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GPC acts to end confusion over enhanced services

The Government's drive to make exercise promotion a routine part of GPs' work is based on 'insufficient evidence', its own health advisory body has admitted.

In a blow to ministers, the Health Development Agency said it could not make policy recommendations on exercise 'with any confidence'.

The Government sees exercise advice as a key element of the battle against obesity and is considering it as a quality indicator in the next draft of the contract.

The agency conducted a 'review of reviews' of all the existing evidence on exercise schemes and concluded it was 'still not known' whether GP advice could have any long-term effects.

The report concluded: 'The existing reviews provide insufficient evidence about the effectiveness of health care-based interventions. It is possible expectations of the effectiveness of brief advice and encouragement from a health professional were too high. They may be insufficient to overcome an environment that is ''hostile'' to the behaviours promoted.'

The report did suggest GPs might help increase exercise levels long-term if supported by health trainers, but evidence was 'limited'.

But the Department of Health remained determined to push ahead with exercise promotion, as set out in its public health White Paper. It pointed to evidence for short-term benefits of referral to an exercise specialist and said it hoped the first accredited health trainers would be in place by 2006.

GPs said advising patients on exercise was not a good use of their time or resources.

Dr Gill Jenkins, a GP in Bristol with a special interest in obesity, said: 'Obesity is a medical problem, but is getting people to be more active the role of GPs?'

By Nerys Hairon

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