The environment is very much firefighting and we’re trying to create that prevention narrative: Exploring the Implementation of Physical Activity Promotion within Primary care in England

Abstract Background Physical activity (PA) is crucial for prevention and management of chronic diseases, yet its promotion in primary care remains suboptimal. This study investigated how healthcare professionals (HCPs) in primary care across England promote PA and collaborate to promote PA. Methods A qualitative study using semi-structured interviews with general practitioners (GPs), practice nurses (PNs), first contact physiotherapists (FCPs), and link workers (LWs). Interviews were analysed thematically to understand experiences and perceptions related to PA promotion and interprofessional collaboration. Results PA promotion was infrequent, often reduced to brief and general messages such as “move more” and endorsing the health benefit of PA. GPs commonly perceived patients as disinterested in PA advice, which limited engagement and contributed to a reticent to initiate in-depth discussions. PA assessment tools such as the General Practice Physical Activity Questionnaire (GPPAQ) were rarely used. There was a notable preference for structured or supervised PA (e.g., gyms, walking groups), often at the expense of more flexible, lifestyle-based approaches. Collaboration with LWs was limited and inconsistent. FCPs engaged more routinely in PA promotion, while LWs faced role ambiguity and competing social referrals. Conclusions PA promotion in primary care is limited by perceptions of patient expectations to receive medication, and time constrains. Advice is often generic (move more message and endorsing PA for health), with minimal behavioural support. Collaboration between health care professionals is underused. An emphasis on supervised activities overlooks accessible, lifestyle-integrated options that do not require referral or cost. Systemic changes including targeted training, improved communication, and incentives prioritising prevention should be considered to embed PA promotion into routine care. Future research should evaluate training, explore clinician perceptions of patient readiness for PA, strengthen interprofessional collaboration, and develop scalable, equitable, person-centred strategies for sustainable integration of PA promotion within primary care.