GPs must routinely prescribe physical activity to older people, say MPs

GPs must start routinely prescribing physical activity to keep older people healthier for longer, MPs have argued.

In a new report, the House of Commons health and social care committee called for social prescribing of exercise, stronger links between the NHS and leisure providers, and a regulatory duty to ensure exercise is provided in care homes.

The cross-party committee named GPs as a crucial part of the drive to encourage more active lifestyles. GPs could routinely prescribe activities ‘that reflect patients’ individual needs’, such as swimming, yoga or walking groups, it suggested.

In response, the RCGP said that delivering this kind of proactive, preventative care well ‘takes time’ and it is ‘increasingly challenging’ against a backdrop of ‘significant’ workload and workforce pressures.

The report questioned NHS England’s decision to reduce its focus on social prescribing, given the potential benefits. Research by the National Academy for Social Prescribing showed a 42% drop in GP attendance among referred patients, MPs said.

According to Public Health England, 80% of GPs are unfamiliar with the UK Chief Medical Officers’ Physical Activity Guidelines, and 55% had received no specific training on having conversations about physical activity, the report said.

It called for a national framework to support greater social prescribing, plus the rollout of best practice model.

These measures should be supported by a national conversation on healthy ageing, standards around evidence-based exercise programmes, a reversal of cuts to public health spend and a wider rethink of public spaces to physical activity, MPs said.

The committee stressed that regular physical activity cuts the risk of dementia, cardiovascular disease, stroke, type-2 diabetes, musculoskeletal conditions, and some cancers.

Health and social care committee chair Layla Moran said: ‘Promoting active lifestyles among older people would also tackle two policy objectives at once – shifting the NHS’s focus to prevention, and bringing services closer to home, not the nearest hospital.

‘Experts told us that exercise can be more effective than medication, and these changes would also cut the NHS’s vast expenditure on drugs. It’s a win-win.’

RCGP president Professor Victoria Tzortziou-Brown said: ‘GPs and our teams already have a key role in having trusted conversations with our patients about lifestyle and how it can impact on their health. Many of us work with social prescribers, or link workers, in our practices who can recommend activities or schemes in the community to support patients to keep active.

‘However, delivering this kind of proactive, preventative care well takes time – far more than the standard 10-minute consultation many GPs have with their patients – and benefits from continuity of care.

‘Whilst most GPs will always try to offer their older patients the time they need, this is increasingly challenging against a backdrop of significant workload and workforce pressures.

‘The college strongly agrees with the committee that prevention is better than cure and has supported the government’s aspirations to both promote prevention and shift more care out of hospitals and into the community, but prevention requires time, workforce capacity and sustained investment if it is to be delivered effectively.’

A recent study concluded that aerobic exercise – including running, swimming and dancing – may be the most effective way to relieve symptoms of depression and anxiety.

Another study found that the effectiveness of exercise therapy to ease the symptoms of osteoarthritis is likely minimal, short lived, and probably no better than no treatment at all. However, it acknowledged that some patients may consider exercise ‘worthwhile’ even if expected effects are small or absent, for example, to prevent worsening of symptoms.