CHAPTER 4: Findings and Recommendations
52. During the course of this short inquiry we
were presented with little evidence to suggest that the enhancement
of the performance of elite athletes is generally based on strong
biomedical science. Given the difficulties associated with conducting
research with elite athletes, it is important to develop a two-way
flow between, on the one hand, observations on elite athletes
and, on the other hand, rigorous research on non-elite athletes
and the wider public (paragraph 20).
53. The evidence we received has led us to the
view that the latest advances in relevant areas of biomedical
research are not being consistently applied to improving the performance
of elite athletes. Robust methodologies must be applied to sport
and exercise medicine (SEM) and sport and exercise science (SES)
for them to have maximum effect, and to enable a two-way flow
of research between the fundamental and applied disciplines (paragraph
22).
54. We recommend that the Department for Culture,
Media and Sport (DCMS) and UK Sport take steps to ensure that
the biomedical science UK Sport applies to improving the performance
of elite athletes is of the highest quality and meets international
peer-review standards that would be applicable in other areas
of science (paragraph 23). (Recommendation 1)
55. We recommend that UK Sport should, as a matter
of principle, undertake to share its research findings more widely,
especially where the research is publicly funded (paragraph 24).
(Recommendation 2)
56. There seems to be sufficient evidence to
demonstrate a causal link between physical activity and health
benefits for a very wide range of diseases. However, the reasons
for this link are not well understood. Research to understand
these underpinning mechanisms could be of benefit to elite athletes,
non-elite athletes and the wider public (paragraph 26).
57. Where there is a good scientific basis, lessons
could be learnt from the study of elite and non-elite athletes
that have relevance to the wider public. This "trickle down"
of research from athletes to public health benefits will be even
more valuable where underpinning mechanisms are better understood
(paragraph 30).
58. Given the estimated costs of inactivity (see
paragraph 3 above), and the potential benefits of the use of exercise
as a preventative measure and treatment for chronic diseases,
we recommend that the National Institute for Health Research (NIHR)
and other research funders should stimulate research to translate
findings of sport and exercise science and medicine to public
health benefits (paragraph 39). (Recommendation 3)
59. We recommend that the National Health Service
(NHS), medical schools, the General Medical Council and relevant
professional bodies ensure that appropriate training, both at
undergraduate level and in continuing professional development
opportunities, is available for health professionals to support
the prescription of exercise as a preventative measure and treatment,
where science supports this. We invite the NHS to consider adding
physical activity to the Quality and Outcomes Framework (paragraph 42).
(Recommendation 4)
60. We recommend that the National Institute
for Health and Clinical Excellence (NICE) assess the quality of
research to support the prescription of specific exercises in
the management of chronic diseases and, where the evidence supports
it, update their guidelines to reflect these findings (paragraph
43). (Recommendation 5)
61. We recommend that the NHS and NICE evaluate
the most effective mechanism for assuring the quality of service
delivered by exercise professionals in exercise referral schemes
(paragraph 44). (Recommendation 6)
62. We find it remarkable that DCMS is not concerned
with the health benefits of sport (as a form of physical activity).
We recommend that the Government take a strong, joined-up approach
to promoting the health benefits of exercise and physical activity,
and that DCMS play an active part in this. We also recommend that
the Government look to international models for improving the
quality and application of sport science (paragraph 47). (Recommendation
7)
63. Given the level of seed investment made,
and the importance of this research, the proposed strategy is
unsatisfactory. We recommend that the Department of Health (DH)
clarifies the intended role of the National Centre for Sport and
Exercise Medicine (NCSEM) and outlines how it will ensure that
the work of the Centre will be sustainable (paragraph 48). (Recommendation
8)
64. The NCSEM, sports scientists and sport medical
professionals must demonstrate that they can undertake research
of the same quality as fundamental disciplines and that they have
the institutional support to carry it out. We recommend that the
Research Councils, particularly Biotechnology and Biological Sciences
Research Council (BBSRC) and Medical Research Council (MRC), demonstrate
that they are co-operating to ensure that good quality research
in SES and SEM does not fall between the two councils (paragraph
49). (Recommendation 9)
65. Given the importance of co-ordination and
co-operation to further this field, we recommend that the NCSEM
lead the development of a National Sports and Exercise Science
and Medicine strategy. Such a strategy would seek to engage researchers
and clinicians (both from within and outside the Centre) to identify
key research needs, improve the quality of research, promote collaboration
and co-ordinate research in SES and SEM over the next five years.
The Centre should consider the work of international counterparts,
to learn from their experiences (paragraph 50). (Recommendation
10)
66. Furthermore, the expertise of MRC, BBSRC,
NIHR, UK Sport, charities, researchers and clinicians in these
fields must be shared to facilitate cross-fertilisation of ideas,
and to ensure that the lessons of good science applied to elite
and non-elite athletes are translated into public health benefits.
We recommend that the NIHR provide a lead to this work (paragraph
51). (Recommendation 11)
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