GP consultations not long enough to provide advice on exercise, says RCGP

GPs are less likely to ask patients about physical activity because 10-minute appointments are 'unfit for purpose', the RCGP has said, after researchers warned most GPs are unfamiliar with guidelines on exercise.

Just one in five (20%) are broadly or very familiar with national guidelines on physical activity, research published in the British Journal of General Practice (BJGP) sugggests.

The study, conducted by Public Health England, included responses from 1,100 GPs. It found that many self-reported a lack of confidence in raising the issue with patients – and this correlated with their familiarity on guidelines.

Some 70% were aware of the general practice physical activity questionnaire (GPPAQ) – recommended by NICE to identify patients who require intervention – while 26% were not familiar with any physical activity assessment tools. Around 70% said they did not use these tools in practice.

The RCGP warned that the use of these tools was ‘being stifled’ by the constraints of 10-minute consultations, which it said were ‘increasingly unfit for purpose’.

RCGP chair Professor Helen Stokes-Lampard said: ‘GPs will always consider a patient’s lifestyle – along with other physical, psychological and social factors that might be affecting their health – when making a diagnosis and developing a treatment plan, and this often will include conversations about their weight and lifestyle choices.

Physical activity

‘It’s really important that GPs and our teams are aware of up-to-date clinical guidelines around physical activity – and the tools available to us to best implement them in the best interests of our patients – so it is clear from this research that more needs to be done by Public Health England and others to ensure these resources are readily available to GPs.

‘What is also clear is that when GPs are aware of these tools – as the majority are – use of them is being stifled because of a lack of time and resources to do so effectively, particularly within the constraints of the standard 10-minute consultation, which is increasingly unfit for purpose, especially for patients with complex health needs.

‘The RCGP is certainly playing our part in supporting GPs and our teams to encourage patients to live healthier lives – we have made physical activity and lifestyle a clinical priority, and are producing a toolkit of educational resources for this purpose.

‘We are also developing an "active practice" model, to encourage GPs to talk more with patients about exercise, and work closely with local physical activity providers in the community.

‘Ultimately, we need the pledges in NHS England’s GP Forward View, including £2.4bn a year for general practice and an extra 5,000 full-time equivalent GPs by 2020, to be delivered in full and as a matter of urgency so that GPs can spend longer with our patients and inspire them to make improvements to their lifestyle, in the best interests of their long-term health and wellbeing.’

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