Intended for healthcare professionals

Letters Prescribed exercise for osteoarthritis

Let patients self-refer to lifestyle management services for osteoarthritis

BMJ 2022; 377 doi: (Published 31 May 2022) Cite this as: BMJ 2022;377:o1359
  1. Azeem Majeed, professor of primary care and public health
  1. Department of Primary Care, Imperial College London, London, UK
  1. a.majeed{at}

I agree that the aims of the new draft NICE guidance on the management of osteoarthritis in primary care are good,1 but the problem will be providing patients with access to suitable lifestyle and exercise programmes. In many parts of England these services are not currently in place. As well as these services, we also need to ensure there is equitable access to them, based on clinical need. We know from experience that it is the more affluent and better educated patients who are likely to take up these kinds of lifestyle and exercise interventions.

We also need to simplify clinical pathways and allow patients to refer themselves directly to services without requiring a referral from a GP. This will improve the speed of access and reduce demand on already overstretched GP services.


  • Competing interests: None declared.