Written submission submitted by the Sport and Recreation Alliance (IDH0051)

Key points

• The positive impact of physical activity on health is well known and evidenced.
• The sport and recreation sector has a unique contribution to make to improving levels of physical activity.
• There needs to be national and local leadership and commitment to drive change.
• Everyone should have the opportunity to be active throughout the life course and we need to work together to overcome barriers to participation.
• There needs to be greater focus on prevention and early intervention. Physical activity can benefit the population by reducing health-related conditions as well as make vital cost savings.

Sport and Recreation Alliance

1.      The Sport and Recreation Alliance is the umbrella body for governing and representative bodies of sport and recreation in the UK. We represent 320 members covering a wide range of activities from football, rugby and cricket to rambling, mind games and dance.

2.      We are responding to this inquiry as the sport and recreation sector has a unique contribution to make to getting people active and improving their health and wellbeing. In addition, our Public Health Working Group brings together experts within our membership, recently working with Public Health England (PHE) around Everybody active, every day.

The impact of physical activity on health

3.      Evidence shows the impact of activity on both physical and mental health. Physical activity can not only help many people living with life-limiting health conditions, but also play an important preventative role that impacts on individuals as well as cost savings.

4.      Physical inactivity is the fourth leading risk factor for global mortality.[1] The estimated direct cost of physical inactivity to the NHS across the UK is £1.06 billion. Inactivity also creates costs for the wider economy, through sickness absence and through the premature death of productive individuals. In England, the costs of lost productivity have been estimated at £5.5 billion per year from sickness absence and £1 billion per year from the premature death of people of working age.[2]

5.      We also know that regular physical activity can reduce the risk of many chronic conditions including coronary heart disease, stroke, type 2 diabetes, cancer, obesity, mental health problems and musculoskeletal conditions. Even relatively small increases in physical activity are associated with some protection against chronic diseases and an improved quality of life.[3]

6.      A recent study suggests that the rise in obesity has been primarily caused by a decline in physical activity at home and in the workplace, not an increase in sugar, fat or calorie consumption.[4] Despite this, the attention given to diet and to healthy eating often appears to be far higher than that given to the need for physical activity.

7.      Reduced physical health increases the chances of poor mental health. When a person with a long-term physical impairment or health condition also has a mental health problem the average cost to the NHS rises by 45% to £5,670 per year. Poor mental health can lead to poor physical health; in adults, depression leads to a 50% increase in the risk of mortality. Sport and recreational activities which require greater levels of mental activity can reduce both the risk and the effects of dementia.

8.      Physical activity can also help combat social isolation and getting active outdoors is associated with lower levels of stress, tension and depression, and with increased self-esteem and energy levels.

9.      Our Reconomics report (2014[5]) sets out the economic impact of outdoor recreation which is a crucial part of achieving a healthy nation. 3 in 4 adults regularly get outdoors and the King’s Fund (2013) prioritised green space as one of the most effective ways for local authorities to improve public health and reduce health inequalities.

10.  We are currently working with the Department of Culture, Media and Sport, Sport England and the Outdoor Industries Association to drive forward the development of a national outdoor recreation strategy. We believe that recognising the importance and contribution of outdoor recreation to the objectives of many government departments will help ensure that outdoor recreation is considered a priority and invested in.

11.  Our Game of Life report[6] found that:

• In the time it takes Usain Bolt to run 100m (9.58 seconds) the NHS spends around £10,00 tackling preventable ill health.
• 150 minutes of physical activity a week is twice as effective as medication at reducing the risk of developing type 2 diabetes.
• The same amount of weekly physical activity also reduces the risk of cardiovascular disease by 40%.

The role of schools, parents, local authorities and government in encouraging active play, travel and sport for children and young people

Schools and education

12.  Physical activity can have a positive impact not only on pupils’ health but also on achievement. PHE (2014[7]) states that:

• Pupils with better health and wellbeing are likely to achieve better academically.
• Effective social and emotional competencies are associated with greater health and wellbeing, and better achievement.
• The culture, ethos and environment of a school influences the health and wellbeing of pupils and their readiness to learn.
• A positive association exists between academic attainment and physical activity levels of pupils.

13.  Given schools’ potential to increase levels of physical activity, we are concerned by the Amateur Swimming Association finding that 45% of primary school children were unable to swim 25m despite it being a national curriculum requirement.[8] Swimming is a skill that can save lives and we hope to see a reduction in this figure.

14.  Outdoor learning is a fun, creative way of getting children and young people active and healthy while helping their development; ‘when planned and implemented well, learning outside the classroom contributed significantly to raising standards and improving pupils’ personal, social and emotional development’ (Ofsted, 2008[9]).

