Maintaining quality in exercise referral schemes: a case study of professional practice

The epidemiological evidence regarding physical activity and health has triggered, within health care, an interest in the development of physical activity promotion, in an attempt to address concerns regarding levels of physical inactivity within the population. These initiatives have varied during the past decade, from public health campaigns, to the development of nationally recognized training qualifications. By far the most prolific physical activity programme that has developed however, has been the ‘exercise referral scheme’. These schemes now exist in most towns and cities, providing a formal link between local primary care and leisure provision. However, professional bodies in both medicine and exercise, responsible for the care of their members, have expressed concerns over the duty and quality of care that exists within such schemes. Research too, has provided conflicting evidence regarding their efficacy for health improvement. As such, national recommendations have been produced and published by the Department of Health to set and maintain standards in this growing area of service delivery.This case study of professional practice provides one innovative approach to ensuring that a countywide exercise referral scheme is a successful conduit for raising physical activity levels, and thus, health. By employing professionals from exercise science to deliver the Proactive Management Service, Somerset Physical Activity Group have devised a unique approach to ensuring and maintaining the quality of service delivery to the patients referred onto the exercise referral scheme within Somerset.The case study concludes with lessons learnt from these developments and proposals for the future, including, establishing a national register of exercise referral schemes and the importance of addressing the competencies of both health professionals and leisure professionals, who are involved in such schemes.