Maximizing Returns: The Economic Impact of Physical Activity and Sport

2. What’s it really worth?: Return on Investment for Physical Activity and Sport Suzanne Gardner Senior Health Manager

3. Types of Return on Investment Economic Analysis • 2. Where benefits are expressed in monetary units • Cost-benefit • Social Return on Investment • Where benefits are expressed in ‘natural’ units • Cost-consequence • Cost-effectiveness • - Cost-utility £ per outcome £ per improvement in mental health £ per person physically active £ per symptom free day £ per QALY Little philosophical distinction – but often significant technical differences Direct comparison Cost of life (cost of death) Value of outcomes in £ Source: ICF GHK Training Manual

4. Principles for Social Return on Investment • Involve Stakeholders • Understand what changes • Value the things that matter • Only include what is material • Do not over claim • Be transparent • Verify the result

5. GHGIS Cost Effectiveness: April 2013 – July 2014: Delivery costs • 15 Projects to increase the evidence base for sports role in decreasing inactivity. • Cost per head to engage a participant: £88.31 • Cost per head to engage inactive people: £235.99 • Cost per head to get participant to 1 x 30 through sport: £617.72 These figures are taken from interim data and do not represent final figures and as such should be used with caution Creating a sporting habit for life

6. Cost Utility ROI Examples Brief Interventions in Primary Care • Costs between £20 – £440 per QALY • Net costs saved per QALY gained £750 - £3,150 • Cost Savings of up to £3,300 per person LEAP • Costs between £50 - £510 per QALY • Costs Savings of up to £4,900 per participant Exercise Referral – Welsh Trial • Cost of £12,111 per QALY • Cost Saving of £367 per QALY for completers.

7. Birmingham BeActive • Cost-Benefit Analysis • City wide Gym, Swim and Exercise for Free Programme • Focuses on: - health benefits of PA, - decreased smoking - subjective well being • The health care cost savings, health related quality of life gains, and productivity gains make up the ROI. • It was assumed Be Active users stay in the scheme for five years. Some of the Facts • Population of 1.1 million • 300,000 residents signed up to the scheme • 140,000 regular users • 75% were not previously members of the facilities • The unit cost of Be Active is £33.80 per person per annum. Source: Matrix evidence 2011 Creating a sporting habit for life

8. The Analysis • For every £1 spent on Be Active the return for the local NHS is £22.80 • For every £1 spent on Be Active the return for the Local Authority is £2.30 • The cost of Be Active per QALY gained is £1,164.60 Every £1 invested in Be Active generates on average £21.30 in benefits. Creating a sporting habit for life

9. How was the information used • Business Case for continued funding • Economic pressures on Local Authorities • Been in existence since 2008 • Revision of the offer • Development of an Active Parks Programme Creating a sporting habit for life

10. Dame Kelly Holmes Trust https://www.youtube.com/watch?v=PDLKDzr_G1U Source: Dame Kelly Holmes Trust

11. Cost Utility Analysis: NICE Comparison

12. “If physical activity was a drug it would be regarded as a miracle”. Professor Dame Sally Davies, 2011 “If a medication existed that decreased the risks of chronic disease to a comparable extent, it would undoubtedly become one of the most widely prescribed drugs within the NHS.” Prof Sir Liam Donaldson Chief Medical Officer’s annual report 2010

13. In Summary • There are a number of ways of calculating ROI, select the right approach for your audience. • The narrative is as important (if not more so) that the £ signs when considering ROI. • Be aware of the caveats and assumptions made within the data. • Do not use data if you do not believe that you can defend it • Physical Activity and Sport is a commissionable commodity with high returns of investment in terms of £’s, QALY’s and Communities.