Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding.

1.1 Strategies, policies and plans to increase physical activity in the local environment

1.1.1 Develop and use local strategies, policies and plans to encourage and enable people to be more physically active. Use information from sources such as the joint strategic needs assessment and local cycling and walking implementation plans. Follow established best practice to ensure everyone's needs are identified and addressed, including those of people with limited mobility. [2018]

1.1.2 Use community engagement approaches to develop and review these local strategies, policies and plans:

  • Take account of the views and needs of people who walk, cycle, drive or use public transport in the local area, particularly in relation to shared or contested space. (For example, space shared by pedestrians and cyclists, or cyclists and motorists.)

  • Take account of the views and needs of people with limited mobility who may be adversely affected by the design and maintenance of streets, footways and footpaths and urban and rural public open spaces.

  • Take account of the views of voluntary and community sector organisations.

  • Assess whether initiatives successfully adopted elsewhere are appropriate locally and, if they are, how they can be adapted to local needs. [2018]

    For more information see NICE's guideline on community engagement.

1.1.3 Develop and put policies into place to ensure people with limited mobility can safely move along and across streets and in public open spaces:

  • Adopt a consistent approach to permanent or temporary obstructions. This may include vegetation, vending boards, bins, parked cars, scaffolding and street furniture.

  • Ensure that there are enough pedestrian-controlled crossings, and that they all incorporate accessibility features. Also ensure that signal-controlled crossings give enough time to cross the road safely.

  • Provide accessible temporary crossings during street and road works (see the Department for Transport's Safety at street works and road works).

  • Use and maintain tactile paving and dropped kerbs correctly (see the Department for Transport's guidance on the use of tactile paving surfaces).

  • Provide step-free access or, where this is not possible, clearly signposted accessible alternatives. [2018]

1.1.4 Ensure planning permissions always prioritise the need for people (including people with limited mobility) to be physically active as a routine part of their daily life, for example ensuring access on foot to local services such as shops and public transport stops.

For more information see Public Health England's Spatial planning for health report. [2018]

1.1.5 Ensure children, young people and their families and carers can be physically active, for example when playing and when travelling to school, college and early years settings. [2018]

1.1.6 Use existing health impact assessment tools to assess in advance what impact (both intended and unintended) any proposed changes are likely to have on physical activity levels. For example, will local services be accessible on foot, by bike, and by people with limited mobility? Make the results publicly available and accessible. [2018]

See how the committee made recommendations 1.1.1 to 1.1.6.

1.2 Active travel

1.2.1 Identify and prioritise local areas where there is a high potential to increase travel on foot, by bicycle, or by other forms of active travel. Base this on demographic data, travel surveys, land use mix and other sources of local information. Take into account views identified through community engagement (see recommendation 1.1.2). [2018]

1.2.2 Increase physical activity associated with using public transport services. This includes encouraging use of these services by:

  • Ensuring available services are reliable, particularly in rural areas where public transport may be more limited.

  • Making information about public transport services accessible to people with visual and hearing impairments, for example provide spoken and visual announcements about destinations and stops on board services, and at stops and stations.

  • Making public transport physically accessible to everyone (see the Department for Transport's guidance on inclusive mobility).

  • Improving public transport to parks and other green and blue spaces. [2018]

1.2.3 Ensure new and refurbished footways, footpaths and cycle routes link to existing routes and improve the connectivity of the network as a whole. Aim to make it as easy as possible for people to walk, cycle or use other forms of active travel rather than making short journeys by car. This includes journeys between residential areas and:

  • public transport stops and stations

  • places of work

  • public open spaces

  • schools, colleges and early years settings

  • healthcare services

  • shops, and leisure sites. [2018]

1.2.4 Ensure footways, footpaths and cycle routes are convenient, safe and appealing to users, and are built and maintained to a high standard. For example, ensure:

  • they are even and do not include any hazards, for example from tree roots, pot-holes, broken paving slabs or seasonal and weather-related obstructions

  • they have enough lighting to make people feel secure

  • they are free from permanent or temporary obstructions, where possible (see recommendation 1.1.3)

  • they are not hidden by overgrown or poorly managed vegetation

  • they have clear signs to help people find their way.

    Work in association with relevant third sector organisations and volunteers to plan and carry out this work.

    For more details, see the Department for Transport's guidance on inclusive mobility and the Traffic signs manual. [2018]

1.2.5 Ensure pedestrians, cyclists and users of other modes of transport that involve physical activity are given the highest priority when developing or maintaining streets and roads. (This includes people with limited mobility.) Use 1 or more of the following methods:

1.2.6 Improve cycling infrastructure using information from people who walk, cycle, and drive in the local area, including those with limited mobility (see recommendation 1.1.2). Improvements may include:

1.2.7 Make it as easy as possible for people with limited mobility to move around their local area, and work with relevant third sector organisations to achieve this. For example:

  • Ensure footways:

    • have even, non-reflective, anti-glare surfaces

    • are free from unauthorised and unnecessary obstructions (whether permanent or temporary) including being free from pavement parking (see recommendation 1.1.3)

    • are set back from traffic, if possible (for example, by a grass verge).

