Olympic legacy of a better life
NHS London is hopeful the Games will leave a lasting legacy after the athletes depart
We know that participation in sport and physical activity is good for health and reduces healthcare costs. The 2012 Olympic and Paralympic Games are a unique opportunity to boost that participation, but this is not all. They are also a once-in-a-lifetime chance to improve the health system for the whole country.
In 2009, NHS London published Go London: An active and Healthy London for 2012 and Beyond. This strategy set out how we could use the games as a catalyst to improve health in the capital. It aimed to generate a sustainable increase in physical activity and to promote healthier lifestyles up to and beyond 2012. It set out how we would use the celebratory atmosphere of the games to secure an uplift in physical activity, recognised as the “best buy” in public health, with a particular emphasis on the 50 per cent of Londoners who are inactive.
We also recognised that this was not solely our responsibility, nor something we could do on our own. The strategy therefore outlines a partnership approach which has been a consistent theme of our work.
There are marked health inequalities across London, particularly in the Olympic host boroughs of Barking and Dagenham, Hackney, Greenwich, Newham, Tower Hamlets and Waltham Forest. Because of this, delivering this health legacy has been an important focus of the work of NHS London over the past four years. We have learnt much along the way about what works.
Given that in the UK there are 7.8 million people over 55 with long-term conditions such as diabetes or obesity, we can make a sizeable impact if we can improve their activity levels.
Public health clinicians and managers have used interest in the games as a way to tackle these conditions. For example, many patients with a long-term condition such as cardiovascular disease see their ill-health as a barrier to being more active and look to their doctor for permission to do more. My Best Move, a pilot project inspired by the games, provides guidelines to GPs on prescribing exercise for people with long-term conditions. It is already showing promising results and is changing patterns of behaviour among doctors, health practice staff and patients.
The health system
By the end of 2010 we extended our strategy as it became clear that the potential impact of the games was not limited to increasing physical activity. We realised improvements could also be made to the health system that will have a lasting impact beyond 2012.
For example, we have made adaptations to the NHS’s emergency preparedness. The NHS is already excellent at meeting fluctuations in demand for its services during difficult periods such as severe weather conditions or major incidents. Every winter, demand for beds increases but flexibility requires detailed planning. If there are additional patients to be treated, then additional staff are needed, sometimes at short notice.
NHS London has led a comprehensive programme to make sure that this extends to the summer, and that service as usual can continue throughout the games. This has included developing a business continuity strategy and toolkit, providing training and expert support to the local NHS, and undertaking resilience testing for various scenarios. The improvements that this process has brought about will remain in place once the games are over.
Another lasting health legacy of the games that will benefit the entire country is new real-time systems that can flag up and analyse outbreaks of infectious diseases. One, a system for collating anonymous information from patients attending hospital emergency departments, was developed for 2012 but has now been introduced into hospitals around the country. It can detect trends in symptoms via syndromic indicators taken from electronic patient records. The information from this system will improve the speed with which the NHS and the Health Protection Agency respond to outbreaks of infectious disease, as well as incidents such as heat waves.
A healthy commitment
The impact of the games on health was at the core of London’s original bid. This commitment has evolved, and NHS responsibilities, set out in the bid commitments and the host city contract, are for:
- 24-hour ambulance cover at sports venues
- Designated hospitals with emergency services
- Free comprehensive healthcare for athletes, coaches, officials and accredited media who attend the games - known as the Olympic and Paralympic family
- NHS volunteers
- Public health surveillance
- A well-tested emergency response
- “Business as usual” service levels for local people and visitors
- A health legacy
Lessons have been learnt from other events that attract big crowds, and one of the outcomes of this is that we have now planned for more contingencies than there are Olympic sports.
We discovered that 75 per cent of those who seek medical help at such events have respiratory illness, minor injuries or heat-related injuries. Alcohol can also play a part. It was clear to us that considering health promotion at the event planning stage is likely to help. But while there are clear responsibilities for event planners in relation to health and safety, environmental health, emergency services and first aid requirements, until now there has been little official guidance for promoting health behaviours at events. NHS London has therefore published a set of Healthy Event Principles, based on an analysis of best practice from UK and international events. They have been included in NHS London Games Planning packs and shared with 2012 NHS health leads in all local trusts, event organisers and other stakeholders.
These lessons, and the planning that has taken place, should benefit the big UK events of the future. But we too have a duty to document and evaluate our results for future Games cities and other mass events. We are therefore working with UCL to produce a full evaluation of our work, which is due to be published in April 2013.
As NHS London will cease to exist in April 2013, our partnership approach now looks wise. We are not the sole holders of the baton - it can be carried, we hope, by other partners and passed on to new structures within the NHS.
Find out more
The Go London Directory 3rd edition lists a range of projects in London.
Dr Simon Tanner is the regional director of public health, NHS London