Download Physical activity - UK Government Web Archive

Physical activity –
a national perspective
PAN-WM, 27 March 2007
Alison Giles,
Physical Activity programme manager, DH
In April 2006, the Prime Minister
asked Caroline Flint to develop a
cross-government strategy to
transform the population into a fitter
and more active nation in the run up to
the 2012 Olympic and Paralympic
Games.
This builds on the commitments set out
in the Choosing Health White paper.
 What are government
departments currently doing?
 What should they be doing?
 What should cross-government
working look like?
What departments are doing
everyday PA
Healthy
schools
DCMS
Play
Early years
DfT/DfES
Travel to School
active travel
DH
Healthy Living Social
Marketing Programme
School age
DfT/Cycling England
Promoting walking and cycling
DEFRA
active
promoting active recreation
recreation
and play
Parents
18-25
Adults
DH
Healthy Ageing
Older people
DCMS/Sport England
fitness
Adult sport PSA
DCMS/DfES
PESSCL
sport
episodic PA
low medium high
= impact as function of clarity of focus x leadership x resources
(DH qualitative perspective)
What drives departments?
PA Implicit
no PA target
no audience
PA Explicit
specific PA target(s)
audience identified
DfT
DfT/ DEFRA / DTI
Walking and cycling
action plan
PSA 3 Public transport
PSA 4 Congestion
DfT / DfES
PSA 5 Road accidents
School travel
PSA 6 Air quality
PSA 7 Climate change
DEFRA / Nat. England
DEFRA
Health benefits of
outdoor recreation
PSA 3 Countryside
DCMS
DCLG
Play
PSA 6 Planning
DCMS / DfES
PSA 8 Cleaner Safer
Greener
DWP
PSA Workplace Health &
Safety
DCMS / Sport England
Sport facilities
PSA 3 Adult sport and active
recreation
DH
DCMS / DfES
PSA 3 Child obesity
(with DfES and DCMS)
PSA 1 PE, school sport and club
links
PSA 1 CHD mortality
= PSA
= supporting action
Game Plan* priorities - progress
To increase mass participation in physical activity and
sport, we need to:
 Support children and young people
To build a life-long participation.
 Target specific groups who are below the national
average in terms of participation
Lower socioeconomic groups, ethnic minorities,
women, disabled.
x Target the sedentary
This is where the greatest health gains will be made.
x Support older people
Most to gain in terms of short-term health benefit and
delaying or preventing the effects of ageing
*Strategy Unit/DCMS. 2002
Target the sedentary and
older people
(Source: Health Survey for England 2003)
The effects of activity on
disease risk
(Source: “At Least Five a Week” CMO 2004)
RISK
Death
INACTIVE
Diseases and disorders
Risk factors
ACTIVE
Impaired growth
& development
Childhood Adolescence
Young
adulthood
Middle
adulthood
Old
adulthood

As people get older the health gap between active and inactive people widens

Becoming active at any stage in life decreases that health gap significantly

ITS NEVER TOO LATE TO START EXERCISING!
Role of DH
1. Develop the evidence base
2. Promote health benefits of all types
of activity
3. Focus on sedentary and older adults
4. Develop a social marketing strategy
5. Identify mechanisms to engage NHS
in physical activity promotion
6. Increase regional capacity
7. Deliver a health legacy from 2012 Games
8. Advocate action across government
Engaging the NHS
 Patient activity questionnaire
 NHS physical activity care pathway
 National Step-O-Meter programme
 Health trainers
 Practice-based commissioning?
GP PA questionnaire
 General Practice Physical Activity
Questionnaire
 Patients 16-74
 Self-completion (30 seconds)
 Identification of patients who would
benefit from increased physical activity
 Available from www.dh.gov.uk
GPPAQ
Draft Primary Care Physical Activity Care Pathway (Adult)
1
Health
Screening
3
Classific
ation
PAI
Active
2.5 hr+
Mod
Active
1.5 – 2.5 hr
Mod
Inactive
30 min –
1.5 hr
Inactive
0 – 30 min
•
•
•
•
•
6
7
9
Assess motivation:
Precontemplation
Contemplation
Preparation
Action
Not Motivated
8
NHS London / Sport England London
ADHERENCE LOOP
Walk Group
Local Classes
Success
Sports Clubs
Success
16
Leisure Centre
Review
@ 6 mths
Active Travel
Review @
12 mths
18
Pedometer Prgm
Active Workplace
Parks & Green
Spaces
Pre existing
Medical
Condition
Moderately
Active or
Moderately
Inactive
No
Inactive
Yes
Clinical Need
No
A Exercise Referral
12
MAINTENANCE
Fit Club
Active Daily Living
(Gardening, DIY)
BI
follow-up
@ 3 mths
15
13
Yes
Relapse
17
B Condition Specific
C Self Management
D Activity Clinic Support
• Advice
• Buddying
• Helpline
• Drop-in
• Incentives
• Discounts
14
Jo Foster / John Harkin
Green Exercise
Assist/
Arrange
BRIEF ADVICE
Leaflet
Raise issue
Benefits
Record
Re-check 3/12
BI syllabus
BI script
Advise
Agree
Negotiate
Goals
11
Motivated
Record
Praise
Encourage
Incentivise
OUTCOME
Condition Unlimited
4
Seeking
Advice
2
10
5
Practice
Nurse
SERVICE DELIVERY
A Structured Activity
Patient
BRIEF
INTERVENTION
GP PAQ
Existing
Condition
Clinic
B Self Directed Activity
Health Professionals
Opportunistic
RELAPSE LOOP
Relapse
Relapse
Increasing regional capacity
 To work across the GO to influence
regional and local plans;
 To develop a social marketing approach to
delivering regional physical activity and sport
strategies, and attract match funding where
appropriate;
 To ensure senior engagement with the regional
sports board, and maximise opportunities for
joined up action on physical activity and sport.
To engage with the delivery system at the regional,
sub-regional and local level;
Increasing regional capacity
 To develop a regional Health & 2012 delivery
plan that complements the national plan;
 To develop plans to maximise the engagement
of the NHS in promoting physical activity
and sport;
 To work in partnership with obesity, food and
health, and healthy schools leads to ensure a
joined-up approach to tackling obesity.
Role of government departments
1.
2.
3.
4.
5.
6.
Focus on their own contribution
Get their own house in order
Set national policy framework
Identify levers to local action
Remove barriers to local action
Develop regional and local
capacity
Walking and cycling
Department for Transport has concluded that:
1. One in 5 of all car journeys are less than 1 mile. By shifting
these to bicycle or foot, traffic congestion would become a
thing of the past.
Game Plan and Choosing Activity identify that:
2. Walking and cycling provide important opportunities for
activity for both young people and adults
3. Walking and cycling are two of the four main activities that
continue from childhood to adulthood
The Health Development Agency has concluded that:
4. Activities that do not require specific equipment or facilities are
more likely to be maintained long-term
Walking and Cycling - Trends
Average miles travelled per person per year
300
250
200
Walking
Bicycle
150
100
50
0
1975-76 1985-86 1989-91 1992-94 1995-97 1998-00 1999-01
(Source: National Travel Survey: 1999-2001 Update - figures exclude walking and cycling for leisure)
The future…..
…is uncertain




PSA targets are changing and
reducing
More local ownership
Change of leadership?
Change of approach to tackling
obesity?