Physical activity in the UK: a unique crossroad?

912 Br J Sports Med October 2010 Vol 44 No 13 £1 million across the UK, and GPs have proved adept at reaching QOF targets.6 GPs are not trained to give lifestyle modifi cation advice, but last year QOF included physical activity for the fi rst time under a ‘cardiovascular risk assessment and management’ indicator. Specifi cally, 40–70% of newly diagnosed hypertensive patients should be ‘given lifestyle advice in the last 15 months for: increasing physical activity, smoking cessation, safe alcohol consumption and healthy diet.’ Smoking and diet are already included elsewhere under QOF, and the lack of emphasis on physical activity as an individual indicator provides mixed messages, negating its fundamental importance and rendering its promotion an afterthought. As things stand, QOF will not change in 2010/2011 because of unique circumstances relating to swine fl u costs and implications.7 Nevertheless, evidence shows that even brief interventions (3–10 min) or simple pedometer-based programmes delivered through health professionals can lead to substantial increases in patients’ activity levels (by ~30%).8 Lawton et al9 have shown in a randomised controlled trial (RCT) that physical activity promotion can improve behaviours in general practice care when coordinated with exercise on referral, which is widely accessible in the UK. Regular intervention built on existing real, longstanding primary care relationships may have a signifi cant impact and effect on patients. It seems illogical that physical activity interventions in primary care remain neglected and unrewarded at the expense of other ‘recognised’ risk factors, which are all symptoms of physical inactivity. Further objective research with greater consideration of methods and interventions with reliable outcome measures, which can be applied in real life, is needed.