Tackling Obesity in England - National Audit Office

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TACKLING OBESITY IN ENGLANDPerformance targets for healthy transport4.10 The policy commitment is supported within theDepartment of the Environment, Transport and theRegions by a target to quadruple the level of cycling,against a 1996 base, by the year 2012.4.11 At the operational level, the Highways Agency, withresponsibility for motorways and trunk roads, has anobjective to improve conditions on the roads for cyclists,pedestrians and equestrians. Whilst the Agency has notset a quantified performance target for access forcyclists, its management plan includes operationaltargets for four accessibility schemes costing over£100,000, and a further 15 costing under £100,000.Setting a strategic performance target to measure itssuccess in delivering accessibility would provide theAgency with a further incentive to work closely with theDepartment of the Environment, Transport and theRegions to improve access and safety for cyclists.Integrating health and transport plans locally4.12 Health authorities and local authorities provide themain links in translating Government policy on health,transport and the environment into local action: healthauthorities are responsible for identifying the healthneeds of the local population and for seeking to addressthem through co-ordinating the local HealthImprovement Programme; and local authorities makethe planning decisions which affect the localenvironment and transport infrastructure. Joint workingon these issues at departmental level needs to bemirrored by collaboration at the local level todevelop and implement integrated health andtransport strategies.4.13 To develop these links, the Department of theEnvironment, Transport and the Regions and theDepartment of Health jointly sponsored a report called'Making The Links: Integrating Sustainable Transport,Health and Environmental Policies', published in 1999by the Health Education Authority 33 . The report aimedto promote joint working between local authorities andhealth authorities by identifying common themes innational transport, health and environmental policies,by providing guidance on the development of integratedstrategies, and by disseminating good practice.Case Study 5 illustrates what can be done.4.14 Local Transport Plans will provide an opportunity toapply this integrated approach more widely. They wereintroduced by the 'New Deal for Transport' WhitePaper 32 as a centre piece for local action and key to thedelivery of integrated transport. They are five-year planson which local authorities are required to consultwidely, including with health care providers. Some localauthorities have set their own targets to increase cycling,in line with the Department of the Environment,Transport and the Regions' national objective, and areworking with local user groups to achieve them.4.15 In developing their policies on walking and cycling, anumber of local authorities have designated 'Walking'and 'Cycling' Officers in order to develop plans andimplement schemes on the ground. Walking and cyclingare also being promoted through Green Transport Plans,which were introduced by the 'New Deal for Transport'White Paper as a means of delivering changes in travelmodes to and during the course of work. Through suchplans, employers are encouraged to promote the use ofwalking and cycling by offering incentives andproviding the equipment and facilities to make thesemore attractive options. As part of the National ServiceFramework for coronary heart disease 6 , NHS and localauthority employers are required to develop GreenTransport Plans by April 2002.4.16 As a sister publication to 'Making The Links', the HealthEducation Authority published a further report in 1999called 'Active Transport' 27 , designed to helpprofessionals working at community level to developlocal initiatives to promote walking and cycling. This isa practical document which makes extensive use of casestudies to disseminate good practice in developinghealthy transport initiatives. Some examples from thereport are described in Case Studies 6, 7 and 8.ii. Promoting more active recreation insociety4.17 Another way in which Government can encourage morepeople to take more exercise is by promoting physicalrecreation. The Department for Culture, Media andSport has a lead role in promoting participation in sportand in ensuring that adequate opportunities for activeleisure and play are provided for the whole population,including the socially disadvantaged. The Department'sPublic Service Agreement with the Treasury published in2000 includes a strategic objective to raise significantly,year on year, the average time spent on sport andphysical activity by those aged 5 to 16.part four34
TACKLING OBESITY IN ENGLANDCase Study 5: Integrated health and transport strategies in LiverpoolLiverpool Health Authority identified action areas on "transport, air, planning and landuse" in its Health Improvement Programme (1999). These included:nnnnnnThe health impact assessment of new transport plansImplementing a cycle users' programmeDeveloping a targeted and cohesive transport strategy, linked to the cycling strategyIncorporating health and sustainability into local planning guidanceReducing the amount of long-stay car parking and promoting the health benefits ofthe car parking strategySecuring organisational commitment for implementing green commuter plans,including incentives to use public transport and walking.Merseyside local authority's transport strategy had a section devoted to transport andhealth, and a health impact assessment of the regional transport strategy was conducted.Projects included:nnnnnHealthy transport plans at NHS sitesGreen commuter plans for NHS staff and links to "health at work" programmesA TravelWise regional campaign, with transport/health promotionsCycling and walking route development and promotion, linked to physical activity programmes"Safer routes to school" and links to children's health.Source: Making The Links 33Case Study 6: Health promotion by encouraging the use of stairsA study was undertaken by researchers at Glasgow University and Glasgow Health Board to encourage the use of stairs ratherthan an escalator at a city centre underground station. The aim was to test whether incidental physical activity could beincorporated into the daily routines of members of the public.Posters with the slogan " Stay Healthy, Save Time, Use the Stairs" were placed in prominent positions at the point of choicewhere an escalator and two flights of fifteen steps ran side by side.Prior to the erection of the posters, stair use was around eight per cent. During the three week period when the sign waspresent, stair use went up to between 15-17 per cent. Twelve weeks after the removal of the posters, stair use remainedsignificantly above the level recorded prior to the erection of the posters. The Health Education Board for Scotlandsubsequently distributed motivational stair walking posters throughout Scottish workplaces.Source: Active Transport 27Case Study 7: Promoting Walking and Cycling in StockportA unique NHS project has been established in Stockport to promote walking and cyclingthroughout the borough. A Project Officer is employed to promote walking and cyclingas part of every day living.A range of programmes has been established including adult cycling classes, a resourcepack to support school talks, a cycling festival and a cycle leasing scheme whichencourages NHS Trust staff to cycle to work. This scheme enables staff to rent one of 85bicycles purchased by the Trust. It aims to increase fitness and activity levels among staff,as well as alleviate parking problems at hospital sites.The scheme has proved to be extremely popular, with far more staff cycling to work thanpreviously as all the bikes have been rented out. It is part of a broader sustainabletransport plan produced by the local Transport Working Group- an alliance betweenStockport NHS and Stockport Metropolitan Borough Council.part four35Source: Active Transport 27
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Tackling Obesity in England - National Audit Office

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