Changing how an exercise referral scheme is delivered

Role: Project lead

Funder: National Institute for Health and Care Research (NIHR) (award ID: NIHR131573; project reference: NIHR134153)

Award: Funding awarded to the Public Health Responsive Studies Team (PHIRST) 'Connect'. Chief investigator: Prof Katherine Brown. Click here for more information on the PHIRST programme of research.

Dates: January 2021 to July 2022

Background

In response to the Covid-19 pandemic, the Welsh National Exercise Referral Scheme (NERS) shifted from its standard programme (all activities delivered face-to-face) to a remote programme (all activities delivered remotely including virtual exercise sessions, home exercise scripts, phone calls), and then later to a modified programme (all activities delivered face-to-face, virtually, or a mixture of the two). This research examined the effect of these changes and other demographic characteristics on programme uptake, adherence, outcomes, and costs.

What did we do?

The records of all patients referred to the NERS between the 1st Jan 2019 and the 9th Dec 2021 were included in the analysis. Data were cleaned and then analysed using specialist statistical software. Cost data, obtained from NERS employees and audit reports, were analysed separately.

What did we find?

• Attendance at the first NERS consultation was lower for the modified programme than the standard programme. This may reflect a level of hesitation about returning to leisure facilities in the context of Covid-19 rather than a judgement about the type of programme delivery

• The mean number of exercise sessions attended was lower on the remote programme than on both the standard and modified programmes. This may reflect the

• Patterns of uptake and adherence across demographic groups reflect those in the wider exercise referral scheme literature

• Findings concerning the effect of programme type and demographic variables on health and quality of life outcomes were mixed

• Virtual delivery of NERS is costly. This is largely due to having two instructors present (for safety reasons), and waiving charges to service users. In its current format, this has implications for future sustainability

Next steps

In September 2022, a full report of the findings was presented to Public Health Wales (the organisation that manages the NERS programme). These findings are under review with the intention of being used to inform future delivery of the NERS programme.

Publications

A paper is currently under review at BMC Public Health: ‘Moving an exercise referral scheme to remote delivery during the Covid-19 pandemic: an observational study examining the impact on uptake, adherence, outcomes, and costs’ - A preprint is available here.  

Other outputs

See the PHIRST website for full report and a research briefing for this study.