Official guidance has recommended that patients should speak to their GP ‘before starting any exercise plans’ over the winter.
NHS England, the UK Health Security Agency (UKHSA) and the Met Office’s joint cold weather plan for England, updated this week, made the recommendation as part of its advice for the general public.
A section entitled ‘main public health messages’ said that individuals should ‘look after [themselves] by… if possible, trying to move around at least once an hour, but remember to speak to your GP before starting any exercise plans’.
It added that they should contact their GP or pharmacist if they think they or someone they care for might qualify for a free flu jab.
And it recommended that individuals receiving social care or ‘health services’ should ask their GP, key worker or ‘other contact’ about ‘staying healthy in winter and services available’ to them between 1 November and 31 March.
Meanwhile, the document set out various measures GP practices should take at each cold weather alert level.
These include considering ‘training on seasonal weather and the identification of vulnerable individuals’ for staff as part of year-round planning.
GPs should be supported to ‘identify vulnerable patients and clients on their practice lists’, it added.
The document said: ‘All local organisations should consider this document and satisfy themselves that the suggested actions and cold weather alerts are understood across the system and that local plans are adapted as appropriate to the local context.
‘NHS and local authority commissioners should satisfy themselves that providers and stakeholders will take appropriate action according to the cold weather alert level in place and their professional judgements.’
GP Survival chair Dr John Hughes said the advice for patients to speak to their GP before starting any exercise plans is ‘absolutely ridiculous’ and could lead to a ‘substantial increase’ in workload for GPs.
He told Pulse: ‘It’s absolutely typical of the idiocy that comes out of NHS England from people who don’t understand what GPs actually do.
‘They give out all this advice to the public without any consideration or any risk assessment as to what the implications of saying these things are.’
He added: ‘Given the fact that people are likely to be trying to keep warm by exercising, there may well be a substantial increase in numbers presenting with this if people actually see this. It’s absolutely ridiculous.’
And he warned that patients may ‘get upset’ when GPs suggest that they are ‘neither trained nor indemnified to do it’ and that if they do provide advice ‘they will have to pay for the letter’.
Dr Hughes said: ‘The contract is to see patients who are ill or believe themselves to be ill. Pronouncing fitness for exercise is not any part of the GMS contract.
‘If NHS England wishes GPs to fulfil that role on top of all the other roles they are doing and despite the pressures on GP appointments, then they would need to be negotiating an additional payment for this.’
Cold weather guidance for GPs and their staff
Level 0: year-round planning
- be aware of emergency planning measures relevant to general practice
- promote flu immunisation to both staff and patients
- ensure GPs and practice staff members are aware of local services to improve warmth in the home
- consider training on seasonal weather and the identification of vulnerable individuals to help staff be more aware of the effects of cold weather on health; those groups of patients likely to be most vulnerable; and how they can signpost patients on to other services
- consider utilisation of tools to aid systematic identification of vulnerable individuals
- consider using opportunistic approaches to signpost appropriate patients to other services when they present for other reasons. For example, flu vaccination clinics can be an opportunity to promote core public health messages with vulnerable individuals
Level 1: winter preparedness and action programme 1 November to 31 March
- staff training should include a specific session on the cold weather plan and cold weather resilience where required, relevant and appropriate to local conditions
- consider how you can promote key public health messages in the surgery; for example, take advantage of clinical contacts to reinforce public health messages about cold weather and cold homes on health
- get a flu jab to help protect you and your patients
- consider using a cold weather scenario as a tabletop exercise to test your business continuity arrangements
- be aware of systems to refer patients to appropriate services from other agencies
- when making home visits, be aware of the room temperature in the household, and if required, know how to advise on levels that are of concern and as necessary, to signpost to other services
Level 2: severe winter weather is forecast – alert and readiness
(Mean temperatures of 2°C and or widespread ice and heavy snow predicted with 60% confidence)
- take advantage of clinical contacts to reinforce public health messages about cold weather and cold homes on health
- when prioritising visits, consider vulnerability to cold as a factor in decision making
Level 3: response to severe winter weather – severe weather action
(Severe winter weather is now occurring: mean temperature of 2°C or less and or widespread ice and heavy snow)
- be aware of a possible surge in demand in the days following a cold spell
- ensure that staff members are aware of cold weather risks and are able to advise patients appropriately
Level 4: major incident – emergency response
(Central Government will declare a Level 4 alert in the event of severe or prolonged cold weather affecting sectors other than health)
- continue actions as per Level 3 unless advised to the contrary