1. Promoting physical activity for children and young people
Local authorities and local strategic partnerships
Implementing NICE guidance
ABOUT THIS PRESENTATION:
This presentation has been written to help you raise awareness of the NICE public health guidance on promoting physical activity for children and young people. The guidance is for all those who have a direct or indirect role in – and responsibility for – promoting physical activity for children and young people. This includes those working in the NHS, education, local authorities and the wider public, private, voluntary and community sectors. It will also be of interest to parents, grandparents and other carers (including professional carers), children and young people and other members of the public. It includes recommendations for schools, but does not make recommendations for the national curriculum.
The guidance and a quick reference guide are available from NICE. You may want to hand out copies of the quick reference guide at your presentation so that your audience can refer to it. See the end of the presentation for ordering details.
You can add your own organisation’s logo alongside the NICE logo.
We have included notes for presenters, broken down into ‘key points to raise’, which you can highlight in your presentation, and ‘additional information’ that you may want to draw on, such as a rationale or an explanation of the evidence for a recommendation.
DISCLAIMER
This slide set is an implementation tool and should be used alongside the published guidance. This information does not supersede or replace the guidance itself.
PROMOTING EQUALITY
Implementation of this guidance is the responsibility of local commissioners and/or providers. Commissioners and providers are reminded that it is their responsibility to implement the guidance, in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this guidance should be interpreted in a way which would be inconsistent with compliance with those duties.
2009
NICE public health guidance 17

2. What this presentation covers
Background
Scope
Recommendations
Costs and savings
Discussion
Find out more
NOTES FOR PRESENTERS:
In this presentation we will start by providing some background to the guidance and why it is important.
We will then present the recommendations aimed at local strategic partnerships (LSPs) and local authorities (LAs).
Next, we will summarise the costs and savings that are likely to be incurred in implementing the guidance. Then we will open up the meeting with a list of questions to help prompt discussion on local issues for incorporating the guidance into practice.
Finally, we will end the presentation with further information about the support provided by NICE.
Additional information
For further information on LSPs and LAs role in them please refer to: or

3. How NICE can help you
NICE is an independent organisation responsible for producing standards for healthcare and for improving people’s general health and wellbeing
NICE applies the same rigorous processes to producing guidance for local authorities and others
We give advice on effective services that offer the best value for money (and sometimes savings)
NOTES FOR PRESENTERS:
Key points to raise:
Local authorities have a critical role to play in tackling health inequalities and promoting everyone’s health and wellbeing. NICE can help you achieve this. Our growing portfolio of guidance covers important issues for everyone involved in social care, education, environmental health, health and safety, trading standards, transport and planning.
Over 40 of the 198 indicators in the national indicator set focus on tackling health inequalities or improving people’s health. NICE’s public health guidance could help you achieve the relevant local area agreement targets.
Our guidance can also help you and your partners take forward the priorities identified in your joint strategic needs assessment.
For further information on how to implement NICE guidance please refer to:
‘How to put NICE guidance into practice and improve the health and wellbeing of communities: practical steps for local authorities’, available from

4. The issues
Physical inactivity in England is estimated to cost £8.2 billion a year and is predicted to rise
Physical activity is important for children’s growth and development
Physical activity contributes to general health and wellbeing and can reduce the risk of a range of chronic conditions
NOTES FOR PRESENTERS:
Key points to raise:
The estimated costs include both the direct costs of treating major, lifestyle-related diseases and the indirect costs of sickness absence.
Definitions of physical activity
Physical activity is any force exerted by skeletal muscle that results in energy expenditure above resting level: - moderate-intensity activity increases breathing and heart rates to a level where the pulse can be felt and the person feels warmer. It might make someone sweat on a hot or humid day (or when indoors) - vigorous-intensity activity results in being out of breath or sweating.
Recommended levels of physical activity
The Chief Medical Officer recommends that children and young people should do a minimum of 60 minutes moderate to vigorous physical activity daily.
At least twice a week, this should include weight-bearing activities to improve bone health, muscle strength and flexibility. This can be achieved in a number of short, 10-minute (minimum) bouts.
There is likely to be a link between the amount and intensity of physical activity and its effect on health. Recent evidence suggests that children aged 9 may need 120 minutes per day and young people aged 15 may need 90 minutes per day, to reduce their risk of cardiovascular disease. (Please see the guidance for more information.)
Additional information:
Opportunities for moderate to vigorous physical activity include everything from competitive sport and formal exercise to active play and other physically demanding activities (such as dancing, swimming or skateboarding). They also include some of the actions involved in daily life (such as walking, cycling or using other modes of travel involving physical activity). 4

