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					                                                                          AGENDA ITEM 7

PUBLIC BOARD MEETING / 31 JULY 2008 / FOR INFORMATION and APPROVAL

The 2012 Olympic and Paralympic Games: achieving a lasting health legacy in the
      East of England

Report of Dr Paul Cosford, Regional Director of Public Health
____________________________________________________________________


This paper relates to delivery of the following pledges in the strategy Improving Lives;
Saving Lives:
Pledge 5:     Ensuring fewer people suffer from, or die prematurely from, heart disease,
              stroke and cancer;
Pledge 8:     Working with our partners to reduce the difference in life expectancy
              between the poorest 20% of our communities and the average in each
              PCT; and
Pledge 11: We will halt the rise in obesity in children and then seek to reduce it.


1     PURPOSE

1.1   The London 2012 Olympic and Paralympic Games is the first for which delivery
      and legacy are being jointly planned, with the International Olympic Committee
      (IOC) now promoting the following definition of legacy: ensuring that as many
      long-term benefits as possible are generated for the host city, region and nation
      well before, during and long after the event. The promise is to create a
      sustainable legacy by making the following happen:
           make the U.K. a world-leading sporting nation;
           transform the heart of East London;
           inspire a generation of young people to take part in local volunteering,
            cultural and physical activity;
           make the Olympic Park a blueprint for sustainable living; and
           demonstrate the U.K. is a creative, inclusive and welcoming place to live in,
            visit and for business.

      In June 2008, the Government Department for culture, media and sport published
      the legacy action plan for the 2012 Olympic and Paralympic Games Before,
      during and after: making the most of the London 2012 Games. The plan spells
      out how the Government is using the Games to deliver positive changes in line
      with its five promises stated above.



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1.2   Under the Government‟s overarching goal of stronger communities and a better
      quality of life, PSA 22 states: deliver a successful Olympic Games and
      Paralympic Games with a sustainable legacy and get more children and young
      people taking part in high quality PE and sport. This relates to the delivery of
      pledge 11 in Improving Lives; Saving Lives. From 2008/09, PSA 22 is an
      underpinning priority within the Government Office East (GO-East) business plan.

1.3   This paper details the following:
           progress with securing a regional legacy from the 2012 Games;
           regional infrastructure for delivery and health engagement;
           opportunity and support for developing health as a cross cutting theme;
           importance of the Legacy Plan and of Sport England‟s role and
            infrastructure in increasing participation in sport and physical activity;
           opportunities to use the cultural Olympiad, the Legacy Trust and
            volunteering to address inclusion, diversity and to develop skills leading to
            employment; and
           the need for the NHS to ensure robust emergency plans and the ability to
            respond to an incident in the region, or London, including mutual aid as part
            of regional resilience.

1.4   The paper also details the proposed way forward, identifying key actions that the
      NHS East of England can deliver in line with promoting health and wellbeing for
      their staff and support the implementation of the 2012 health action plan.

2     BACKGROUND

2.1   Regional Proximity to the London 2012 Games

      The East of England is the closest region to the London 2012 Olympic and
      Paralympic Games, had the highest level of public support (84%) for the 2012
      Games bid and has two 2012 Games venues (canoe/ kayak slalom at the
      Showground in Broxbourne, Hertfordshire and mountain biking in Essex (venue
      tbc)). These should create a valuable legacy for both elite competition and
      community use.

      Sixty-five Olympic, and ten Paralympic, pre-games training camps have been
      confirmed across the East of England for international teams in the run up to the
      2012 Games. Teams are expected to carry their own health insurance and to use
      private health care except for accidents and emergencies, when they would be
      treated as any other visitor. For the period from two weeks before the Games
      opens until a few days after, health care for athletes will be provided by the U.K.
      through the Olympic Village.

