recommendation, CQC's own assessment framework and inspections, is not mentioned anywhere in the government's reply. It is not declined; it is simply absent.
A cross-government plan answered with a children's fund
Recommendation 15 asked for machinery, not just intent: "The government should restore the health mission and develop a cross-government 10-year plan to embed prevention and reduce inequalities in healthy life expectancy that prioritises physical activity," the committee wrote, specifying that "this should include creating pooled budgets that require multi-department bids to access, supported by shared outcome and accountability measures" [1].
The response claims a direct match: "The government's 10 Year Health Plan, published in July 2025, does exactly this" [1]. The evidence offered for that claim is three bullet points: a Sir Brendan Foster-fronted movement campaign, an unbuilt UK City of Culture-style scheme for activity, and, as the headline figure, having "announced, in May 2026, more than £1 billion of investment in PE, school sport and physical activity by 2029, including £530 million to launch the new PE and School Sport Partnerships Network, which will support all children to have fun and reap the benefits of movement" [1]. None of the three is a pooled, multi-department budget with its own accountability measures, and the single largest sum attached to the claim is explicitly for children's school sport, not the older population the recommendation and the report as a whole are about.
The claims, tested
| The claim | What the text and record show | Verdict |
|---|---|---|
| "The government agrees with the committee that ICBs should consider how population health measures, including physical activity, are integrated into care" (response to recommendation 1) [1] | The committee's recommendation asked the department to "require" ICBs to act "with clear accountability for delivery". The response substitutes "should consider" and names no physical-activity-specific accountability mechanism, only a pre-existing general framework [1] | A duty downgraded to an aspiration |
| "DHSC is not actively considering setting additional national standards specifically for social care settings" (response to recommendation 12) [1] | The cited standard, NICE QS183, predates the committee's report by more than six years [2]. The recommendation's second half, on CQC's own inspection framework, is not addressed at all | New standards declined; the inspection ask is not answered |
| "The government's 10 Year Health Plan, published in July 2025, does exactly this" (response to recommendation 15, on a cross-government plan with pooled, multi-department budgets) [1] | The evidence offered is single-department programmes, led by DHSC, with no pooled budget or multi-department bid process. The largest sum cited, over £1 billion, is for children's PE and school sport, not the older population the recommendation addresses [1] | Evidence does not match the mechanism asked for |
Credit where due
None of the committee's 15 recommendations was rejected, and the response is not uniformly thin. The UK Chief Medical Officers did complete a genuine update to adults' physical activity guidance in the course of this year, which the response cites accurately. The Strategic Commissioning Development Programme for ICBs, launched on 10 June 2026, is a real and recent workstream, even where it is not specific to physical activity. And NICE's existing quality standards, old as they are relative to this report, do substantively cover physical activity in community and NHS settings; citing them is not a fabrication, only a reuse of existing work to answer a call for new work [1].
Three documented mistakes. (1) Recommendation 1 asked the department to require ICBs to embed physical activity "with clear accountability for delivery"; the government's response answers with "should consider" and names no accountability mechanism specific to physical activity, pointing only to a pre-existing general framework. (2) Recommendation 12 asked for new CQC national standards for physical activity in social care and greater emphasis in CQC's own assessment framework and inspections; the response states DHSC "is not actively considering" new standards, citing a NICE quality standard published more than six years before the committee reported, and never addresses the CQC-inspection half of the recommendation. (3) Recommendation 15 asked for a cross-government plan with pooled, multi-department budgets and shared accountability measures; the response claims the 10 Year Health Plan "does exactly this", then evidences the claim with single-department programmes, the largest a children's school sport fund with no connection to the older population the recommendation addresses. Rated four stars out of five.
Sources
- Government response to the Health and Social Care Committee's eighth report of 2024 to 2026: Healthy Ageing, physical activity in an ageing society (DHSC, Command Paper CP 1688, PDF)
- Physical activity: encouraging activity in the community, Quality standard QS183 (NICE)
- Physical activity as important as medication for keeping older people healthy and happy, MPs say (National Health Executive)