5. Scope The recommendations are for:
all children and young people up to age 18
specifically: - children aged 11 and under - girls aged 11 to 18
NOTES FOR PRESENTERS:
Key points to raise:
The recommendations cover all children and young people up to 18, including those with a medical condition or disability.
They do not apply to children and young people who require clinical assessment or monitoring prior to and/or during physical activity.
They do not cover specialised services for children and young people with a disability.
Rationale for the target age groups:
Girls aged 11 to 18
There is evidence of a reduction in children’s physical activity after the age of 11. This is more marked in girls than boys, which may result in health inequalities.
Children aged 11 and under
There is evidence that early development of core physical skills would lead to greater enjoyment of physical activities. In addition, being physically active from an early age would become an ingrained habit. 5

6. Recommendations Key priorities:
Involving children and young people (3, 6, 11, 14)
Working with families (12, 15)
Developing a skilled workforce (7, 8)
Coordinating a local strategy (2)
Providing space, facilities and equipment (2, 4, 9, 10, 13)
Promoting physically active travel (5, 12)
NOTES FOR PRESENTERS:
The NICE guidance contains a number of recommendations. For this presentation we have identified six key areas (we have included the number of the relevant recommendations in brackets). All six apply to LAs. LSPs need to take action on two of them, specifically:
- involve children and young people in coming up with ideas for and planning the type of physical activities that are provided
- coordinate a local strategy.
We shall consider each in turn. 6

7. Involving children and young people
Children and young people should be:
consulted on a regular basis to find out what helps or prevents them from being physically active and what type of activities they enjoy
involved in the design, planning and delivery of activities
NOTES FOR PRESENTERS:
This advice is aimed at both LAs and LSPs.
Key points to raise (drawn from the recommendations):
Bullet 1
Pay particular attention to those who are likely to be less physically active (recommendation 3).
Bullet 2
Ensure children and young people from different socioeconomic and minority ethnic groups and those with a disability (or who are living with a family member who has a disability) are actively involved in the provision of activities (recommendation 3).
Use the information gathered to increase opportunities for physical activity and to plan dedicated programmes that tackle any inequalities in provision (recommendation 3).
Remove locally identified barriers to participation (recommendation 6). 7

8. Working with families
Encourage parents and carers to get involved in physical activities. Make them aware of:
government advice on physical activity
the wider benefits
NOTES FOR PRESENTERS:
The government advises that children and young people should undertake a minimum of 60 minutes moderate to vigorous physical activity a day. At least twice a week, this should include activities to improve bone health, muscle strength and flexibility.
Key points to raise (drawn from the recommendations):
Promote physically active travel such as walking and cycling as a lifelong habit and option for all the family (recommendation 15).
Involve families in implementing the school travel plan (recommendation 12).
Emphasise how enjoyable physical activity is when providing information and advice on its benefits. Provide examples of local opportunities (recommendation 15). 8