      A network of “Live Sites” – large outdoor video screens with linked performance
      spaces – is being developed around the U.K. The East of England is installing a
      Live Site in Norwich which is due to open on 8th August 2008, planned in time for


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      the Beijing handovers on 24th August (Olympic Games) and 17th September
      (Paralympic Games). There are plans for other Live Sites to be rolled out across
      the region during the four-year Cultural Olympiad. These will provide a wider
      platform for community engagement for a range of cultural events and
      performances in addition to relaying great sporting moments, supporting 2012
      education projects and offering a local focus for information and opportunities
      related to the 2012 Games. Primary Care Trusts (PCTs) are ideally placed to
      present local health information and raise the awareness of the important link
      between health and physical activity and sport via these Live sites.

      Each local authority has also been invited to mark the handover of the Olympic
      Flag to the U.K. in Beijing on 24 August 2008 by raising a specially designed flag
      themselves and developing events and activities to celebrate the handover.

      Proximity to London and hosting two venues also poses risks and challenges to
      services. The Government Office has recently identified resilience as a key issue,
      and the NHS needs to ensure that it has robust emergency plans and the ability
      to respond to an incident at a regional venue, or in London, including mutual aid.

2.2   Regional Infrastructure

      The East of England Public Health Directorate takes the lead for the health sector
      on the Nations and Regions East (NRE) Board and Executive, the GO-East
      Project Board and on the sport and health themes. They are actively involved in
      developing the proposal for the Arts Council Legacy Bid. The GO-East integrating
      initiative looked at the strengths and weaknesses of GO‟s influence and
      engagement in delivering the 2012 Games programme in the region and across
      Whitehall. GO-East views the 2012 Games as a key cross-cutting theme which
      will enable the delivery of other priority Public Service Agreements. The GO
      Board holds regular briefing sessions with Councillor Stephen Castle, Chair of the
      NRE Board; the health sector is represented by the Regional Director of Public
      Health (RDPH).

      Seven thematic areas have been identified: tourism; business & economic
      development; skills, education, training & employment; sport; culture;
      infrastructure & transport; and volunteering. Health was not originally recognised
      as an objective or theme in the regional plan. The East of England Public Health
      Directorate has been working to raise the profile of health as a cross cutting
      issue, particularly for the legacy, and this has been welcomed by the NRE Chair
      and Board and health now sits as an eighth and cross-cutting theme.

2.3   Engagement of Counties and PCTs with regional infrastructure

      Each of the six Counties has created a partnership to support the 2012 Games
      and capitalise on the related opportunities. County 2012 leads have been
      appointed and sit on the NRE Executive with the theme leads. Essex,
      Hertfordshire and Suffolk have appointed full time managers for the 2012 Games.


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      Other county leads have responsibility for the 2012 Games whilst undertaking
      their current role. Business plans and annual action plans are available from each
      county lead.

      Health engagement varies by county and with co-terminosity. Most counties
      either have a PCT representative on their board or have extended an invitation to
      a PCT (not all 14 PCTs are individually engaged e.g. a representative for Dr Liz
      Robin takes the lead for Cambridgeshire including Peterborough).

3     SECURING A LEGACY FOR THE EAST OF ENGLAND

      „To make the U.K. a world-leading sporting nation‟ is one of the 5 key legacy
      promises. Under this heading, the national legacy action plan includes both new
      initiatives and ones that have been enhanced as a result of London staging the
      Games. A headline ambition for health is „Getting more people more active – help
      at least two million more people in England be more active by 2012‟.

      As well as free swimming for over 60‟s, it includes schemes to target the least
      active to encourage more walking, cycling demonstration towns including
      Cambridge, Colchester, Leighton-Linslade and Southend in the East of England
      to create a better environment for physical activity and, for the first time ever, an
      Inspire mark - using the London 2012 logo to recognise outstanding non-
      commercial projects and events inspired by the Games across the U.K. In
      addition, a number of initiatives will be structured around better coordination with
      PCTs.

3.1   Health and Wellbeing

      The East of England, with four Regional Public Health Groups (East Midlands,
      London, South East and West Midlands), has commissioned a piece of research
      to investigate the evidence base for utilising the Games as a catalyst for
      developing and realising a health and physical activity participation legacy. A
      position statement will be prepared, planned in time for the Beijing-London
      handover, which will be used to inform the development of national and regional
      legacy plans for the London 2012 Olympic and Paralympic Games.

