GP Aporoval

[4Stents4me]

Ok so I’m keen to do the London - Brighton bike ride T&C’s state that I need GP approval, GP can’t make that decision can we please change T&C’s to Cardio approval - I had 4x stents fitted Dec / Jan I can run 5k in 30 mins and ride 80k a Week on my mountain bike. Do I really need sign off by anyone else other than me - come on admin wake up please

[JulianM]

I, too, have a very keen personal interest in this issue; I've been diagnosed with an ascending aortic aneurysm and am grappling with risk assessment for taking part in sports activities.

I was diagnosed by sports cardiologists and observe (1) that their emerging discipline is precisely the right one for this task, but hard to access: there is no way that GPs are in a place to decide on this; and (2) that the model sports cardiologists are working with is shifting from 'doctor decides' to 'doctor and sports participant decide together'.

The issues are different when the participant is a minor and involved in an elite training programme which is intrinsically about pushing yourself to your limits, vs when the participant is an adult, not aiming to win anything, and capable of adjusting and controlling efforts within boundaries.

I think that BHF needs to look at these issues very seriously for events it promotes itself, as these are bound to set the tone for many other mass-participation events too, and event directors are - with good reason - seriously concerned about cardiac events which can kill participants and de-rail their on-the-day organisation. I've seen the impact of a participant death on subsequent events, too - both positive (family members and friends taking part in memory) and negative (loss of confidence and status for the event). It's genuinely very challenging, not a simple matter. For example, when family members take part in an event to commemorate someone who died, have all of them been thoroughly and appropriately screened? In the UK, we haven't gone down the French route of insisting on medical screening and certification for all participants; the public health benefit of promoting mass participation is likely to outweigh any benefit of the screening, if that sets up barriers to participation. Routine screening of healthy people has costs as well as benefits. Tests are never perfect. But it's a debate.

My personal suggestion for London to Brighton would be that advice from a cardiologist, where there's a known heart condition, especially one that is treated, should be accepted as fully equal to that from a GP, and there should be a declaration by the participant that they will comply with any advice given in relation to modifying the way they take part, if the medical advice includes conditions and reservations. But I'm just a sports person (and coach) - not a doctor.

I'm a member of BHF's patient information panel and Heart Voices, and very keen to contribute to any consultation they may pursue in this area.

[Alison_L]

T&C actually says "doctor's approval" not GP.

" BHF understands that heart patients are keen to support BHF and many are fit enough to take part in our Events, however, Participants who have any doubt about their health or have a medical condition that could be affected by exercise, particularly a heart condition, must obtain their doctor’s approval before participating in any Event."

[JulianM in reply to Alison_L]

Thank you for the clarification, I think that covers my main point!