Intended for healthcare professionals


The BMJ Awards 2018: Clinical Leadership Team of the Year

BMJ 2018; 360 doi: (Published 28 March 2018) Cite this as: BMJ 2018;360:k1339
  1. Nigel Hawkes, freelance journalist
  1. London, UK
  1. nigel.hawkes1{at}

Nigel Hawkes finds out how this year’s nominees are transforming practice

Deconditioning awareness

Too many people are taking their hospital treatment lying down, says consultant geriatrician Amit Arora of the University Hospitals of North Midlands. Too much time lying or sitting in bed or on chairs is bad for patients: they should be getting up, walking around, getting dressed in their own clothes, eating at tables, and generally being active. “The more time they spend in bed, the more dependent and deconditioned they become,” he says.

The process of deconditioning is well known but has been forgotten, he believes. “There are times when I’ve seen a patient in hospital and said he’s doing pretty well. But a week later he’s still in hospital and in a worse state. Deconditioning starts as early as the first 24 hours, when patients can lose up to 5% of muscle mass. As time passes, they have reduced mobility, increased dependence, confusion, lack of self confidence, depression, and demotivation.”

He launched an awareness campaign called Sit up, Get Dressed, Keep Moving. “It’s not about saving money or making up for lack of staff. Patients who are less active can come to a lot of harm. Of course, there are some with medical reasons for bed rest, but for the majority that’s not the case. Patients welcome it. One man said to me ‘I didn’t know I was allowed to walk’.”

Arora started small, with one or two wards at the hospital, but the campaign gained momentum and was launched nationally on 1 October 2016. He says that staff are supportive—“It doesn’t make their life more difficult, it makes it easier”—and many other hospitals have expressed interest. An audit has shown no increase in serious injuries caused by falls. Costs have been minimal, just £835 (€958; $1181) for …

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