      A care pathway, Let’s Get Moving, for promoting physical activity has been
      developed nationally. The aim is for the care pathway to be built into the 2012
      health legacy, encompassing childhood activity, people with long-term conditions,
      inclusion for people with mental health problems and other excluded groups. A
      pilot has been launched in London and is progressing well with the scheme being
      available to all PCTs across England from November 2009.

      Building momentum and linking into existing agendas, such as the 2004
      Choosing Health white paper and 2008 cross-government strategy Healthy
      Weight, Healthy Lives, is needed to ensure the sustainability of the legacy,
      particularly as increasing physical activity and reducing levels of obesity are key


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      issues for the region and Improving Lives; Saving Lives. In addition, the
      Paralympic Games can be used to address the inclusion agenda incorporating
      mental health and learning disabilities as well as physical health.

      Healthy Weight; Healthy Lives stated that „to tackle unhealthy weight, a wider
      cultural shift is needed‟. For this to be effective a number of communications will
      be created: simple universal messages with broad impact, tailored messages for
      different at-risk families and targeted products for those who have the greatest
      need. In January 2009 the National Social Marketing Centre will launch the social
      marketing brand Change4life in response to this which will be supported by
      national television advertising. Local authorities and PCTs will be able to use the
      Change4Life brand identity from September 2008.

      Health 2012 Action Plan
      To establish health as a cross-cutting issue in the delivery of 2012 and its legacy,
      the East of England Public Health Directorate has developed a 12-month action
      plan for NRE focused around promoting participation in physical activity and
      healthy eating. The high level objectives, reflecting those in the NRE Business
      Plan Rising to the Challenge, were agreed prior to the inclusion of health as a
      separate theme, therefore this initial health action plan is presented under Sport
      England‟s objectives for the sport theme.

      Whereas the sport action plan objectives focus on participation and volunteering
      in sport and sporting infrastructure, the aims of the health action plan are:
           to increase participation in physical activity;
           to increase cross-sector working in meeting other agencies‟ agendas (for
            example the role of physical activity in reduction in carbon emissions via
            active travel, prevention of obesity via awareness programmes linking sport
            and health, community cohesion, skills and employment);
           to face issues of inclusion and diversity; and
           to develop a health and physical activity participation legacy.

3.2   Regional Economic Benefits

      The East of England Development Agency (EEDA) is leading the work to secure
      economic benefits for the region from the 2012 Games. EEDA‟s 2005 Economic
      Impact study suggests the value of the 2012 Olympic and Paralympic Games to
      the region could be of the order of £600m if the region works to capture these
      benefits. Small and medium sized enterprises in the East of England are being
      encouraged and facilitated to secure contracts to supply goods and services to
      the main contractors involved in the regional and national venues. The East of
      England is one of the few regions to identify economic benefits in its business
      plan.

      The regional launch of the London 2012 Business Network was in Newmarket in
      early March, following the national launch in January 2008. Part of this network is
      CompeteFor, a unique procurement „dating agency‟ supported by the East of


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      England Development Agency, which is the chosen website of the London 2012
      Games for the publication of Games-related contract opportunities. Businesses
      can use it to express an interest in the London 2012 supply chain and
      subcontracting opportunities will be listed on CompeteFor by contractors. The
      Olympic Delivery Authority (ODA) released latest statistics in relation to the
      London 2012 Business Network and CompeteFor on 5th June 2008. The East of
      England has 53 businesses which have won ODA contracts. Nearly 2100
      companies have now registered and even at this early stage two companies from
      the East of England have won work through CompeteFor.

      EEDA are also leading on promoting tourism, capitalising on the region‟s
      proximity to London for accommodation and conferences, Stansted as an
      international gateway, the coast and the cultural heritage.

