Having resolved to ‘do more exercise’ in 2012, I spent the morning having a swim and hoping that I would be one of the 12% who actually manage to keep their new year’s resolutions. Some might put low success rates down to unachievable targets being set. However, trawling through lists of top ten resolutions, most of the favourites (get fit, cut down on alcohol, quit smoking, save more) appear to be quite realistic. So, why aren’t these goals being achieved? Too often, the degree of will and determination required to change a habit, or start and sustain something new, is underestimated.
As such, the Future Forum’s suggestion that health staff routinely speak to patients about their diets, smoking, drinking and exercise habits in an attempt to reduce NHS spend on lifestyle-related illnesses seems futile. Discussing lifestyle with a patient who is at heightened risk of a heart attack makes sense and the benefits of change are clearly demonstrable. Talking to a patient about doing more exercise when they visit their doctor with an ear infection and are at no immediate risk from their current lifestyle choices, is more likely to irritate than spur someone into action.
Discussing lifestyle with patients where there is a clear risk to health makes sense but to achieve higher success rates than those embarking on new year’s resolutions, the NHS needs to develop a holistic approach that goes beyond exhortation and shows patients how to make sustainable improvements in their lifestyle. This probably requires investment but spending on public health to save NHS expenditure will be a difficult proposition in these cash-strapped times.
