What will exercise referral schemes look like in a post-Covid world?

By Dr Nikita Rowley

The COVID-19 pandemic has changed the way we go about our daily lives and has affected the operations of many services, especially in the world of leisure and sport. Exercise referral schemes (ERSs), in particular, have been affected due to the many leisure centres and sport facilities that were forced to close their doors on 20 March 2020.

ERSs are clinical exercise interventions used in non-clinical settings throughout the UK, which aim to improve a patient’s physical activity (PA) levels and health condition for which they were referred (Pavey, et al. 2011).

Typically, referrals are made from primary care (GPs, healthcare practitioners) to third party service providers (exercise professionals in leisure centres/gyms) to promote increased PA through exercise prescriptions (Duda, et al. 2014; Pavey, et al. 2011). Prescriptions are usually conducted on-site at leisure facilities under the watchful eye of exercise specialists to provide adaptations to the prescription, encouragement and social interaction.

At present schemes are heterogeneous in design and delivery (Pavey, et al. 2011), offering different activities (such as one-to-one sessions, group activities) and recording various outcome measures. Research therefore has the inability to make clear comparisons between schemes when reviewing effectiveness on a national scale.

However, the current situation caused by the global Coronavirus pandemic has forced some schemes to either close, or adapt, their delivery via online platforms and home exercise programmes. With developments such as these, could this be the start of something new for exercise referral schemes across the UK? And could this be the perfect time for a shake up within the world of ERSs?

With a lack of evidence of schemes’ effectiveness, future research should focus on finding new ways to design, implement and evaluate ERSs across the UK to inform best practice guidelines and national ERS policies. At present, some schemes have decided to continue providing some level of service to their patients and clients, so that they can continue exercising at home during this pandemic and complete their exercise referral. Current research by the author and colleagues is reviewing what steps schemes have put in place to ensure that delivery of ERSs can continue during lockdown, and how this could inform future practice.

With this knowledge, schemes may be able to offer a variety of delivery approaches, which weren’t offered prior to the lockdown. This could include online exercise sessions, regular contact with exercise specialists via phone/video calls, home exercise programmes posted to individuals who may not have internet access, alternative exercise options and the ability to personalise a home exercise prescription based on exercise preference, availability of equipment and space.

This new found flexibility is extremely beneficial for individuals who may be worried about going to gyms and leisure centres once lockdown has eased further, and who may no longer want to physically attend sessions. With schemes being creative and finding new ways to deliver their services, they may find that they are able to offer patients and clients much more than they could prior to lockdown. It is hoped that the availability of virtual options may provide patients with the opportunity to become physically active and improve health outcomes, without worrying about attending these facilities. Maybe making these adapted delivery approaches more permanent will be the ‘new normal’ for exercise referral schemes.

Author Bio

Nikita completed her PhD viva in November 2019. The PhD title is-  Exercise Referral Schemes in the United Kingdom: Initial Observations from The National Referral Database. Nikita’s research interests include exercise referral schemes, exercise, physical activity and health, and the design and implementation of exercise prescriptions. Nikita is a lecturer in Psychology at Coventry University.

To learn more about Nikita’s research, please follow her on Twitter @nikitarowley, and Linkedin @nikitarowley.



Tomas Allum