3.3   Cultural Olympiad and Legacy

      Charles Allen, Chair of the national Nations and Regions group, spoke in March
      2008 about the London 2012 Olympic and Paralympic Games being a "catalyst
      and amplifier” of existing programmes, an opportunity to "inspire and engage with
      a purpose" and that this is the key social legacy. His vision was inclusive and
      engaging with a focus on opportunity, physical activity and volunteering. He
      challenged the region to make more use of the „Live Sites‟ - not just to show
      Olympic and Paralympic events. Promotion of health and physical activity
      throughout the year with stepped challenges and provision of human interest
      media stories could build enthusiasm and engagement with the Olympic and
      Paralympic Games and the legacy ambition.

      The Cultural Olympiad
      The 2012 Games will belong to the whole U.K. and not just London as the host
      city. The transfer of the Olympic flag from Beijing to London in summer 2008 will
      mark the transfer of the Games to London and the Cultural Olympiad will be
      launched on 26-28th September 2008. This will celebrate the diversity and
      creativity of the cultural sector in the four year run up to the 2012 Games. The
      Cultural Olympiad will:
            welcome the world;
            inspire and involve young people; and
            leave a lasting and positive legacy.

      Part of the Cultural Olympiad will be a UK-wide festival which is new to the
      Olympic and Paralympic games. A mix of projects will be selected to carry the
      ‘Inspire Mark’, a London 2012 brand identifying them as reflecting the values of
      the Olympic and Paralympic movements. This will be awarded to innovative, non-
      commercial projects and events inspired by the London 2012 Games across
      sport, culture, education, environment and volunteering. The London 2012 Inspire
      Mark will form a key part of the 2012 Games lasting legacy, touching lives across
      the U.K.



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The U.K. Centre for Carnival Arts (UKCCA) will be established in Luton in
September 2008 as the first dedicated centre of excellence for carnival arts,
home to the largest one-day carnival event in the country and Luton Carnival Arts
Development Trust (LCADT). LCADT is dedicated to the creation and promotion
of carnival internationally. The trust believes that participation and enjoyment of
carnival arts can significantly enhance cultural understanding, improve quality of
life, build a confident local cultural identity, improve educational attainment and
tackle issues of social inclusion. It is proposed that the Olympic Carnival will be
core to the Cultural Olympiad and delivery of the opening and closing
ceremonies.

The Royal Opera House Production Park in Thurrock will also house the
proposed National Skills Academy (NSA) for Offstage and Technical Skills for
Music and Live Theatre which will open in 2010. They are keen to work with the
London Organising Committee of the Olympic Games and Paralympic Games
(LOCOG), Iconic Events and the NSA to develop a cohort of „Olympic
Apprentices‟ who by 2012 will be ready to deliver the backstage production of the
opening and closing ceremonies and wider project management of celebrations
and events across the country. Research and analysis from Creative and Cultural
Skills on the skills needed to improve visitor experience and sports presentation
for 2012 concluded that “skills and knowledge must be amplified in technical
theatre occupations in the context of major events”. The Aldeburgh festival, in
Suffolk, is the third high profile cultural event which has been linked to delivering
an Olympic and Paralympic legacy in the region.

Legacy Trust
Living East, the regional cultural consortium, has secured £1.51 million from the
Legacy Trust for the East of England over the next four years. This work is
informed by a Legacy Trust Regional Advisory Group whose membership
comprises: a board member of the Legacy Trust (chair), Executive officer from
the Legacy Trust, Executive Director of Living East, NRE Manager, Creative
Programmer, and representatives from Arts Council England, Public Health,
EEDA and Sport England.

The project, Step Up, aims to deliver a skills programme for young people,
teaching skills in event production and event management for cultural and
sporting activities. It has two phases: firstly, Skills Development, which will use
training programmes such as Personal Best, a pre-volunteering skills programme
(see section below on Volunteering for details); secondly, Major Events, where
some individuals will then use their learnt skills to volunteer for higher profile
events in the region. The East of England Public Health Directorate are working
to secure a health and wellbeing outcome by ensuring that young people from
disadvantaged and excluded groups are targeted for recruitment, skills and
training, addressing inequalities through facilitating access to work and so
securing a health benefit. EEDA has identified the potential for European Social
Funds to match fund the volunteering element, which needs to be secured via the
development of the business plan.


