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GPs should promote public health in every consultation

Adrian O'Dowd

Tuesday, 10 January 2012

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All GPs and NHS staff should have a new responsibility to promote healthy living in every consultation with patients, claims a new government commissioned report published today.

The NHS Future Forum, the panel of experts commissioned by the government to come up with recommendations on how to improve the NHS, has published a second set of reports.

One of the reports on the role of the NHS in public health, proposes that every healthcare professional should “make every contact count” by using every contact with the public to help them improve their health – focusing on lifestyle  factors such as diet, physical activity, alcohol and smoking.

This should become a core staff responsibility in the NHS Constitution, says the report, which also calls on the NHS to do more to prevent poor health, reduce health inequalities, but also help the NHS workforce of 1.4 million to live healthily and spread healthy messages with family, friends and patients.

The NHS Future Forum has given its second set of reports to health secretary Andrew Lansley and sets out a series of recommendations to improve the quality of patient care and achieve better outcomes.

Chaired by the former RCGP chair Professor Steve Field, the Forum looked at four areas – the NHS’s role in the public’s health, information, education and training, and integration.

Over four months the Forum listened to more than 12,000 people and attended more than 300 events.

Professor Field said: “We are making robust and ambitious recommendations to the NHS and to government. We have heard an enormous amount of support for the shift to patient centred care but also frustration that this has not yet been achieved. This must now become a reality for patients across England and health and social care professionals must lead the way.”

The Department of Health said it was going to accept all of the Forum’s new recommendations.

On public health, the Department said it would consult on a new responsibility for healthcare professionals to promote healthy living through their daily contact with patients.

However, RCGP chair Dr Clare Gerada was sceptical about how useful such an approach would be and concerned that it might put people off seeing their GP.

“There's some evidence for low level drinkers and for smoking that brief intervention works. But for exercise and obesity the evidence is minimal,” said Dr Gerada.

“We need a population based approach - looking at issues like pricing and advertising.

“We already look for opportunities to offer advice, but the idea that every consultation will have to address these four concerns may deter patients from coming in the first place. The discussion must be based on the patient's agenda, and we should prize open these other issues only if it feels appropriate.”

Other Forum recommendations included the proposals that:

  • patients should have access to their online GP held records by the end of this Parliament
  • the NHS should move to using its IT systems to share data about individual patients and service users electronically in the interests of high quality care
  • the Government should set a clear deadline by which all information about clinical outcomes is put in the public domain
  • integration should be defined around the patient, not the system
  • local commissioners and providers should be given freedom and flexibility to “get on and do” – through flexing payment flows and enabling planning over a longer term.

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