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6th August 2020

Gear Change: A cycling revolution in the UK?

The COVID pandemic has demonstrated that the reason people don’t cycle is not because they don’t want to, but because they are normally too scared of the high number of cars on the road. A 2018 survey by the Department for Transport (DfT) revealed that 62% adults believe it is too dangerous to cycle on UK roads1, but, as soon as the motor vehicles were taken away, people appeared and took back the space that had been occupied for many years. Encouragingly this is not just a UK trend – cycling is booming from Bogotá to Beijing2. Last Tuesday, the DfT published Gear Change: A bold vision for cycling and walking3. It has an incredibly supportive foreword from the Prime Minister, Boris Johnson, endorsing the changes proposed in the document. The words are clear and easy to read. It covers all aspects of the changes needed to support a cycling revolution. Gear Change recognises that readjusting the distribution of space to allow people to use the space to walk and use other forms of active transport without fear will improve physical activity, reduce pollution, reduce greenhouse gas emissions from transport and also improves the local economy, and reduces congestion.

A new precedent

The document has some progressive ideas in line with UKHACC requests which will make a big difference to reducing pollution in towns and cities. In addition to a focus on tackling some major disincentives to cycling, by increasing and improving infrastructure, the Government makes a notable commitment to establishing a new precedent for the prioritisation of cycling and walking, saying:

“We will ensure that all new housing and business developments are built around making sustainable travel the first choice for journeys.”

They are also supporting use of cycles to carry freight and ensuring last mile deliveries are made via a consolidation centre to reduce the number of unnecessary journeys by high polluting vans and lorries.  Perhaps most excitingly, Gear Change proposes a zero emission city within the UK, where the entire transport network is electrified in conjunction with an extensive cycle network and a ban on petrol and diesel vehicles in the city centre. Central Government support for endeavours such as this is essential; currently all plans for the introduction of Clean Air Zones (CAZs) in cities across the UK been delayed until 2021 at the earliest.

UKHACC’s Top-3 Active Travel Policies:


Bikes for patients and health professionals

Nice has long supported active travel both to improve the health of staff and patients4, and one of the key recommendations of the BMA guidance to increase physical activity in the population is for the NHS to “act as an ‘anchor institution’ to encourage and facilitate active travel and set an example for other employers”5 As the largest employer in the country, responsible for around 3.5% of all road traffic in England6, ‘setting an example’ in this way would also have a material impact on total UK transport-related emissions. Yet many UK hospitals still have very limited support for staff who use active transport, cycle sheds can be an afterthought at a far corner of the hospital campus, showers and lockers are difficult to access.  Two weeks ago, nearly 200 healthcare staff, including UKHACC Chair Richard Smith, sent a letter to Matt Hancock, calling for an increased commitment to support and incentivise the NHS to use active travel. Staff and students who cycle should be paid an equivalent business mileage. Community teams should be enabled to make visits on electric assist bikes. Deliveries between hospital trusts should be made by cargo bikes. Much more work can be taken to reduce the number of delivery vehicles attending the hospital. NHS England is already working on collecting and spreading sustainable best-practice across the health service through it’s ‘Greener NHS’ decarbonisation programme. The government has talked about “bikes on prescription” from GPs, but secondary care is also a very valuable time for consideration of this. Patients attending diabetes clinics, cardiac rehab, renal failure should be supported to attend by bicycle, as treatment for their disease.  While there will always be a necessity for motor vehicles in certain circumstances, many many journeys can be made actively to support our personal health, the health of those around us and the health of the planet. Health professionals must take the lead by demonstrating the importance and effectiveness of active travel. Cleo Kenington Consultant Emergency & Upper GI Surgeon and ASGBI representative to the UKHACC Council
  1. Department for Transport (2018) Statistical data set. Walking and cycling statistics
  2. BBC (2020) Will Covid-19 make urban cycling more inclusive?
  3. Department for Transport (2020) Gear Change: A bold vision for cycling and walking
  4. NICE (2015) Physical activity: for NHS staff, patients and carers
  5. BMA (2020) Steps to increase physical activity levels in the UK
  6. UKHACC (2018) Moving beyond the air quality crisis
The COVID pandemic has demonstrated that the reason people don’t cycle is not because they don’t want to, but because they are normally too scared of the high number of cars on the road. A 2018 survey by the Department for Transport (DfT) revealed that 62% adults believe it is too dangerous to cycle on UK roads1, but, as soon as the motor vehicles were taken away, people appeared and took back the space that had been occupied for many years. Encouragingly this is not just a UK trend – cycling is booming from Bogotá to Beijing2. Last Tuesday, the DfT published Gear Change: A bold vision for cycling and walking3. It has an incredibly supportive foreword from the Prime Minister, Boris Johnson, endorsing the changes proposed in the document. The words are clear and easy to read. It covers all aspects of the changes needed to support a cycling revolution. Gear Change recognises that readjusting the distribution of space to allow people to use the space to walk and use other forms of active transport without fear will improve physical activity, reduce pollution, reduce greenhouse gas emissions from transport and also improves the local economy, and reduces congestion.