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3.4       Volunteering

          Volunteering is seen as a key platform for developing skills and social networks,
          focusing on young people, the over 50s and inclusion, and targeting excluded and
          disadvantaged groups. The initial focus is on volunteering for the 2012 Games
          and associated sporting and cultural events as part of the Cultural Olympiad. The
          legacy will be a group of people with skills in customer service, volunteering, team
          working etc who will continue to use these skills through work and/ or
          volunteering in their communities so increasing social capital.

          Young people sometimes do not respond to the concept of volunteering but with
          the focus on coaching and recognition this has been addressed. The Personal
          Best programme has been developed to encourage workless and socially
          excluded individuals to gain new skills, engage in their communities, raise their
          aspirations and build self-confidence. It has been piloted in London, where 60-
          70% of participants have gone on to employment or further training, and will be
          rolled out across the U.K. later in 2008. By enabling people, who would otherwise
          not have the skills, to be interviewed as a potential Games volunteer for London
          2012 and signposting them towards jobs and further training opportunities, a
          lasting legacy will be created via this programme.

4         DELIVERY

4.1       DCMS and Sport England

          Following the announcement in November 2007 (by the then Secretary of State
          for Culture, Media and Sport, James Purnell) that Sport England were to develop
          a new strategy to deliver a world class community sport infrastructure and
          sporting excellence, other Government departments and agencies need to
          understand the implications regarding their leadership and investment in the
          wider physical activity agenda. A Treasury-led review of sport and physical
          activity, in response to the Sport England strategy review, is currently underway.
          Increased participation in sport and physical activity remain a top priority for
          Government and form a key part of the London 2012 legacy ambition.

          The East of England Public Health Directorate will continue working with Sport
          England; they are reliant on their infrastructure to promote sport and physical
          activity as part of daily life. Physical activity at a level that promotes better health
          is low across the East of England1. Only 20.5% of the East of England adult
          population take part regularly2 in sport and active recreation (national average of
          21%) and 50% of adults do no regular sport or active recreation. Regular
          participation, by Local Authority, ranges from a high of 26.8% in St Albans to a

1
  Sport England. Active People Survey. London: Sport England, 2006.
2
  Regular participation in sport and active recreation (including recreational walking and cycling) is defined as taking part on at least
three days a week in moderate intensity sport and active recreation for at least 30 minutes continuously in any one session.



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       low of 16.2% in Tendring, with males being more active (range 15.6% to 30.8%)
       than females (13.7% to 26.3%). In addition, socio-demographic trends are evident
       highlighting the need to target priority groups. People with a limiting longstanding
       illness or disability, black and minority ethnic groups and lower socio-economic
       groups show a lower population percentage participating in regular activity.

       Projects are underway to promote the health benefits of sport. These range from
       5-a-day England Athletics road shows for children across the region to conducting
       research into the impact of mass participation events on sustained physical
       activity.

4.2    Aligning the 2012 Games with local priorities

       The diagram below sets out schematically the opportunities to align national
       indicators and local priorities to securing an Olympic legacy. The NRE Executive
       and the county 2012 leads will be well placed to develop these opportunities in
       the run up to the Games.




ref: Katie Huane, Regional 2012 Project Manager




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5       KEY ACTIONS FOR THE NHS

5.1     Workplace health

        Nationally
        The benefits of improving health in the workplace are widely recognised. People
        spend up to 60% of their waking hours either at work or travelling to/ from work,
        and with an increasing number of jobs with high workloads which can contribute
        to stress, it is essential that employee health is considered and promoted through
        the workplace.

        The British Heart Foundation National Centre for physical activity and health has
        reported that:
             physically active employees take 27% fewer days sick than non-active
              employees;
             individual work performance can be improved by between 4% and 15%
              when people engage in regular physical activity; and
             if present trends in obesity continue, one in four people will be unable to fit
              in a standard office chair by 2012.

        Tackling obesity and promoting healthy weight is a key area for the Government.
        Healthy Weight, Healthy Lives3 was published in January 2008 with a focus on
        supporting healthy eating and physical activity.

