3. Heart disease
Colon Cancer
Stroke
Bone fractures
High blood pressure
Dementia
Depression
Diabetes
Anxiety
Breast cancer
Childhood development
Social isolation
Bereavement
4. What should we do?
Step 1 = Find out what is effective
Step 2 = Find out what is good value for money
Step 3 = Do it
17. Which actions should we
prioritise?
•
•
•
•
•
•
Easy
Cheap
We were going to do it anyway
We wouldn’t have done it otherwise
The people who cycle already want it
The people who don’t want to cycle might try it
18. Indicators of a healthy
street environment
Pedestrians
from all walks
of life
Easy to
cross
Clean Air
Shade &
Shelter
People feel
relaxed
Places to stop
Things to see
and do
People feel
safe
Not too noisy
People
choose to
walk and
cycle
19. Post traumatic stress disorder
Heart disease
Bone fractures
Stroke
Diabetes
Colon Cancer
Asthma
High blood pressure
Depression
Anxiety
Dementia
Traumatic injuries
Chronic Obstructive Pulmonary Disease
Breast cancer
Childhood development
Social isolation
Bereavement
Who I am NICE have produced new guidance on how to promote walking and cycling locally.I will go through what this covers briefly, and if you would like to learn about it in more detail then you can read it in full on line.Firstly I will give you a bit of background on NICE and I will try to point you towards useful resources as we go along.
However a bigger problem is all these conditions which could be reduced if more people walked and cycled.Lots of people focus on obesity but really that is just an indicator that we aren’t looking after ourselves, there are a much broader range of conditions which relate to people not being physically active enough. So the benefits of walking and cycling far outweigh the risks.
So we know that we want more people cycling, how do we go about making it happen?
So we have big public health reasons to want more people to cycle and our first step in doing that is finding out what is effective and good value for money in getting more people to cycle.NICE guidance is to make sure that the services provided are of the best possible quality and offers the best value for money. NICE provide independent, authoritative and evidence-based guidance on the most effective ways to prevent, diagnose and treat disease and ill health, reducing inequalities and variations across the country.The guidance is not just for the NHS but also local authorities, charities, and anyone with a responsibility for commissioning or providing healthcare, public health or social care services. The guidance is developed by working with experts from the NHS, local authorities, and others in the public, private and voluntary sectors - including patients and the public. The guidance is produced openly and transparently, and they make sure that those that use our guidance, as well as those it affects, are involved every step of the way. The recommendations are based on the best available evidence of the most effective care.
So what do they recommend?There are 10 recommendations which I will take you through very briefly.
Ensure that senior member of the PH team is responsible for promoting walking and cycling – coordinating cross-sector working and resourcesJSNA & H&WBS address impediments to walking and cycling and maximise opportunities to increase it.Consider walking and cycling alongside other interventions when tackling local health issues such as CVD, obesity, diabetesInclude walking & cycling in chronic disease pathways
Huge range of stakeholder show should take action incl many parts of local authority, transport authorities, police.Huge range of policies and plans incl housing, disability, education, regen, land use, community safety.Work with the voluntary and community orgsInclude the built environment recommendations – PH8Evaluate the policies that are implemented
For local authorities and policeDevelop cross sector programmes based on long term visionShift away from individual risk factors and small-scale interventions, instead have an integrated package of measuresEnsure walking and cycling programmes form a core part of local transport investment planning on a continuing basis.Peds and cyclists should be considered before other user groups in the design process. So they aren’t treated as an afterthought.
For transport planners and DsPHHelp those interested in changing their travel behaviour to make small, daily changes by commissioning personalised travel planning programmes.Implement NICE PH 8 to provide a supportive environment.
CCGs, Local authorities, orgs with an interest in walking and cycling.Address infrastructure and planning issues that may discourage people from walking and cycling including PH8 guidance e.g. reducing traffic speeds.Implement town-wide programmes both transport and recreation walking and cycling to promote it.Fun rides, led-walks, car-free days, information and maps and signage, cycle storage, training, bike checks and maintenance training, use mediaMust base programmes on behaviour change theory and linked to local and national initiativesIntegrate walking and cycling into public transport to support longer journeys.
For CCGs, Local authorities, orgs with an interest in walking.Replaces previous guidance on pedometers – only use pedometers asd part of a package which includes support to set realistic goals, monitoring and feedback.Don’t set a target to aim for, assess level of current activity and gradually increase walking.Provide one-to-one supportProvide general information
Road safety officers, police traffic officers, schools and local authority transport planners.Safe routes, support travel to school and activity in school, school travel plans, cycle training, develop parental awareness of the wider benefits of travelling actively, active travel champion in senior staff.
Local authorities and NHS as employers.*Use NICE Guidance on promoting walking and cycling in the workplace*Use behaviour change theory.Consult staff and other stakeholders e.g. patientsLink actions to local and national strategiesLiaise with local authority to improve the environment for walking and cycling to access the workplaceTailor info to the specific workplace and local routes.Have a senior level active travel champion to coordinate promotion, BUG, bike discounts, pool bikes
CCGs, National Commissioning Board, primary and secondary healthcare professionalsIncorporate info on walking and cycling into clinical advice to patientsInclude walking and cycling in the *Let’s get moving* physical activity care pathwaySupport individual patients who show an interest in walking or cycling more.
So we have a long list of things that we can do to promote walking and cycling, now we have to decide which ones we should prioritise. All of these could be the right answer or the wrong answer depending on what they are. It can be a tricky discussion but what I would say is that it does require multiple methods and it is much more likely to be effective if you think about the value that street environment are giving you and how these can be enhanced.
Earlier I showed you the benefits of being more physically active but actually creating an environment that entices people to cycle would have even more health benefits as there are other harms of creating streets which can be reduced by making streets good for cycling.