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exercise referral


Terms of REFERENCE


Medical Wellness E


xercise referral in the UK is not currently where it needs to be, with conflicting advice and a huge diversity of


practice – this is the verdict of Dr John Searle, chief medical officer for the FIA. There are without doubt some hugely


successful, well-implemented exercise referral schemes out there – more of these later. However, in large part thanks to a lack of agreed standards, there’s no consistency in structure, delivery or outcomes. Indeed, the British Heart Foundation’s (BHF) exercise referral toolkit – based on an assessment of 158 exercise referral schemes and published in March 2010 to highlight the issues and offer some


HEELERS (see p55): The team sees around 750 new patients every year


Kate Cracknell investigates the challenges of exercise referral and takes a look at some best practice schemes


guidance – threw up some startling facts. Some scheme completion rates were as low as 20 per cent. Ten per cent of programmes had no exit strategy, while 31 per cent undertook little or no evaluation of their usefulness. And 15 per cent made little or no use of the National Quality Assurance Framework to inform their scheme development. Also noted were a lack of appropriate


qualifi cations among those delivering exercise referral, with one in fi ve schemes using Level 2 instructors to work with patients; inconsistency in terms of the length of the referral period, which varied from four weeks to as much as one year; and general


confusion over who should qualify for referral in the fi rst place, with big differences in terms of inclusion/ exclusion criteria.


building credibility It’s perhaps not fair to point the finger exclusively at our sector: in many cases, GPs aren’t confident in prescribing exercise, resulting at best in nebulous referrals. “We need proper, well- informed referrals from GPs so it’s clear what’s expected of us,” says Searle. Funding is also an issue. Governmental


Skills Funding Agency funding is not currently available for the Level 3 Exercise Referral qualifi cation, so operators wishing to deliver exercise referral schemes in their facilities – and needing to upskill their staff to do so – would have to pay for the training themselves. Particularly in these times of belt-tightening, this isn’t always feasible. However, we’re not doing ourselves


any favours. In addition to the BHF fi ndings, it’s also the case that – while high quality training is certainly available within the fi tness industry, including specialist Level 3 and 4 qualifi cations – those working in exercise referral remain the only group of people working with patients who don’t have to be accredited on a regular basis: CPD is all that’s required to keep practising.


“I know that doctors are not happy with this,” observes Searle. Not really surprising, then, that


the medical sector has yet to be convinced of our credibility in this area. Indeed, in a 2006 report, NICE went so far as to suggest that there was


52 Read Health Club Management online at healthclubmanagement.co.uk/digital april 2011 © cybertrek 2011


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