15.  We want to see Government support all primary and secondary schools to deliver frequent, continuous and progressive outdoor activity experiences within the curriculum. We believe that:

• Outdoor learning should be promoted across the curriculum and accessible to all, with schools inspected against high-quality delivery. The English Outdoor Council is preparing a document - High Quality Learning Outdoors - which would help with this.

• Each school must have a lead teacher for outdoor learning.
• All schools should achieve the Learning Outside the Classroom Quality Badge or a recognised equivalent.

Access

16.  Providing high-quality, accessible facilities is crucial to getting people to not only to engage with, but maintain, physical activity. The Inclusive Fitness Initiative (IFI), managed within the English Federation of Disability Sport, helps address inequality in physical activity. There are now over 400 IFI Mark facilities throughout the country equipped with a range of IFI accredited fitness equipment with highly-trained gym staff who are experts in providing advice on adapted physical activity.[10] 

17.  We would like to see local areas take a strategic approach to increasing physical activity opportunities by producing a robust and comprehensive strategy in response to local needs. This would need to have clear objectives, deadlines, responsibilities and accountabilities.

18.  We need to seize opportunities to make use of existing spaces in rural and urban areas to encourage activity. For example, Parkour is a non-competitive physical discipline of training to move freely over and through any terrain using only the abilities of the body, principally through running, jumping, climbing and quadrupedal movement. It develops attribute such as strength and fitness, balance, agility and co-ordination.

19.  We can also use facilities in different ways. For example, schools are ideally placed to open-up their facilities to the community but this opportunity is not being maximized in some areas; Merseyside Sports Partnership found that:

• Education sites in Liverpool currently provide 651 hours of community sports provision each week.
• There are 784 hours each week in which facilities are open and not used (cited here as ‘down time’).
• An extra 1627 hours of community sports provision could be gained by opening and utilising facilities during reasonable times when they are currently closed.
• Opening facilities and filling down time could be worth £72,330 in revenue income each week.

20.  In many areas, sport and recreation organisations are helping to develop school-club links and increase the use of education sites for activity.

21.  Town planning can impact on participation by making routes to the outdoors and facilities more accessible. We want to see Government make active travel the easiest option for all short journeys by requiring public transport operators to provide more regular, convenient and affordably-priced services from urban to rural areas. The Infrastructure Bill currently going through Parliament is an opportunity for Government to include a firm commitment to investment in walking and cycling.

Work-based physical activity

22.  Employers investing in their employees’ wellbeing can reduce absenteeism through sickness, improve safety and make the work environment healthier and more productive. The economic cost of sickness absence among those people of working age is thought to be over £100 billion per year.

23.  One example of how the sport and recreation sector is facilitating work-based physical activity is the Workplace Challenge.[11] This national programme - delivered by the County Sports Partnership Network, funded by Sport England - aims to engage workplaces in sport and activity. It provides challenges to employees as well as training delivered in partnership with the British Heart Foundation to create 'Workplace Challenge Champions'.

24.  Another example is swimming which can help with stress and muscular-skeletal conditions; two of the most common occupational health problems.[12] The Amateur Swimming Association found that swimming regularly for around 30 minutes per week over a year can reduce coronary heart disease, stroke and Type-2 diabetes. This would lead to a saving of around £1.1bn annually in terms of treatment costs to the NHS. Swimming can be recommended to employees and has positive benefits for general wellbeing, reduces tension, depression and anger.

Equality

25.  PHE’s (2014[13]) Everybody active, every day framework highlights the need to embed physical activity across communities which may involve tackling cost, access or cultural barriers. Common inequalities include issues such as age, gender, religion and disability. But there is a responsibility under the Equality Act 2010 to consider protected groups – for example, by ensuring access, monitoring, and staff training.

26.  To provide opportunities for physical activity, providers need to consider people’s individual needs and invest in the necessary resources, equipment and training. We would welcome Government commitment to a specific and rigorous training programme for teachers that would support them to deliver diverse, inclusive provision. For example, schools should provide targeted sessions in response to local demographics and needs.

27.  The sport and recreation sector is contributing to this agenda through projects we would like to see expanded. For example, the Youth Sport Trust’s Project Ability aims to have more disabled pupils taking part in competitive sport. Project Ability is delivered as part of the School Games, and includes bespoke training, delivery of local competitions and the development of school club activities. Schools are encouraged to work alongside national governing bodies (NGBs) of sport to establish inclusive formats with tips and advice on how to adapt activities as well as specific impairment formats.

