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GPs to quiz adults on exercising

GPs should quiz all adult patients about their levels of physical activity and offer advice to inactive people, under new NICE recommendations published this week.

GPs should quiz all adult patients about their levels of physical activity and offer advice to inactive people, under new NICE recommendations published this week.

In its first public health guidance, NICE said GPs should take the opportunity to identify inactive adults 'whenever possible'.

Primary care professionals should advise patients to aim for 30 minutes of moderate activity five or more times a week, help set goals, and follow up individuals 'at appropriate intervals' over a three- to six-month period.

A Department of Health questionnaire will be available shortly to help practices identify which patients would benefit from advice.

The guidelines warned against the use of exercise referral schemes, pedometers and walking and cycling schemes unless they were part of a research study.

GPs said they did not have time during consultations to tackle public health issues and called for more resources.

Dr Shaun O'Hanlon, a GP in Guildford, Surrey, said the time GPs spent implementing the guidance would be very challenging.

'This is going to increase the pressure on us to make our consultations longer. It makes it more difficult to offer as many appointments as we need.'

But Dr Matt Kearney, a member of the independent public health interventions advisory committee at NICE and a GP in Runcorn, Cheshire, denied the guidance would increase workload.

'A lot of this opportunistic health promotion is what we do on a day-to-day basis. It gives us evidence-based confidence that what we are doing is right. I don't actually believe that this will create a lot more work.'

He added the guidance advised being sensitive to patients' needs: 'Clearly it could have a counter-productive effect if we hassle every patient every time they come through the door.'

Dr David Haslam, clinical director of the National Obesity Forum and a GP in Watton-at-Stone in Hertfordshire, welcomed the move to promote physical activity.

But he added: 'It will take an enormous amount of time. What we need are resources in order to do what we all know is beneficial.'

NICE is to produce a costing report and implementation advice later this month.

nhairon@cmpinformation.com

NICE recommends:

· GPs and primary care staff should identify inactive adults and advise 30 minutes of moderate activity five days a week or more.

· Judgment should be used to determine when advice would be inappropriate.

· A validated tool, such as the Department of Health's forthcoming GP physical activity questionnaire, should be used to identify inactive patients.

· GPs and other staff should take into account patient circumstances, agree goals with patients, provide written information on local opportunities, and follow up at intervals over three to six months.

· Exercise referral schemes, pedometers and walking and cycling schemes should only be recommended if they are part of a research study.

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