9. Developing a skilled workforce
Physical activity sessions should be led by people meeting sector standards
Staff and volunteers should have the skills to design, plan and deliver these sessions
Staff and volunteers should be given regular and relevant training and development opportunities
NOTES FOR PRESENTERS:
Key points to raise (drawn from the recommendations):
Bullet 1
Relevant sector standards and qualifications for working with children include the requirements for child protection, health and safety, equality and diversity (recommendation 7).
Physical activity sessions should include active play (recommendation 7).
Bullet 2
Staff and volunteers need the ability to inspire and raise children and young people’s aspirations. They also need general interpersonal skills and the ability to make physical activities enjoyable (recommendation 7).
Bullet 3
Use community networks and partnerships to encourage, develop and support local communities and volunteers involved in providing physical activities for children and young people (recommendation 7).
Establish continuing professional development (CPD) programmes for all those involved in organising and running formal and informal physical activities (recommendation 8).
Train people to deliver CPD programmes (recommendation 8).

10. Coordinate a local strategy
Ensure a coordinated local strategy is in place to:
increase physical activity among children, young people, their families and carers
help achieve local area agreement targets
NOTES FOR PRESENTERS:
This advice is aimed at LSPs as well as LAs.
Key points to raise (drawn from the recommendations):
Bullet 1
Ensure local transport and school travel plans are coordinated so that all local journeys can be carried out using a physically active mode of travel (recommendation 2).
Ensure partnership working is developed and supported within local physical activity networks (recommendation 2).
Ensure physical activity partnerships establish and deliver multi-component interventions involving schools, families and communities. Partners may include: schools, colleges, out-of-school services, children’s centres and play services, youth services, further education institutions, community clubs and groups and private sector providers (recommendation 2).
Ensure individuals responsible for increasing the amount of physical activity undertaken are aware of national and local government strategies as well as local plans in this area (recommendation 2).

11. Space, facilities and equipment
Provide high quality, safe and accessible spaces for children and young people to be physically active
Ensure spaces and facilities meet the recommended safety standards
Actively promote public parks, play areas and more non-traditional spaces for physical activity
NOTES FOR PRESENTERS:
Key points to raise (drawn from the recommendations):
Bullet 1
Ensure facilities are suitable for those with different needs, particularly those from lower socioeconomic groups, those from minority ethnic groups with specific cultural requirements and those who have a disability. Provide daily opportunities for participation by providing guidance and support, equipment and facilities (recommendation 4).
Remove barriers to participation by, for example, offering girls and young women appropriate and private changing facilities (recommendations 6, 11).
Keep children motivated to be physically active by updating and varying the way physical activities are delivered (including the resources and environments used) (recommendation 10).
Provide access to environments that stimulate children’s need to explore and which safely challenge them (recommendation 10).
Ensure both indoor and outdoor opportunities are available after school, at weekends, during half-term breaks and during the longer school holidays (recommendations 10, 13).
Additional information
You may also find it helpful to refer to ‘Physical activity and the environment’. NICE Public health programme guidance 8 (2008). Available from 11

12. Physically active travel
Continue to encourage physically active modes of travel (such as walking or cycling)
Continue working with schools on travel plans, focusing on physical activity
Ensure local transport plans take account of children and young people’s need to be physically active
NOTES FOR PRESENTERS:
Key points to raise (drawn from the recommendations):
Bullet 1
Encourage children and young people, especially those who live within a 2-mile radius of school, to walk, cycle or use another mode of physically active travel to get there (recommendation 12).
Bullet 2
Implementing school travel plans may include: mapping safe routes to school and to local play and leisure facilities; organising walk and bike-to-school days and walking buses; organising cycle and road safety training; and helping children to be ‘streetwise’ (recommendations 5, 12).
Organise training courses for school travel plan advisers (recommendation 5).
Bullet 3
Identify any aspect of transport policies which discourages children and young people from using modes of travel involving physical activity (such as walking or cycling) (recommendation 5).
Ensure local transport and school travel plans continue to be fully aligned with other local authority plans which may impact on children and young people’s physical activity. This includes local area agreements, local area play strategies and healthy school plans. Local transport authorities, school travel advisers and transport planners should liaise with LSPs to achieve this (recommendation 5).
Ensure local transport plans continue to be developed in conjunction with local authority departments and other agencies that provide spaces and facilities for children and young people to be physically active (recommendation 5). 12