A new precedent

The document has some progressive ideas in line with UKHACC requests which will make a big difference to reducing pollution in towns and cities. In addition to a focus on tackling some major disincentives to cycling, by increasing and improving infrastructure, the Government makes a notable commitment to establishing a new precedent for the prioritisation of cycling and walking, saying:

“We will ensure that all new housing and business developments are built around making sustainable travel the first choice for journeys.”

They are also supporting use of cycles to carry freight and ensuring last mile deliveries are made via a consolidation centre to reduce the number of unnecessary journeys by high polluting vans and lorries.  Perhaps most excitingly, Gear Change proposes a zero emission city within the UK, where the entire transport network is electrified in conjunction with an extensive cycle network and a ban on petrol and diesel vehicles in the city centre. Central Government support for endeavours such as this is essential; currently all plans for the introduction of Clean Air Zones (CAZs) in cities across the UK been delayed until 2021 at the earliest.
UKHACC Top-3 Active Travel Policies:

Bikes for patients and health professionals

Nice has long supported active travel both to improve the health of staff and patients4, and one of the key recommendations of the BMA guidance to increase physical activity in the population is for the NHS to “act as an ‘anchor institution’ to encourage and facilitate active travel and set an example for other employers”5 As the largest employer in the country, responsible for around 3.5% of all road traffic in England6, ‘setting an example’ in this way would also have a material impact on total UK transport-related emissions. Yet many UK hospitals still have very limited support for staff who use active transport, cycle sheds can be an afterthought at a far corner of the hospital campus, showers and lockers are difficult to access.  Two weeks ago, nearly 200 healthcare staff, including UKHACC Chair Richard Smith, sent a letter to Matt Hancock, calling for an increased commitment to support and incentivise the NHS to use active travel. Staff and students who cycle should be paid an equivalent business mileage. Community teams should be enabled to make visits on electric assist bikes. Deliveries between hospital trusts should be made by cargo bikes. Much more work can be taken to reduce the number of delivery vehicles attending the hospital. NHS England is already working on collecting and spreading sustainable best-practice across the health service through it’s ‘Greener NHS’ decarbonisation programme. The government has talked about “bikes on prescription” from GPs, but secondary care is also a very valuable time for consideration of this. Patients attending diabetes clinics, cardiac rehab, renal failure should be supported to attend by bicycle, as treatment for their disease.  While there will always be a necessity for motor vehicles in certain circumstances, many many journeys can be made actively to support our personal health, the health of those around us and the health of the planet. Health professionals must take the lead by demonstrating the importance and effectiveness of active travel. Cleo Kenington Consultant Emergency & Upper GI Surgeon and ASGBI representative to the UKHACC Council
  1. Department for Transport (2018) Statistical data set. Walking and cycling statistics
  2. BBC (2020) Will Covid-19 make urban cycling more inclusive?
  3. Department for Transport (2020) Gear Change: A bold vision for cycling and walking
  4. NICE (2015) Physical activity: for NHS staff, patients and carers
  5. BMA (2020) Steps to increase physical activity levels in the UK
  6. UKHACC (2018) Moving beyond the air quality crisis