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DH to mandate GPs to encourage lifestyle change every time they see patients



The Government is set to include a statutory duty in the NHS Constitution for GPs to ‘make every contact count’ to ensure their patients and colleagues are leading healthier lives, despite concern it will be used for performance management.

In a document summarising the responses to their consultation on the proposed changes, the Department of Health concluded that mandating NHS staff to ‘maximise opportunities’ at each contact on health and wellbeing would be a ‘welcome’ change to the constitution.

But the DH admitted a ‘significant’ number of respondents were concerned about its implementation and enforcement, voicing concerns about whether this would be used as a tool for performance management.

The duty was first suggested by the NHS Future Forum last January to require GPs to ask about diet, smoking, exercise and drinking habits, but was described at the time by the RCGP as a ‘muddled’ idea.

But the DH looks set to push ahead with the change, after holding a consultation on the plans, and despite it admitting a ‘a significant number of respondents were concerned about how the practical implementation and enforcement of “making every contact count” will occur’.

There were also concerns about possible extra workload, whether the proposal could be achieved with the current resources, whether staff would require extra training, and whether it would be hypocritical for unhealthy staff to advise patients on healthy living.

Another said that it would improve health outcomes for patients and could have a ‘profound impact on service users’ by making them feel ‘valued on an individual basis by staff and service providers’.

The DH said it had concluded from the consultation that: ‘health professionals are very well placed to support patients with wider support around their health and wellbeing… A more holistic approach which maximizes opportunities for each contact is therefore to be welcomed in the NHS Constitution.’

Dr Andrew Mimnagh, chair of Sefton LMC, said he was concerned about how this proposal, which he supported in principle, would be implemented.

He said: ‘The aspiration, the principle is fine. But it’s often in the implementation that the DH falls down.

‘If it’s saying that everyone in the NHS should take to have a responsibility to encourage to empower patients, explain that the accepted conduct in a society with a national health service is that there is a demand to take their social obligation to look after their health seriously – fine. I welcome that the DH are picking up on what holistic care has been provided since long before I qualified.

‘But if the NHS are doing a Virgin airways style: “Did you smile at the patient?”, “How long for?”, “What was their response?” and instead of it being an ethos that pervades the organization it becomes a tick box exercise with 48-page long forms, then it’s a worry.’

The proposal comes after the RCGP has endorsed a recommendation to include the referral of patients to weight management in the QOF, as part of a programme of changes to reduce obesity in the UK.