        Regionally
        Active East4, the East of England‟s physical activity strategy, identifies as one of
        its key themes „an activity-promoting NHS‟. As the largest employer in the region,
        the NHS should strive to be an exemplar organisation in promoting physical
        activity to its workforce.

        The 4th July 2008 saw the launch of the Fit For Business scheme within the SHA,
        appropriately timed to coincide with the 60 th anniversary of the NHS. Fit For
        Business is a workplace health program that supports „workplace health
        champions‟ in encouraging the workforce to become more active, raise
        awareness of workplace wellbeing and promote healthy eating choices. The 2012
        Olympic and Paralympic Games can be used as a catalyst to this end.

        Proposed NHS / SHA workplace health initiative
        It is proposed that the SHA and NHS in the East of England use the London 2012
        Olympic and Paralympic Games as a lever to be included in the proposed healthy
        workplace initiative for their staff. The key message of ‘High Five’ will be
        developed and promoted as the linking theme based on the 5 Olympic rings
        (which represent the five continents involved in the Games) and their colours

3
  Department of Health and Department of Children, Schools and Families. Healthy Weight, Healthy Lives: a Cross-
Government Strategy for England. 2008
4
  Department of Health. Active East: a physical activity framework for the East of England. 2005


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         (black, blue, red, yellow and green):

               5-a-day (fruit and vegetables consumption – e.g. one each of the 5 colours)
               5-a-week (30 minutes of physical activity 5 times a week for adults)
               5-top-tips (to be more active)
               5-top-tips (to lose/ manage weight)
               Try-5 (try 5 new fruit and vegetables and/ or activities from around the
                region, for adults and children)

         Initial thoughts include an awareness campaign, promotional materials,
         signposting to local events, challenges/ tasks etc; appropriately coloured fruit and
         vegetables for the themed rings or appropriately selected healthy food from the
         continents represented by the themed ring. Each ring could also represent an
         illness/ disorder that is commonly seen within the workplace (for example
         coronary heart disease/ stroke, diabetes, cancer, obesity and stress/ anxiety).
         This relates to the delivery of pledges 5 and 8 in Improving Lives; Saving Lives.

         Delivery of the proposal could involve the SHA workplace health champions
         taking the lead for the SHA/ NHS, in line with the Fit for Business workplace
         health program that has been taken up.

         These are preliminary suggestions; further work is needed to scope the initiative,
         subject to SHA approval. A particular challenge will be how best to present and
         promote the project as the Olympic logo, itself, cannot be used. The proposal
         enables the SHA to identify and maximise specific benefits to health for NHS/
         SHA staff by using the Olympic and Paralympic Games as a catalyst for
         delivering improved outcomes within and beyond the workplace. It would also
         provide an opportunity to apply for the Inspire Mark when this becomes available.

5.2      Impact Assessment

         The national cost of physical inactivity is estimated to be £8.2 billion a year – this
         includes direct costs of treatment for the major lifestyle related diseases and
         indirect costs caused through sickness absence.5

         This workplace health initiative will help reduce this impact and enhance the
         health and wellbeing of employees in support of pledge 5 and pledge 8 in
         Improving Lives; Saving Lives.

         With over 2 days of improved attendance per year for those employees who are
         physically active, this equates to a saving of £135 per employee per year.




5
 Department of Health. At least five a week: evidence on the impact of physical activity and its relationship to
health. London: Department of Health, 2004.


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6      RECOMMENDATIONS

       The SHA Board is asked to
          note the progress made to secure a health and well-being legacy from the
            Olympic Games and the Legacy Trust;
          note the leadership and co-ordination provided by the NRE Board and
            supporting infra-structures;
          encourage NHS organisations to review and test their emergency plans in
            the light of the 2012 Olympic and Paralympic Games, with a particular focus
            on regional resilience and mutual aid; and
          approve and support the further development of the High Five initiative of an
            Olympic/ Paralympic theme in relation to workplace health and to champion
            its implementation in the NHS.



DR ROZ COOMBS                                    DR ANNE MCCONVILLE
Regional Physical Activity Co-ordinator          Deputy Director, Head of Health Programmes

11 July 2008




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