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RESEARCH


MIKE KELLY


Director of the Centre of Public Health Excellence at NICE, Professor Mike Kelly, tells Julie Cramer why it's time to do whatever it takes to highlight the benefits of physical activity


“W


e’re not talk- ing about a new virus or


germ, it’s something within our grasp to do something about, in a fairly straight- forward kind of way,” says Mike Kelly, director of the Centre of Public Health Excellence at NICE (the National Institute for Health and Clinical Excellence). Kelly is not referring to some infectious disease requiring the attention of the medical community, but to the newly-defined set of lifestyle diseases (Type 2 diabetes, cardiovascu- lar disease, hypertension) linked to obesity and phys- ical inactivity, which now urgently require a wider approach. “We’re facing an epidemic of non-communicable diseases related to the way we live our lives – the diets we consume, the physical activity we don’t do,” says Kelly. “It’s not that we [as leaders] don’t know what to do, it’s the fact that we haven’t so far taken a systematic approach across the whole of society.” The grim predictions by govern- ment health officials are that by 2050, more than half the adult population in England will be obese. Current trends show that 26 per cent of adults and 16 per cent of children are now classed as obese – a condition that can have grave consequences for their health, and place a huge cost burden


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not being active are scien- tifically utterly compelling. The issue is now one of implementation. “We can argue about exactly how much physi- cal activity, plus there’s an ongoing debate about weight loss and physical activity [calories in or calo- ries out] – but the problem is not a scientific one, it’s the will to make it happen”.


It's important to identify the barriers to physical activity


on the NHS (currently over £5bn a year and rising rapidly). In its role as health watchdog, NICE


is there to offer independent, evi- dence-based guidance on ways to prevent and treat illness and poor health not only to the NHS, but also to local authorities and anyone with responsibilities in healthcare, public health and social care.


Kelly says that the kind of scientific evidence and data related to lifestyle diseases that NICE has been reviewing in recent years is now pointing to one very significant conclusion. “The evidence about the benefits of physical activity and the disbenefits of


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GP FRAMEWORK NICE has recently taken the significant step of rec- ommending that physical activity be included in the QOF (Quality and Outcomes Framework) indicators for GPs. GPs are currently incentivised financially to optimise and record treat- ment to patients for a range


of health issues – such as asthma, mental health, diabetes, coronary heart disease and hypertension. Given what is known about its physical and mental benefits, offer- ing exercise advice to patients would represent a major step forward, and a move that would be hailed by the greatest proponents of physical activ- ity – the health and fitness industry. Kelly says: “QOF is a complex sys- tem that doesn’t involve NICE directly. It involves the Department of Health in the four home countries and represent- atives from the medical profession. “NICE lines up the sort of things that could go into the QOF and these bod-


ISSUE 1 2013 © cybertrek 2013


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