28.  The Sainsbury's Inclusive PE training programme will be a national, free course specifically designed to improve teachers' competence and confidence in providing a fully inclusive PE experience for young people with a wide range of needs. The programme is designed to be delivered in a number of different ways and will reach a wide audience, including primary teachers, secondary PE specialists and new entrants to the profession.[14]

29.  Facilities are once again crucial. Investment is needed to update existing facilities and build new ones where needed which are accessible to children, young people and adults with additional needs. Use of such facilities would be maximised by allowing community groups and clubs to use them outside of school hours.

30.  Personal budgets could help to get more disabled people active as it puts the decision making power into the hands of the individual. This initiative is an opportunity for sectors to work together to increase engagement in physical activity and improve people’s health.

Accountability and leadership

31.  A crucial part of achieving a step change in physical activity levels is through national leadership. PHE’s Everybody active, every day highlights the role of the Minister for Public Health through the Chair of the Olympic and Paralympic Legacy Cabinet Committee and the Ministerial Sub-group on Physical Activity in governance and leadership. We would support a cross-departmental approach as physical activity and health benefits can be derived from a variety of initiatives which are the responsibility of not one single department.

32.  The Chief Medical Officer’s (CMO) guidelines on physical activity are still not widely understood, they need communicating more effectively to professionals, including front-line medical professionals and teachers. National leadership by the Department of Health (DH) would be helpful to achieve this. For example DH could issue guidance on the CMO guidelines for professionals and ensure specific reference to physical activity is included as a key part of education and medical professionals’ training.

33.  We would also welcome work to raise awareness of the CMO guidelines with the public, in particular targeting the inactive. A national campaign along the lines of the ‘five-a-day’ adage would help to embed physical activity as the norm and encourage all across the life course to get active. We would be happy to support such a campaign.

34.  PHE’s Everybody active, every day put a welcomed clear focus on physical activity across the life course. PHE can offer valuable support and insight and we would welcome further clarification on how PHE intends to work with partners, such as NGBs of sport, to improve evaluation systems and data collection so that they are appropriate for use, recognising the nature of provision at the grassroots.

35.  NGBs and sport and recreation representative organisations can provide leadership through delivering programmes and supporting clubs to provide myriad participation opportunities. They are also conduit for promoting activity and are able to target specific under-represented groups.

36.  At a local level, there needs to be commitment and investment across agendas in physical activity. Research by ukactive[15] found that:

• Local authorities have nearly doubled the amount of public health funding that they have allocated to tackling physical inactivity between 2013/14 and 2014/15.
• 70% of local authorities have increased their allocated public health budget spend on physical activity in 2014/15.
• Spend on inactivity still represents the smallest proportion of public health grants (4%) in comparison to the other top tier public health areas: sexual health (36%), alcohol misuse (30%) and smoking cessation (9%).

37.  Local strategies and frameworks must recognise physical activity. Health and Wellbeing Boards are an ideal conduit to bring partners together and ensure that service delivery reflects the needs of the community, making Joint Strategic Needs Assessments essential.

38.  A robust school sport infrastructure is crucial to delivering a range of high-quality participation opportunities for children and young people. County Sports Partnerships are now doing valuable work bringing people together to deliver activity and offer more children and young people the chance to be active. Government needs to invest in what we know works to deliver joined-up provision that meets the needs of local communities.

39.  To support engagement in physical activity, health and education professionals must be aware of what outdoor recreation opportunities are available locally and sign-post to them. Information must be available to community members in accessible places, such as libraries, GP surgeries and the local corner shop. Councils can also facilitate sign-posting online. For example, Blackburn and Darwen Borough Council and the Care Trust Plus have come together to set up an online resource for all health and wellbeing information and services. This also includes information on leisure activities and clubs.[16]

Are we losing the fight and simply encouraging a 'normalisation' of obesity and is this distracting from prevention and early intervention?

40.  Obesity must not dominate the agenda. We recognise that the biggest way to reduce obesity is for people to consume less than they expend but we know that sport and recreation is a crucial part of the solution. Importantly, being physically active can not only help with recovery, it also has a preventative role which can deliver cost-savings to the state. It is this preventative aspect that we would like to see more focus and evidence on.

41.  Research[17] has shown that participating in sport generates significant economic value in terms of healthcare costs saved and improved health related quality of life:

•          The typical lifetime healthcare cost saving generated by doing sport varies between £1,750 (badminton) and £6,900 (health and fitness) per person.

•          The total economic lifetime value generated by doing sport varies between £11,400 (badminton) and £45,800 (health and fitness) per person.

42.  Thank you for the opportunity to submit evidence to this timely, important inquiry. We would be happy to provide further detail if helpful.

18 December 2014