13. Costs
Funding is available and this guidance is unlikely to result in a significant change in the use of resources. However, the following may result in additional costs:
provision of high quality and safe spaces for children and young people to be physically active
initiatives to promote physical activity (set-up costs)
recruitment and training of staff and volunteers
NOTES FOR PRESENTERS:
NICE has found that implementing this guidance is unlikely to result in any significant changes in resource use, as any investment that is made now is likely to be offset by long-term savings and benefits from increased levels of physical activity among children and young people. However, different areas may vary from the national average and it is important to look at the recommendations most likely to have a resource impact to make sure that local practice matches the national average.
Examples of funding already available include:
The Play Strategy: Through the Play Strategy (Department for Children, Schools and Families), every local authority will receive at least £1 million in funding, to be targeted on the children most in need of improved play opportunities. A total investment of £235 million will be made.
The Extended Schools programme: The government will be investing £1.3 billion in this programme between 2008 and Schools are expected to provide extended services including a varied menu of activities such as sport and dance, and community access to facilities including sports facilities.
For further information please refer to the costing statement for this guidance on the NICE website.

14. Potential savings and benefits
Reduction in health problems such as obesity, heart disease and cancer
Improvements in children and young people’s cognitive ability and academic achievement
Improved social cohesion and a reduced risk of criminal behaviour
NOTES FOR PRESENTERS:
These are potential longer-term savings and benefits.
In the long term, increasing the physical activity levels of children and young people is likely to reduce some of the health problems associated with inactivity, such as obesity, diabetes, heart disease, stroke, cancer and osteoporosis. It is also likely to benefit their mental wellbeing in the short term. Other wider benefits may include:
improving their general cognitive functioning and academic achievement (Sibley and Etinier 2003).
improving social cohesion and reducing the risk of criminal behaviour (Sport England online).
helping deter them from other risky behaviours, such as smoking.
As a result of the above, the NHS, other public sectors and the wider economy are likely to benefit in the longer term.
For further information please refer to the costing statement for this guidance on the NICE website.

15. Discussion
How do we ensure high-level policies and strategies are linked up to address the need for children and young people to be physically active?
How can we help support and develop physical activity partnerships?
How can we get children and young people and their families involved in the design, planning and delivery of physical activities, including active play?
NOTES FOR PRESENTERS:
These questions are suggestions that have been developed to help provide a prompt for a discussion at the end of your presentation – please edit and adapt these to suit your local situation.
You may want to consider these as an alternative:
How can we evaluate physical activity initiatives aimed at children and young people?
What local training is available for staff and volunteers who provide physical activity opportunities for children and young people?
How do we promote physical activity and encourage parents and carers to participate?
What current forums exist to help us involve children and families?
How do we involve primary care trusts (PCTs), Children’s Services, schools and the third sector in establishing a local strategy?
Please refer to the guide to resources tool for this guidance on the nice website, for examples of good practice. 15

16. Find out more Visit www.nice.org.uk/PH17 for the: guidance
quick reference guide
costing statement
audit support
guide to resources
NOTES FOR PRESENTERS:
You can download the following documents from
•The guidance – all the recommendations, details of how they were developed and evidence statements.
•A quick reference guide for professionals and the public.
Details of all the evidence that was looked at and other background information.
For printed copies of the quick reference guide, phone NICE publications on or and quote reference number N1762.
NICE has developed tools to help organisations implement this guidance, which can be found on the NICE website.
Costing statement – details of the likely costs and savings when the cost impact of the guidance is not considered to be significant.
Audit support – for monitoring local practice.
A guide to resources to signpost relevant policies and resources.