Paternalism or permissiveness - where are we heading?
The World Health Organisation recommends that medical clearance should not be required for people living with long-term conditions who wish to become more active. Despite this, there remains considerable variability in policy and practice across the UK and globally. Many organised physical activity environments continue to adopt paternalistic, outdated, and suboptimal screening tools, with mandated medical clearance serving as the default position for almost all symptomatic and some asymptomatic individuals.
This approach is likely to present a significant barrier to an already ambivalent population, the majority of whom would have much to gain from increased movement.
The session will examine current policy and practice in this area and consider potential solutions, including a shift towards an autonomous, patient-centred model. The speakers will discuss the best available evidence, policies, and practices within the physical activity sector, as well as the barriers to implementing a more patient-centred, evidence-based, and permissive approach.
The session will be followed by an exploration of current and emerging screening practices in asymptomatic athletic populations for the prevention of sudden cardiac death. It will conclude with a debate exploring the rationale and evidence for differing approaches to pre-participation screening across these two overlapping groups.
Dr Natasha Jones has had a lifelong interest in exercise as a key determinant of health. She became a Consultant in Sport and Exercise Medicine in 2011, having initially trained and practiced as a General Practitioner. Since then, she has been working as a Consultant at Oxford University Hospitals NHS Foundation Trust.
Following extensive work in exercise medicine in Oxford, Natasha co-founded the nationalย Moving Medicineย initiative with colleagues in 2018 and has led the project ever since. Initially launched as a set of healthcare-facing educational tools,ย Moving Medicineย has since expanded into policy and patient-facing areas.
Natasha has served as President of FSEM (UK) for the past four years, following a term as Vice President. She continues to lead theย Moving Medicineย initiative at a national level.
Dr Jones is currently leading work with other stakeholders to review the process of pre-participation screening for individuals living with one or more health conditions.
