Testimonial from Ellen Fallows
This framework is a timely opportunity to support GPs to address the rising rates of long-term conditions driven by lifestyle factors. It describes the discipline and how it can be best practiced by GPs to achieve the most impact on health outcomes.
The latest research shows that lifestyle factors have a greater impact on health outcomes than genetic determinants. Reflecting this, all national long-term condition guidance starts with “lifestyle advice” . However, medical education and practice in reality pays little attention to supporting people with lifestyle change, but focuses on medications. Addressing lifestyle factors has also traditionally been relegated outside of the consulting room to public health. Whilst this remains the most effective, impactful and equitable way to support healthy lifestyles, research also demonstrates that it is possible to support people within primary care, to change lifestyle factors through the use of lifestyle medicine.
Lifestyle medicine is a discipline that teaches more than simple advice giving, by exploring behavioural science, person-centered care and more specific assessments and evidence-based interventions. Lifestyle medicine can therefore reduce the harms of over-prescribing and offer more effective treatment options, particularly in primary care.
What does this framework cover?
A quick overview:
- Definition of lifestyle medicine
- How to deliver care by being aware of any socioeconomic drivers of behaviour, assessing the six pillars and supporting behaviour change through person centered care, health coaching, group medical care, social prescribing, etc
- Description of potential roles of a GP with Extended Role in Lifestyle Medicine
- How to develop the role and keep skills and knowledge up-to-date
- A list of resources (papers, textbooks, societies)
How does this framework help colleagues and GPs?
The framework provides a guide to develop an interest in lifestyle medicine, so GPs can better deliver holistic care to their patients whilst also emphasising physician health.
How can GPs get the most out of the framework?
The framework has been structured so that it can be dipped in and out of to guide a career in lifestyle medicine. This goes from why this will help practice, to how to get qualified and maintain skills, and how to deliver in busy practice.
Testimonial from Hussain Al-Zubaidi
Lifestyle medicine is a globally recognised medical discipline with a robust evidence base and widespread practice. It is defined as evidence-based clinical care that supports behaviour change through person-centred techniques, addressing six pillars: healthy eating, mental wellbeing, healthy relationships, physical activity, minimising harmful substances, and restorative sleep.
A GP with an Extended Role in Lifestyle Medicine (GPwERLM) should have additional knowledge and skills in three core principles:
- Understanding the socioeconomic determinants of health and health inequity.
- Training in behaviour change tools and techniques, such as health coaching, motivational interviewing, brief interventions, signposting, goal setting, group consultations, and supported person-centred care including shared decision-making.
- Understanding how to assess and support improvements in the six pillars of lifestyle medicine.
Why is lifestyle medicine important in primary care?
The management of long-term conditions is central to GP work, addressing both less modifiable risk factors through policy and more modifiable ones through lifestyle changes. Supported lifestyle changes can prevent, treat, and potentially reverse diseases like type 2 diabetes, obesity, and hypertension. GPs, as trusted experts with broad patient contact, are well-placed to deliver lifestyle medicine. GPwERLMs provide specialised knowledge, lead primary care personalised care teams, and support their colleagues by keeping updated with the latest research across the six pillars of lifestyle medicine.
How will the framework help?
The framework gives clear direction for GPs and GP trainees interested in developing their skills and knowledge in the field of lifestyle medicine. From understanding what training to undertake to highlighting the wide scope of practice the framework provides clear and practical guidance as well as real world examples of application.
How to use the framework
I would highly recommend interested clinicians review the entire framework in the order that it has been laid out. It has been intentional structured in such a way to inform each section. We have condensed the material down to contain only the most pertinent pieces of information which will help to inform your practice. Along the left-hand side there is a handy navigation dividing the framework into six sections wither further subdivisions to help users navigate the framework.
Why am I passionate about lifestyle medicine?
Over 10 years ago I was diagnosed with non-alcoholic fatty liver disease, hypertension, and burnout. It triggered me to explore the reasons why I had developed these long-term conditions at such a young age. I realised my lifestyle was significantly contributing to my condition, so I went on a journey of learning to improve not only my knowledge of the science (the pillars) but also the techniques (behaviour change), to successfully reverse my condition. I then wanted to support my patients on similar journeys. Incorporating more lifestyle medicine into my practice was extremely rewarding and helped my patients take more ownership over their health which was something they valued.
Testimonial from Rob Lawson
Having practiced as a GP for 45 years, I'm delighted to bring you the good news of this framework for GPs with an Extended Role in Lifestyle Medicine. This framework is important because it acknowledges that a biopsychosocial holistic approach to our patient care is crucial in all our efforts to change the trajectory of our nation's ill.
Many long-term conditions which are increasingly and adversely affecting lives are also avoidable in most cases, and these same conditions bring a huge workload onto the shoulder of GPs and create a massive strain on our health service. So to an extent, this framework is also a route map for GPs, who may want to make this approach core to their work.
It will support you in making supported healthy lifestyle changes in yourself, your patients, your practice, and your community. As a proponent of lifestyle medicine for decades, I can attest to its effectiveness and the joy it can bring to practising medicine. Witnessing individual healthy transformations and experiencing the joyful benefits of group consultations can not only be revelatory, but hugely inspiring.
So do please dig into the substance of this framework, look at the evidence underpinning it, look at examples from your colleagues, and work out how best you can bring pleasure and effectiveness into the work you do, for yourself and for your patients.
Wishing you all good health and many years of joyful general practice.