NHS LIFESTYLE MEDICINE CLINICS Pilot project – Lifestyle Medicine in Practice

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I have been a GP partner at Macklin Street Surgery, central Derby for over 25 years. In day-to-day inner-city practice, I see first-hand the health impact of social inequalities and deprivation. The need for high quality, evidence-based, Lifestyle Medicine input has never been greater in the communities I serve.

I obtained the Diploma in lifestyle medicine in 2022 and wished to use my additional knowledge to motivate patients to make behaviour changes, reduce (and potentially reverse) their risk of chronic disease, whilst improving both physical, and psychological well-being.

I applied for a GP Fellowship to the HUB+ in Derby, with a proposal for a pilot project, to develop a Lifestyle Medicine Clinic. I was delighted to be awarded a fellowship, and started to develop a modular course for 12-15 patients to run over 12 months.

A Systm1 search was performed for patients who would benefit from lifestyle interventions at an early stage to reduce risk, and potentially halt/reverse disease progression. The search included patients with Hypertension, BMI>30, Non diabetic hyperglycemia (NDH), age 35-55 yo (anticipating a ‘ripple effect’ on family). Invites and a poster advert were sent to the identified patients.

The poster and invite gave background as to how Lifestyle medicine can help reduce weight, reduce
risk of Heart Disease, Diabetes, Stroke, Cancer, whilst improving fitness, sleep quality, social connectivity and making long term sustainable health improvements.

The offer was a 1:1 initial one hour assessment, then 30 minute follow up appointments at 1 month, 3, 6, 9 and 12 months. At each appointment all 6 pillars of Lifestyle Medicine would be reviewed.

The initial consultation included an assessment of ‘readiness for change’ and subsequent consultations, behaviour change coaching techniques were used, in tandem with motivational interviewing and positive psychology.

Each patient was given a hand held record of their metrics and their documented ‘WHY?’ i.e. their reason for change. Goal setting was SMART, aiming for small achievable goals. All patients were encouraged to be an active partner, not a passive recipient. Patients, if required, were referred to our social prescribing team.

The metrics being checked included blood pressure, weight, muscle mass, visceral fat, subcutaneous fat, waist-hip ratio, GAD-7, PHQ-9, self assessment ‘wellness scale’.

Base bloods were taken, if not already performed, for FBC, U+E, HBA1C, LIPIDS, LFT and repeated at points during the pilot as appropriate.
All patients were encouraged to self refer to the PCN dietitian team and the local ‘Health and
Well-being Team’ who provide physical activity programmes for all abilities. In addition, patients were invited to join me at our local ‘ParkWalk’ on some Saturday mornings.

Patients metrics are currently being collated. Positive results have already been seen, including reductions in blood pressure, weight, improved GAD and PHQ9 ratings. There has been successful de-prescribing of anti-hypertensive medication and reversal of non diabetic hyperglycemia. The feedback has been enormously positive from patients, and it has been a joy to have enough time to allow a full 360 assessment of patients health and well-being. I will look forward to reviewing the final results.

There is the potential to expand and ‘Scale up’ this model of Lifestyle Medicine Clinics.

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LM Pillars Covered:	Healthy Eating Mental Wellbeing Healthy Relationships Minimising Harmful Substances Sleep Physical Activity
Funded?	Yes – The HUB, Derbyshire. (Training and support for primary care) as part of a G.P. Fellowship
Initiative Sector:	NHS
Approving Body:	Training Hub

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