Exeter Collaboration for Academic Primary Care (APEx) Blog
Exeter Collaboration for Academic Primary Care (APEx) Blog
Posted by ma403
16 June 2026How ‘active’ GP surgeries might support better everyday health and care
GP surgeries serves as the “front door” of the healthcare system. It is where many health concerns are first discussed, and where conversations about prevention and everyday lifestyle habits can be developed. Our work suggests that when GP surgeries engage with initiatives that promote physical activity, they may also be associated with better quality outcomes for patients.
Our two recently published papers look at related but distinct approaches to promoting physical activity. One focuses on the parkrun practice initiative, which encourages GP surgeries to link with local parkrun events and to promote regular, free, community-based physical activity as part of routine care. The second examines the Active Practice Charter, which supports GP surgeries to become more active environments for staff and patients.
Together, they raise an important question: what happens when GP surgeries are more proactive in how they support physical activity and wellbeing?
Two related approaches to physical activity promotion in primary care
The parkrun practice initiative is a partnership between the Royal College of General Practitioners and parkrun, with a clear focus on community connection. GP surgeries sign up as parkrun practices and are encouraged to promote their local parkrun event to patients and staff. parkrun offers free, weekly, timed 5 km walks and runs that are open to all abilities, with the aim of using an existing community asset to make it easier for people to try regular, social physical activity in a local and supportive setting.
The Active Practice Charter is a collaboration between the Royal College of General Practitioners and Sport England developed to help GP surgeries create more movement‑friendly environments. This might include encouraging active travel, reducing sitting time at work, promoting local opportunities to be active, and making a visible commitment to being an active practice. It is deliberately practical and flexible, so that changes can be adapted to the local context rather than imposed from one GP surgery to another.
Both initiatives share the view that physical activity is part of good preventive healthcare. They also both rely on motivated GP surgery teams, with some degree of GP surgery‑level culture change and explicit buy‑in from the wider team.
What our studies found
In the parkrun practice project (published in BMC public health), we analysed 6,185 GP surgeries in England, of which 1,665 were registered as parkrun practices. We used routinely collected data to compare GP surgery characteristics and three markers of GP surgery quality:
After adjusting for socioeconomic deprivation, list size, age profile, sex, ethnicity and rural or urban location, parkrun practices were associated with:
These are modest differences. Our cross-sectional design means we cannot show that becoming a parkrun practice causes better outcomes. It is possible that GP surgeries who choose to affiliate with parkrun already have characteristics that support quality, such as stronger teams or an existing interest in prevention. Even so, the pattern is consistent. GP surgeries that engage with this physical activity initiative also tend to have better-established quality indicators.
Our analysis of the Active Practice Charter initiative presents similar findings
The Active Practice Charter paper points in a similar direction. GP surgeries accredited under the charter were also associated with better quality outcomes compared with non-accredited GP surgeries. Again, the design is observational and cannot prove causation, but it suggests that GP surgeries that commit to becoming more active may also be performing better on wider metrics of quality.
Why these findings are important
What is important is not just the size of the effects, which are small to moderate, but the direction. Across two different datasets, focusing on two different initiatives, there is a consistent signal that movement-oriented and prevention-focused work can sit alongside better quality care, rather than competing with it.
For patients, the idea of an active practice is not only about getting advice to exercise more. It is also about what the surgery pays attention to, what is seen as part of its role in healthcare, and how it connects with the community around it.
If a practice is affiliated as a parkrun practice or accredited as an Active Practice, it may indicate that the team is thinking more broadly about health. This might include:
The equity issue
Our parkrun practice study also highlights important equity concerns. parkrun practices were more commonly located in more affluent areas and tended to serve populations with a higher proportion of older and White patients. This suggests that the GP surgeries signing up to the initiative may be those with comparatively more resources or capacity, and not necessarily those serving communities with the greatest health need.
This is a familiar pattern from other public health programmes. Voluntary initiatives often reach more advantaged populations first. Without deliberate efforts to support uptake by GP surgeries in more deprived areas, there is a risk that these initiatives contribute to widening rather than narrowing existing health gaps.
The Active Practice Charter study can be interpreted in a similar way in terms of equity and capacity. GP surgeries that are able to pursue accreditation are likely to have at least some spare capacity and headspace to do so. The challenge is not only to demonstrate benefits, but also to ensure that those benefits are distributed fairly.
The broader picture for primary care
Taken together, our studies suggest that:
For the wider system, this raises some practical questions. If initiatives like parkrun practice and the Active Practice Charter are considered useful, what support is needed to help GP surgeries in more deprived areas to adopt and sustain them? How can these schemes be adapted so that they are realistic in high-pressure settings? And how can future work move beyond GP surgery-level associations to understand effects on patient-level outcomes and experiences?
Where next?
The findings from these studies are encouraging, but they also need to be interpreted with caution. They suggest that physical activity promotion in GP surgeries can sit alongside better quality care, and may be one part of what good GP surgeries looks like. They also remind us that voluntary, unfunded programmes will tend to follow existing patterns of capacity and resource.
Future work needs to explore:
In this context, more “active” GP surgeries are not a different type of practice, but teams that have found practical ways to weave movement and prevention into already stretched everyday care. Our job as researchers is to help make these approaches feasible and accessible for all surgeries, so that small, realistic steps towards being more active can create extra opportunities to support everyday health and wellbeing.
The papers are:
Mayaud, J., Leese, C., Cross, R., Mann, R., & Cockcroft, E. (2026). Active practice charter accreditation is associated with higher quality outcomes in English general practice: a cross-sectional observational study. BMC Primary Care. https://doi.org/10.1186/s12875-026-03272-y
Leese, C., Cross, R., Mann, R, Cockcroft, E. & Mayaud, J. (2026). Comparing practice characteristics and quality outcomes between parkrun and non-parkrun GP practices in England, with a focus on socioeconomic equity: a cross-sectional study. BMC Public Health https://doi.org/10.1186/s12889-026-27560-5