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FIA UPDATE


NEWS Counting down to exercise referral


FIA CEO David Stalker outlines the timeline for the production and publication of the Professional and Operational Standards for Exercise Referral, the changes that the new standards bring, and some of the challenges along the way


Assessment (HTA) review of exercise referral to appreciate the need for such standards. Te review – Te Clinical Effectiveness and Cost-Effectiveness of Exercise Referral Schemes: A Systematic Review and Economic Evaluation – clearly highlighted the problem, namely that nationally, no evidence exists for the effectiveness of exercise referral schemes. Tere is a gap between academic


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research stating that exercise can be effective in the prevention and management of chronic disease, and the actual coalface delivery. Firstly, I must explain that the


standards are not yet completed – rather we are dotting the i’s and crossing the t’s of the final document. However, as this has been a long process full of challenges, I thought an update would reassure those running the UK’s 1,200 exercise referral programmes that the standards are forthcoming, and also offer some clues as to what is in store.


ew standards are on their way for exercise referral. One only needs to read the Health Technology


Joint consultation As a brief reminder, the Professional and Operational Standards have been the primary focus of the Joint Consultative Forum – a forum established between the medical community and the physical activity sector (see information box, p25). In other words, it’s a forum between those who refer to and deliver exercise services. Te FIA has been represented by a


series of members over the course of the last two years and thanks must go to the Wright Foundation, Nuffield Health, Lifetime Health and Fitness, Citypoint Club, UCL, and independent instructors such as Mike O’Donnoghue who are delivering referral schemes every day. Te role of forum chair has recently been filled by the Royal College of Physicians, and particularly colonel John Etherington. Special thanks must go to the former


FIA chief medical officer, Dr John Searle OBE, who established the forum, reached agreements with the Royal Colleges, and chaired the group in its formative stages. Te forum believed that the issue – the evidence gap mentioned above – could be


changed by improving and standardising the service, so that all 1,200 exercise referral schemes across the UK work with a common evaluation framework. It will mean that, going forward, all schemes operate under a single ‘patient inclusion/exclusion criterion’, with programmes delivered by an agreed level of professional, collecting the same categories of data, and operating under a common referral process. Te British Heart Foundation Toolkit


for Exercise Referral Systems previously demonstrated that there is huge variation in the qualifications and competencies of exercise professionals delivering exercise referral programmes, the data recorded, and the percentage of schemes actually adhering to 2001 National Quality Assurance Framework for Exercise Referral Systems.


Notable changes Against this context, in late 2010 the Joint Consultative Forum assembled a draſting group to develop new Professional and Operational Standards for Exercise Referral, which will bring several notable changes to exercise referral. Firstly, the standards define an exercise


referral as “the referral of a patient by an allied healthcare professional to a service for the purpose of providing an exercise programme as part of the management of people with (i) stable and/or significant functional impairments/limitations related to a chronic disease or disability and/or (ii) with one or more significant cardiovascular disease risk factors”. Secondly, the standards acknowledge


We know exercise works, but don’t yet have sufficient data on gym-based activity 24 Take part in the Health Club Management reader survey: www.surveymonkey.com/s/NQDN2R6


that a number of professionals are involved in an exercise referral. Te ‘referrer’ is not always a GP, but can at times also be a physiotherapist, occupational therapist or nurse, to name but a few. Furthermore, a number of professionals may deliver exercise as part of the management of a chronic condition: a sport and exercise


November/December 2012 © cybertrek 2012


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