By Ann Gates, MRPharmS,CEO Exercise Works! Member of the World Heart Federation Emerging Leaders Programme 2014/15.
The role of Allied Health Professionals (AHPs) in the prevention and treatment of non-communicable diseases (NCDs) has never been more critical 1.
The health burden of illness, pain, health inequalities, disability and death from Great Britain’s top 3 main causes of disease: cardiovascular disease, cancer, and respiratory disease, are the nation’s biggest concerns for the future.2 These tomorrows, are dependent on providing personalised patient care and in managing the overall health economy. We already see the loss of 37,000 lives through physical inactivity alone3 yet the evidence for physical activity,exercise, sport and active leisure pursuits in preventing and helping to treat these diseases is strong4. In fact, physical activity advice is a core aspect of Public Health England’s vision for the framework of personalised care for all patients.5 This provides the opportunity for all nurses, midwives and AHP’s to provide brief intervention on physical activity,and make an immediate and potentially lifelong difference to patient health outcomes.
So what do we know, and what are the barriers and enablers to making every contact count for physical activity advice?
We know from previous studies (mainly with doctors, but transferable to other professions) that knowledge, training and limited time within the patient contact, are key barriers.6 We also know that the National Institute of Health and Care Excellence (NICE) produced specific guidance (PH44, 2013)7on physical activity advice in primary care: suggesting 5 key actions7 for the NHS workforce to overcome these barriers. So the barriers become implementing all these policies, into daily, clinical practice. But to do that, safely and effectively, our workforce needs to be trained to provide these “teachable moments”.8
The NHS workforce needs to know the evidence for the prevention and treatment of disease, with physical activity. And they need to be confident, competent and capable of engaging patients within that brief intervention. And here lies the biggest barrier….
The knowledge that exercise works is critical. Doctors, nurses and AHPs that are trained in physical activity advice, can “move mountains” when it comes to ensuring best patient care- for example, an oncology physiotherapist would have no problem in supporting patients through chemotherapy side effects,using exercise training as a treatment. But what if a dietitian, pharmacist,occupational therapist, or other allied health professional could also support,intervene and sustain that advice, within that patient’s personalised health plan? How much more powerful would our workforce be if they all were trained to provide basic physical activity advice, every contact? How much more consistent could that vital intervention be, in supporting patients with physical activity,as a medicine, to life long health?
So the role of doctors, nurses and AHP’s in physical activity advice needs to be implemented at scale, supported with training and knowledge transfer. We need an “all [trained] hands on deck” approach to help promote and protect the health of our patients. And we need a workforce “fit” for the future.
And talking of “fit”, I mean fit in two senses:
With this in mind, the @WeAHPs #AHPsActive, is a great initiative to encourage the NHS workforce to become active, and maintain their own health, through regular exercise.
It works.It’s fun. And a bit of @WeDocs @WeNurses interdisciplinary competition would certainly drive the health of the NHS workforce forwards?!
But most of all, I passionately believe it helps us, as AHPs, to provide the best possible “health”care……..for our patients of tomorrow.
1 World Health Organisation. Global action plan for the prevention and control of NCDs 2013 2020. http://apps.who.int/iris/bitstream/10665/94384/1/9789241506236_eng.pdf?ua=1
3 Network of Public Health Observatories. Health Impact of Physical Inactivity http://www.apho.org.uk/resource/view.aspx?RID=123459 Public Health England, 2013.
4 Exercise for life: Physical activity in health and disease Recommendations of the Sport and Exercise Medicine Committee Working Party of the Royal College of Physicians. Royal College of Physicians 2012. http://www.apho.org.uk/resource/view.aspx?RID=123459
6 Primary care providers' perceptions of physical activity counselling in a clinical setting: a systematic review. Emily T Hébert, Margaret O Caughy, Kerem Shuval.Br J Sports Med 2012;46:9 625-631 http://bjsm.bmj.com/content/46/9/625.abstract?etoc
7 Physical activity: brief advice for adults in primary care. National Institute of Healthand Care Excellence [PH44]. 2013. https://www.nice.org.uk/guidance/ph44
8 All-Party Commission. (2014) ‘Tackling Physical Inactivity; A Co-ordinatedApproach.’ Available Online http://parliamentarycommissiononphysicalactivity.files.wordpress.com/2014/04/apcopa-final.pdf
Ann Gates is a Member of the World Heart Federation(WHF) Emerging Leaders Programme 2014/15.CEO of ExerciseWorks! Passionate AHP and advocate for daily,regular physical activity for health!
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