“Inactivity costs the NHS an estimated £1.06 billion…” according to report

Pathway sign


This guidance has been prepared for commissioners and all staff providing lifestyle advice in primary care, including community health and allied health professionals, such as physiotherapists. It aims to raise awareness of the issues caused by inactivity, not just for individuals, but for the health service and economy as a whole, and provides a set of five recommendations for staff to apply. This is a partial update of “Four commonly used methods to increase physical activity”.

Obese man

By not exercising, people are at greater risk of chronic conditions

Implications of inactivity

Exercise is good for the mental and physical well-being of everyone, and to reap the benefits, daily activity for all adults over 19 years, should amount to at least two and a half hours per week. This does not mean that people need to join a gym and attend regularly. Physical activity includes walking or cycling, household maintenance, gardening, dancing; anything that increases your heart and breathing rates. By not exercising, people are at greater risk of obesity, heart disease, diabetes, stroke, depression, stress-related disorders, cancer, and musculoskeletal conditions. Each of these conditions leads to a much poorer quality of life for people, and a higher burden of cost for the health service.

Stamp with the word recommended on it

This brief advice, introduces five recommendations


Based on the NICE guidance and research, this brief advice, introduces five recommendations:

  1. Identifying adults who are inactive – this could be done when people visit the GP surgery or as part of the management of long-term conditions.
  2. Delivering and following up on brief advice – emphasise the benefits and tailor it to suit the individual.
  3. Incorporating brief advice in commissioning – incorporate brief advice about physical activity into the care pathway.
  4. Systems to support brief advice – when issuing brief advice on physical activity, make sure this is recorded on the patient record so that it can be followed up on future visits.
  5. Providing information and training – this should include emphasising their role in encouraging people to be more active, and also methods for dealing with people who are more likely to be inactive.

This brief advice document goes into much greater detail on how these recommendations can be implemented, and cross-references throughout.

Exercise is such an easy and healthy way to improve well-being, and as such this guidance has an important role to play.

Colourful kite in the sky

Physical activity promotes health and mental well-being


Although quite long, as opposed to brief advice, this is a clearly laid out document providing the justification for these recommendations, and identifying which staff should apply them. Primary care staff and commissioners should read this report and identify which recommendations apply to them. Think about what changes you can make in your practice to support increased activity in your patients. There are so many benefits to the public and the health service, and by helping those who can be active, you will have more time to spend with those who are not fit enough to be fully active.


Physical activity: brief advice for adults in primary care (PDF)
NICE public health guidance 44
National Institute for Health and Care Excellence
May 2013

Supporting material

Four commonly used methods to increase physical activity
NICE public health guidance 2 (partially updated by PH41 and PH44)


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Caroline De Brún

Caroline De Brún

Caroline has been a medical librarian in a variety of NHS and academic roles since 1999, working in academic, primary and secondary care settings, service improvement, knowledge management, and on several high profile national projects. She has a PhD in Computing and currently develops resources to support evidence-based cost and quality, including QIPP @lert, a blog highlighting key reports from health care and other sectors related to service improvement and QIPP (Quality, Innovation, Productivity, Prevention). She also delivers training and resources to support evidence identification and appraisal for cost, quality, service improvement, and leadership. She is co-author of the Searching Skills Toolkit, which aims to support health professionals' searching for best quality clinical and non-clinical evidence. Her research interests are health management, commissioning, public health, consumer health information literacy, and knowledge management. She currently works as a Knowledge and Evidence Specialist for Public Health England, and works on the Commissioning Elf in her spare time.

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