Intended for healthcare professionals


Doctors are told to “make every contact count” to reduce costs of poor lifestyles

BMJ 2012; 344 doi: (Published 10 January 2012) Cite this as: BMJ 2012;344:e319
  1. Helen Mooney
  1. 1London

Doctors, nurses, and other healthcare professionals in England will be asked to question patients about their lifestyle, including smoking, diet, exercise, and alcohol consumption, at every meeting, under new plans backed by the government.

The proposal is one of a series of recommendations made by the NHS Future Forum, the body appointed to review the government’s plans for the NHS, in its latest reports to the Department of Health.

Surgeons, midwives, and health visitors, as well as GPs and nurses, will be expected to sign up to the “make every contact count” plan in a bid to curb the soaring costs of healthcare and treatment as a result of people’s lifestyle.

The health secretary, Andrew Lansley, said, “The forum’s report shows there is widespread support for the NHS to take every opportunity to prevent poor health and promote healthy living by making the most of healthcare professionals’ contact with individual patients. The government agrees that it should be the role of all healthcare workers in the NHS to make use of those contacts wherever appropriate, with the aim of improving the public’s health and wellbeing and reducing health inequalities.”

The report also emphasises the need for rewards to improve the quality of education and training in the NHS. It calls for a review of the principles and aims of the 2008 Tooke report into medical education, saying that the proposed new local education and training boards need to have the governance structures in place to deliver “strong partnerships” across healthcare providers and academic institutions.

It also wants to see a national “properly structured process” to help nurses and midwives develop “post-qualification career pathways.”

The forum’s proposals mean that NHS trusts’ budgets could be “top sliced” to fund a “quality premium,” which would be given to organisations that are providing high quality training for NHS staff. The forum says that Health Education England, which is to be established in shadow form in October, should consider developing the quality premium to “reward excellence in training.”

Sue Slipman, chief executive of the Foundation Trust Network of the NHS Confederation, told the BMJ that she welcomed the emphasis on education and training but said that the key would be in getting the “incentives right” so as to be able to afford to do this in a time of austerity.

“There will need to be some kind of tariff for this, and the incentives will need to be around rewarding quality. All organisations must make a genuine commitment to train and educate the current and future workforce,” she added.

Elsewhere the report criticises the NHS for still being in the “dark ages” in terms of information technology. In a letter to Andrew Lansley, the forum’s chairman, Steve Field, chairman of the Royal College of General Practitioners, said, “In an age of connectivity where people access information at the click of a button, the NHS cannot remain in the information dark ages.”

The report says that the barriers to more effective use of information are “more cultural than technological” and that there needed to be “a change of mindset in the NHS.”


Cite this as: BMJ 2012;344:e319