  • Ensure footways that have a kerb clearly define the kerb with a change in level (apart from pedestrian crossings).

  • Ensure pedestrian crossings have flush kerbs and tactile paving (see the Department for Transport's guidance on the use of tactile paving surfaces).

  • Ensure signal-controlled crossings have tactile rotating cones and, if appropriate, an audible beep, and give enough time to cross the road safely.

  • Ensure tactile paving is correctly installed and maintained where it is needed, for example at all crossing places, at the top and bottom of stairs, on the edge of railway platforms and on shared use routes (see the Department for Transport's guidance on tactile paving surfaces).

  • Ensure seating is provided at regular intervals along footways that are key walking routes (see the Department for Transport's guidance on inclusive mobility). [2018]

1.2.8 Improve routes that children, young people and their families and carers use, or could use, for active travel to school, college and early years settings. Focus on improving safety, accessibility, connectivity, sustainability and appeal to users. [2018]

1.2.9 Consider improving access routes to school, college and early years settings by:

See how the committee made recommendations 1.2.1 to 1.2.9.

1.3 Public open spaces

1.3.1 Consider ways to enhance the accessibility, quality and appeal to users of local open spaces, especially green and blue spaces, to increase their use. Focus particularly on communities who may not currently use them, for example those with low mobility, low income communities and some black and minority ethnic communities. Consider, for example, providing:

  • facilities that help people of all cultures and backgrounds to feel safe and welcome, for example by providing safe areas in which children can play and picnic facilities

  • lighting and other measures to prevent or reduce antisocial behaviour, such as maintaining vegetation

  • clear signs that can be understood by everyone, including people with visual impairments and learning disabilities

  • seats with arms and backrests, sited at frequent intervals

  • shelter and shade

  • accessible toilets that are clean, well maintained and unlocked during daylight hours

  • footpaths with even, non-reflective, anti-glare surfaces and tactile paving

  • access by public transport, on foot and by bike (including providing cycle parking)

  • car parking for blue badge holders and other people with limited mobility. [2018]

1.3.2 Ensure open spaces and footpaths are maintained to a high standard. [2018]

1.3.3 Involve community groups and volunteers in decisions on how to design and manage public open spaces, including trails, footpaths and towpaths. Encourage them to help maintain them, for example by reporting any problems affecting use and accessibility (see NICE's guideline on community engagement). [2018]

See how the committee made recommendations 1.3.1 to 1.3.3.

1.4 Buildings

1.4.1 Ensure different parts of campus sites (including those in hospitals and universities) are linked by accessible walking and cycling routes. [2008]

1.4.2 Ensure new workplaces are linked to walking and cycling networks. Where possible, these links should improve the existing walking and cycling infrastructure by creating new through routes (and not just links to the new facility). [2008]

1.4.3 During building design or refurbishment, ensure staircases are designed and positioned to encourage people to use them. [2008]

1.4.4 Ensure staircases are clearly signposted and are attractive to use. For example, they should be well lit and well decorated. [2008]

See how the committee made recommendations 1.4.1 to 1.4.4.

1.5 Schools

1.5.1 Ensure school playgrounds are designed to encourage varied, physically active play. [2008]

1.5.2 Primary schools should create areas (for instance, by using different colours) to promote individual and group physical activities such as hopscotch and other games. [2008]

See how the committee made recommendations 1.5.1 to 1.5.2.

Terms used in this guideline

This section defines terms that have been used in a specific way for this guideline. For general definitions, please see the glossary.


Two or more related buildings set together in the grounds of a defined site.


Signal-controlled crossings: these include puffin, pelican and toucan crossings. They have traffic signals for both vehicles on the carriageway and people crossing it.

Pedestrian-controlled crossings: these include both signal-controlled crossings and zebra crossings.

Accessible crossings: these have dropped kerbs that are flush with the carriageway, and tactile paving. Those with signals also have tactile rotating cones and, if appropriate, an audible beep. These characteristics are accessibility features.

Although these are the definitions of crossings which are used in this guideline, various other definitions exist with more detailed technical specifications. For these, see Schedule 1 of the Traffic Signs Regulations and General Directions 2016.

Contested space

A geographical space that is used for different purposes, potentially causing conflict because each type of user has differing priorities.

Limited mobility

People whose mobility is limited, either temporarily or in the long term, because their environment is not adapted to meet their needs. Examples may include:

  • some disabled people, including people with sensory impairments or learning disabilities

  • people using wheelchairs, cycles or other mobility aids, or those supporting people using these aids

  • some older or frail people

  • people using buggies, prams or cargo cycles for transporting children

  • people with conditions such as chronic pain or neurological conditions

  • some people with mental health conditions.

  • Public Health England