Levelling Up Health and Wellbeing

Prevention and Enablement Model

Using a whole systems approach to improve health and wellbeing

The Prevention and Enablement Model (PEM) is a test and learn initiative, which uses physical activity to help improve the lives of people living with disabilities and/or long-term health conditions.

As part of the work in whole system change, the Active Essex Local Delivery Pilot (LDP) developed a strategic partnership with Essex County Council’s Adult Social Care Team and community organisation Sport for Confidence CIC, who support people with barriers to being physically active. By working across systems, the aim of PEM was to create further opportunities for disabled people and those living with a long-term health condition, to be active, independent and engage in physical activity within their community. The LDP has remained a constant support throughout the evolution of PEM.


LDP Whos it for
Who's it for?
Adults living with a disability or long-term health condition
LDP Prime
Prime Objective:
to ensure residents can be active, be happy and live independently
LDP Second
Second Objective:
to reconnect residents to their local area

Adult Social Care needs to transform to be sustainable; empowering people to live healthier lives for longer is key in enabling this transformation. Prevention and Carers were identified as a key strategic change priority for Adult Social Care, aligning to the strategic direction of health reflected in the NHS Long Term plan; collectively striving to create a sustainable model of health and social care fit for the 21st century.

Prevention and Enablement is about supporting adults facing barriers to being physically active. The model involved developing practice-based learning opportunities to embed physical activity as part of a prevention and enablement approach within Social Care, changing the working culture. This included:

  • A re-design of the strength and balance model as part of the wider falls prevention pathway and embed digital solutions as a tool in delivering care and support.
  • Having community-based therapeutic support in local leisure centres using physical activity and sport and supported by an Occupational Therapist.
  • Work within care homes in Colchester, Tendring and Basildon localities to build the capacity of care workers to support incorporation of physical activity as part of residents daily routine and, to appoint physical activity ambassadors within care homes who promote and champion exercise and safe movement for residents.

The University of Essex completed an evaluation of PEM in February 2023, which highlighted significant results among individuals who were attending PEM interventions. Read the report here.

unique user attended the integrated falls prevention programme
return on social value for every £1 invested
estimated cost saving in self-reported service use per PEM participant

PEM was complex project, with multiple layers including system working, workforce, providers, and participants. Evaluating PEM was a large undertaking, and the University of Essex managed to capture nuances of how this whole system approach was able to support individuals in their lives through physical activity. This has shown us the importance of continuing to work in this way alongside health and social care to look at preventative health interventions. Additionally, it was found that much of the ways of working/workforce support from PEM has continued such as the upskilling of existing staff in Care Homes and OTs.


Key Learnings


Increased Physical Activity Levels

Similar levels to Active Lives data for those living without a health condition/disability

Healthcare R Elationships

Improved Wellbeing

Increased levels of happiness, self-efficiency and life satisfaction measured using the WELLBY


Improved Skills

Self reported increase in confidence, social connections, skills and being more independent


Impact on Services

Slight decrease in self-reported service user access to social care and health services

Through the work Sport for Confidence has delivered over the last 7 years, we already know and witness every day, the far-reaching impact physical activity has on the lives of individuals. What the PEM initiative has now evidenced is the true extent of the potential, not just for individuals but for the whole of society. An active, engaged, population is a healthier, happier population which results in a population that is less reliant on or likely to call upon health care interventions.
Lyndsey Barrett, Founder of Sport for Confidence and lead Occupational Therapist

PEM has now evolved into a service called Reconnect, where Public Health and Adult Social Care are continuing to work together to invest £1.35 million into scaling and replicating the previous PEM model across community venues/leisure centres within Essex. This will continue to enable Individuals living with a disability, learning disability and/or long-term health condition to access Early Help and Preventative support in the form of therapeutic interventions using physical activity.