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Obesity management 'should be included in QOF'

GPs should be incentivised to manage obesity more effectively and regard each patient consultation as an opportunity to deal with weight issues, says a report from the Royal College of Physicians (RCP).

The ‘Action on Obesity’ report said GPs should ‘where possible and appropriate’ try to intervene to encourage healthier lifestyles, with evidence-based targets included in QOF.

It also said that GPs should be trained in motivational interviewing in order to meet the NHS’s stated aim of ‘making every contact count’ in terms of dealing with lifestyle issues.

The report comes after the GPC said several of the QOF indicators incentivising practices to promote better lifestyle choices that Government wants to impose on practices were ‘unworkable’. It also comes after NICE released draft guidance that said GPs should screen all adults for their exercise habits and offer advice to those not sufficiently active.

GPs will also be mandated to ‘make every contact count’ to ensure their patients are leading healthier lives under proposed changes to the NHS Constitution, in a change of emphasis supported by the RCP report.

It said that GPs should ‘where possible and appropriate, deal with weight issues as part of their agenda to address risk factors’.

It also said primary care had a ‘core responsibility’ to prevent obesity and that ‘each consultation provides a potential opportunity for this.’

The report concludes: ‘It is therefore important that GPs have training in a range of practical behaviouiral techniques such as motivational interviewing.

‘The effective application of these skills to weight management and obesity should be part of GP training and ongoing professional development. Inclusion of evidence-based targets for successful obesity management should be included in the QOF in order to support this practice.’

Professor John Wass, chair of the working party and academic vice-president of the RCP, said: ‘Britain is getting bigger and whilst we try to prevent the increase in obesity, we must also prepare the NHS for the influx of patients presenting with severe complex obesity. A patient may arrive at my hospital with coronary heart disease, but if the root cause of their condition is obesity, we must be equipped to deal with that root cause.’

It comes as NICE QOF lead Dr Helen Lester has spoken out to say that a QOF indicator that would see GPs promoting exercise habits is workable in practice.

 

Readers' comments (7)

  • My scream is WAY too big (obese) to come out my mouth...

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  • I am a GP and I am overweight despite all my good intentions and efforts.

    If I cannot control my weight, how can I control my patients' ?

    Indeed, the stress of general practice is making my weight problem worse. Pressured eleven hour days are not conducive to good eating habits or taking exercise.

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  • Peter Swinyard

    Another "fatuous" "GPs should" sort of comment. I would invite the originator to spend a day in my practice coping with my existing workload - but, of course, he is not qualified to do the immensely complex job of a GP, only having to know about one lot of diseases. So that would be a fat lot of good. (by the way, I can think of quite a lot of "physicians should" advice if he is short of something to do....)

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  • And the minimum effective length of a motivational interviewing session?
    I don't personally know but I suspect it is longer than the current consultation average.
    The most motivated sucessful longterm weight loss in my practice population seems to be those in the commercial diet and slimming support groups, the least successful the private "pop a pill" medically led sliming clinic.

    It seems to me the
    " I think my weight is someone elses problem to sort out ,so I don't have to try myself"
    mentality with no detectable outcome may be the predictable consequence of "GP ising" weight.

    I must declare an interest ;I suspect I may be on the "compulsory gastric staplling list" of the health facists who require GP's to be vegetrarian olympic fitness standard paragons of virtue to "set the example".

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  • Mark Struthers

    What is a healthier lifestyle anyway? I don't think the food and drug cartels or QOF mafia have honestly sorted out the evidence base. Here, a GP from Hertfordshire provides a compelling list of the evidence on why the western world is fat, and what could possibly be done about it.

    http://www.bmj.com/content/345/bmj.e7666/rr/619241

    All that can be said with certainty is that "QOF is fatuous".

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  • What was that about no new work without new money?

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  • NO NO and NO. Stop medicalising obesity. Slimming World and Weight Watchers are the options for managing obesity not GPs. Which Office boy thought this one up? If government wants to get involved then look at food "fat" tax. not divert a Lifestyle issue into our world.

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