Ministers back call to quiz patients on lifestyles

Man smoking
Image caption The recommendations have received a mixed reaction

NHS staff in England must adapt their roles to ensure they promote good health under plans being published.

An independent panel of government advisers says health professionals should take every opportunity to discuss diet, exercise, smoking and drinking habits.

Ministers have backed the proposal from the NHS Future Forum to "make every contact count".

But the Royal College of GPs says the move could drive some patients away.

The recommendation is part of a series of papers from the panel of independent experts. Their first report last year outlined changes to the Health and Social Care Bill.

They are now setting out their conclusions on four other areas - public health, information, improving links between services and education and training.

NHS responsibility

The paper on public health states that everyone has a responsibility for their own health, but it also contends that the NHS is responsible for helping people to improve their health and well-being.

It goes on to argue that healthcare professionals should use every contact to do this, whatever their area of expertise or the initial purpose of the discussion.

The report points out that each day in England GPs and practice nurses see over 800,000 people, dentists see over 250,000 NHS patients, and 1.6 million people visit a pharmacy.

"There are millions of opportunities every day for the NHS to help to improve people's health and wellbeing and reduce health inequalities, but to take this opportunity it needs a different view of how to use its contacts with the public."

In particular, the report emphasises the importance of the four main lifestyle risk factors - diet, physical activity, alcohol and tobacco.

For example, it suggests that collecting medication from a pharmacy is a chance to offer help on cutting down on alcohol, or that a routine dental check-up could be used to discuss smoking.

The paper says to emphasise the importance of this responsibility, the government should seek to include it in the NHS Constitution.

The coalition government has accepted the forum's recommendations.

Health Secretary Andrew Lansley said: "The NHS Future Forum has again provided invaluable feedback and advice on what the NHS needs to do to improve results and put the NHS truly on the side of patients."

'Cynical diversion'

However Dr Clare Gerada, of the Royal College of GPs, says raising lifestyle risks routinely with patients, even if they are unrelated to their illness, could be counter-productive.

"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 prise open these other issues only if it feels appropriate."

Dr John Ashton, the director of public health in Cumbria, also criticised the initiative.

"The general point of making every contact count is a good idea, and has been the basis of what GPs have been trained to do for thirty years. But the problem is they're making it the centrepiece of public health, whereas it is the wider conditions that actually shape health and behaviour, including taxation, education and improving self-esteem."

But Professor Lindsey Davies, the president of the Faculty of Public Health, backed the plan.

"We don't want healthcare professionals to be telling off ill people. Professionals do need to think holistically about the needs of the person in front of them and taking appropriate opportunities to help them get healthier - and stay that way."

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