Prescribing exercise in general practice Encourage active community life

EDITOR, - Steve Iliffe and colleagues advocate caution in prescribing exercise from primary care but argue that “exercise is good for us, especially as we get older.”1 They cite the benefits of physical activity in a practice population, which include lower rates of cardiovascular disease, reduced depression and anxiety, and improved functional ability in elderly people as well as a lower risk of osteoporosis and fractured hips. Campbell et al evaluated a controlled trial of a community health promotion exercise programme that used a questionnaire and a motivated general practitioner and showed that general practitioners can influence exercise habits.2 Ten years later, with exercise promotion continuing in the general practice, the annual report of the director of public health showed a significant reduction in the all cause standardised mortality ratio in the campaign village compared with the control village.3

I agree that referral to leisure centres alone is not enough. My rural community of Brockenhurst does not have a leisure centre. We promote “active living” and refer patients to appropriate community activities, including activities for young and old people, held in the village hall, church hall, schools, and hotels. We are evaluating the project with the Wessex Institute of Public Health Medicine, the Southampton Health Commission, and New Forest District Council. The “Brockenhurst healthy village project” has a community coordinator, who receives referrals from any member of the …