Introduction and summary

1. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and advice on promoting high quality health, public health and social care. Our role is to improve outcomes for people using the NHS and other public health and social care services. We do this by:

· Producing evidence-based guidance and advice for health, public health and social care practitioners.

· Developing quality standards and performance metrics for those providing and commissioning health, public health and social care services;

· Providing a range of information services for commissioners, practitioners and managers across the spectrum of health and social care.

2. NICE has produced a range of public health guidance on how to increase levels of physical activity in the population, particularly through policies and programmes that encourage people to walk and cycle[1] but also create the conditions in which they are they are more likely to do so. We strongly support the intentions of this Bill.

Cycling and walking and health

3. Physical activity is essential for good health. It can help reduce the risk of coronary heart disease, stroke, cancer, obesity and type 2 diabetes. It also helps keep the musculoskeletal system healthy and promotes mental wellbeing. As well as a direct benefit from physical activity, walking and cycling offer pleasure, independence and exposure to outdoor environments. These benefits may be particularly significant for people with disabilities whose participation in other activities may be more restricted.

4. Cycling is the fourth most common recreational and sporting activity undertaken by adults in Britain. Bicycles are used for around 2% of journeys in Britain – compared to about 26% in the Netherlands, 19% in Denmark and 5% in France. Yet of all trips made in Great Britain in 2009, 20% covered less than 1 mile and more than half (56%) of car journeys covered less than 5 miles. In England on average, 10% of adults cycle at least once a week (although this figure varies from over 50% to less than 5% according to area). On average, 11% of adults cycle for at least half an hour at least once a month (a figure that, again, varies from 4% to 35% according to area).

5. NICE’s public health guidance on physical activity focuses mainly on walking and cycling. In general, the objectives of achieving higher rates of cycling and walking are equally well served by interventions to encourage active modes of transport. However, the guidance cautions that walking and cycling are distinct activities which are likely to appeal to different segments of the population. A range of factors may be important in helping or restricting people from taking part. These will vary according to whether someone is walking or cycling for transport purposes, for recreation or to improve their health.

6. As has been noted, there is a considerable potential benefit in public health terms from increasing physical activity by promoting cycling. While the public health and transport sectors both have an interest in increasing cycling, there are, however, some differences in detail. In particular, from a public health point of view the overall aim is to increase levels of physical activity, especially among those who are not currently active. From a transport perspective the aim might be to move people from motor vehicles to cycles, irrespective of their current activity levels. As well as public health benefits relating to physical activity, a modal shift from motorised vehicles would be associated with reductions in air pollution. This would have an additional public health benefit.

NICE guidance covering cycling

7. The most recent NICE public health guidance relevant to cycling and health is ‘Walking and cycling: local measures to promote walking and cycling as forms of travel and recreation’ (PH41)[2], which was published in November 2012. This guidance sets out how people can be encouraged to increase the amount they walk or cycle for travel or recreation purposes, thus helping to meet public health and other goals (for instance, reductions in traffic congestion, air pollution and greenhouse gas emissions). The recommendations cover:

· Policy and planning, including leadership on walking and cycling, walking and cycling in health and wellbeing board joint strategic needs assessments (JSNAs) and joint health and wellbeing strategies, and ensuring cycling and walking are considered in all relevant policies and plans.

· Coordination of integrated, cross-sector programmes that link to existing national and local initiatives and which are based on an understanding of the behavioural and environmental factors that encourage or discourage people from walking and cycling.

· Strategies for promoting walking and cycling in schools, workplaces and the NHS.

8. The guidance is for commissioners, managers and practitioners involved in physical activity promotion or who work in the environment, parks and leisure or transport planning sectors. They could be working in local authorities, the NHS and other organisations in the public, private, voluntary and community sectors. It is also aimed at employers, estate managers, highways authorities, those involved in land-use planning and development control, private developers, public transport operators, those involved in carbon reduction or sustainability planning, and others responsible for workplace travel, carbon reduction or sustainability plans.

9. The walking and cycling guidance complements earlier guidance. NICE’s guidance on ‘Physical activity and the environment’ (PH8, 2008)[3], which offered the first evidence-based recommendations on how to improve the physical environment to encourage physical activity, is aimed at local authority and other professionals who have responsibility for the built or natural environment, including local transport authorities, transport planners, and those working in the education, community, voluntary and private sectors. Its recommendations cover strategy, policy and plans, transport, public open spaces, buildings and schools. The recommendations are about:

· ensuring planning applications for new developments always prioritise the need for people (including those whose mobility is impaired) to be physically active as a routine part of their daily life;

· ensuring pedestrians, cyclists and users of other modes of transport that involve physical activity are given the highest priority when developing or maintaining streets and roads;

· planning and providing a comprehensive network of routes for walking, cycling and using other modes of transport involving physical activity;

· ensuring public open spaces and public paths can be reached on foot, by bicycle and using other modes of transport involving physical activity.

National Institute for Health and Care Excellence (NICE)

April 2013

[1] The sources of the data can be found in the NICE guidance, ‘Walking and cycling: local measures to promote walking and cycling as forms of travel and recreation’: http://guidance.nice.org.uk/PH41/