1. Creating a sporting habit for life

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

3. Creating a sporting habit for life Types of Return on Investment Economic Analysis 2. Where benefits are expressed in monetary units Cost-benefit Social Return on Investment 1.Where benefits are expressed in ‘natural’ units Cost-consequence Cost-effectiveness - Cost-utility Little philosophical distinction – but often significant technical differences Direct comparison Cost of life (cost of death) Value of outcomes in £ £ per outcome £ per improvement in mental health £ per person physically active £ per symptom free day £ per QALY Source: ICF GHK Training Manual

4. Creating a sporting habit for life 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 4

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 Creating a sporting habit for life 5 These figures are taken from interim data and do not represent final figures and as such should be used with caution

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 6 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. Creating a sporting habit for life 7 Source: Matrix evidence 2011

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 Creating a sporting habit for life 8 Every £1 invested in Be Active generates on average £21.30 in benefits.

9. Creating a sporting habit for life 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 9 Creating a sporting habit for life

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

11. Creating a sporting habit for life Cost Utility Analysis: NICE Comparison 11

12. Creating a sporting habit for life “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 12

13. Creating a sporting habit for life 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. 13

14. Creating a sporting habit for life