• Adam Grice, Amy S Izon, Nada F Khan, Robbie Foy, Rebecca J Beeken, and Suzanne H Richards.
• Leeds Institute of Health Sciences, University of Leeds, Leeds.
• Br J Gen Pract. 2025 Feb 12.

BackgroundClinical guidance recommends promoting physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood.AimTo explore the content of physical activity discussions during routine consultations between patients and GPs.Design And SettingSecondary analysis was undertaken of video-recorded UK general practice consultations from the One in a Million study, which was conducted in the West of England.MethodIn total, 294 consultation transcripts were available; these were screened to identify consultations that included or omitted physical activity advice when recommended by National Institute for Health and Care Excellence guidance. The content, quality, and depth of advice provided by GPs were scored to ascertain how meaningful the advice was.ResultsPhysical activity was relevant to management according to clinical guidance in 175/294 (59.5%) consultations. In 64 (36.6%) of these consultations, physical activity was discussed as part of clinical management; the depth of discussion was judged as 'meaningful' in 22 (12.6%) consultations. Although physical activity advice tended to be given most often for musculoskeletal problems, depth of advice did not appear to be related to the presenting problem. When physical activity advice was relevant and omitted, consultations prioritised another overriding presenting problem, or clinical management focused on another intervention.ConclusionPhysical activity advice, following national guidance, was potentially relevant to more than half of GP consultations; GPs delivered advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently, and equitably within the constraints of general practice.© The Authors.

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