The fitness industry was jubilant a year ago when exercise was added to the Quality and Outcomes Framework (QOF) – a voluntary scheme that rewards GPs for patient care – for the treatment of hypertension. The hope was that it would be the first step towards greater collaboration between the healthcare and fitness sectors, with physical activity embedded across a wider range of indicators for the management of chronic conditions (see HCM Jan 14, p5).

But after just one year, it’s been dropped in a dramatic slimming down of the QOF, which has seen QOF’s scope cut by a third. Just as we thought we were making headway in putting exercise on the radar of GPs who haven’t bought into it yet, it’s off the agenda again.

So what’s the reason for these cuts? Are there questions about the validity of physical activity as treatment for medical conditions, or does the issue lie with QOF itself – is it a dying tool? Physical activity is, after all, just one of many indicators to be removed this month, suggesting it’s less a reflection on the benefits of exercise and more about the QOF not working that well in general.

And might the whole thing be a political move? Last year, the Secretary of State wanted lots of indicators added; this year, following protest from GPs that they feel governed by tick boxes, a knife has been taken to QOF. GPs have also been given more freedom and new payment arrangements in return for longer opening hours and various other service enhancements.

According to ukactive, the take-up of the physical activity indicator within QOF was disappointingly low – it was deemed to be more hassle than it was worth financially and not seen by GPs as a priority area of focus. Would this change even if it were reinstated?

Either way, it’s still vital that we work to forge links with the healthcare sector and convince GPs that, whether exercise is on the QOF or not, they should be recommending it to patients. So what next? We ask the experts...