c CLOA Annual General Meeting. Riding the Wave, Bisham Abbey, Friday 15 th June Professor Mike Kelly PhD FFPH Hon FRCP Director of the Centre for Public Health Excellence, NICE and Institute of Public Health University of Cambridge Local Government and Getting Active

NICE The National Institute for Health and Clinical Excellence (NICE) is the independent organisation in the UK responsible for providing national guidance to the NHS and the wider public health community on the promotion of good health and the prevention and treatment of ill health. Has had a public health role since 2005 and a role in social care from 2012

Audiences for public health guidance The NHS Local government The workplace Education The utilities Industry Retailers DH and other government departments The public National policy makers

The pillars of our work Comprehensive evidence base Expert input Patient and carer involvement Independent advisory committees Genuine consultation Regular review Open and transparent process.

Methodological principles governing all NICE’s work Base recommendations on the best available evidence. To determine cost effectiveness To be seen to be and to be independent of government, the pharmaceutical industry and other vested interests.

NICE Local Government Public Health Briefings to raise awareness among elected members and officers of public health evidence; to demonstrate the potential role of NICE evidence and guidance as the basis for solutions to public health issues and problems at local level; to provide summaries of NICE evidence based recommendations in forms of direct use and relevance to local government. to meet the needs of local government as they prepare for the transition to assume public health responsibilities after April 1st will be derived from the existing Guidance.

Local Government Public Health Briefings Primary studies. Systematic Reviews of multiple studies. Appraisal of the evidence Evidence statements. Recommendations in the Guidance Briefings for Local Government

Style Short Accessible A menu, not a list of “must dos” Relate to the outcomes framework Value for money and return on investment

Local Government Reference Group Elected members Officers Directors of Public Health Chaired by a former LA Chief Executive

Physical activity and links to local authority priorities. –local economic wellbeing –helping children improve their academic performance and develop into healthy adults –increasing leisure and sports participation –improving local transport and traffic flow –improving health and mental well being –improving the accessibility of local services and facilities –reducing social and health inequalities and improving social cohesion –reducing carbon emissions and generally improving the environment.

New responsibilities –use of green space for exercise/health reasons –child development –excess weight in children and adults –proportion of physically active and inactive adults –self-reported wellbeing and health-related quality of life –falls and injuries in the over-65s –air pollution

What local authorities can do directly. Increase leisure and sports participation. Improve traffic flow and air quality by encouraging more physically active travel (by cycling or walking.) Improve accessibility of local services and facilities. Reduce demand on health and social care services. Reduce social and health inequalities and improve social cohesion.

Transport –Incorporate walking, cycling and other modes of active travel when developing or maintaining roads. –Introduce traffic-calming schemes. –Create cycle paths particularly in urban areas. –Promote active travel to schools, colleges and other workplaces.

Leisure and sport –Ensure facilities are easy to reach and use, and are safe. –Ensure facilities suit a range of ages, abilities and cultural norms.

Environment –Provide green spaces and play areas that stimulate children and safely challenge them. –Design new developments to encourage physical activity. –Make local facilities and services easily accessible by foot or bike. –Encourage stair use by providing clear signage and stairwells that are well lit and decorated.

Workplace Workplace policies that support physical activity such as: –flexible working, –offering cycle purchase loan schemes, –promoting active travel, –promoting stair use by clear signage, and –provision of work based physical activity programmes.

Prompts What are your local levels of physical activity? How many local policies, strategies or commissioning support physical activity? What training is available for those involved? How do local workplaces support physical activity? How do local services support and encourage people to be physically active? Are you meeting the needs of all groups locally? Is there a local champion?

The guidance from NICE on physical activity Four commonly used methods to increase physical activity. NICE public health guidance 2 (2006) Physical activity and the environment. NICE public health guidance 8 (2008) Maternal and child nutrition. NICE public health guidance 11 (2008) Promoting physical activity in the workplace. NICE public health guidance 13 (2008)

Mental wellbeing and older people. NICE public health guidance 16 (2008) Promoting physical activity for children and young people. NICE public health guidance 17 (2009) Prevention of cardiovascular disease. NICE public health guidance 25 (2010) Weight management before, during and after pregnancy. NICE public health guidance 27 (2010)

Preventing type 2 diabetes: population and community- level interventions in high-risk groups and the general population. NICE public health guidance 35 (2011) Walking and cycling: local measures to promote walking and cycling as forms of travel or recreation. Currently in development due for publication October