There is increasing recognition, both globally and in the UK, of the need to promote healthier lifestyles and improve physical activity levels in order to reduce premature mortality and morbidity from chronic diseases. In the UK, there is a considerable public health burden due to physical inactivity; in 2003-2004 researchers found that physical inactivity was responsible for 3.1% morbidity and mortality.
Primary care has been recognised as a potentially important setting for the promotion of physical activity. During routine consultations primary healthcare professionals may promote physical activity by either recommending patients become more habitually active or by referring patients to a dedicated physical activity programme.
With respect to the latter, one of the most popular approaches to promoting physical activity in the primary care setting has been through exercise referral schemes. In the UK these schemes are widespread and form an important part of the interface between healthcare practitioners, health promotion/public health specialists, leisure providers, exercise professionals and commissioners.
It is recognised that capacity, resources and funding vary across schemes and that some schemes are struggling to implement elements of the National Quality Assurance Framework and consequently may struggle to adopt some of the recommendations set out within the toolkit.
The toolkit is not designed as a ‘blueprint’ for how exercise referral schemes must be designed, implemented and evaluated; it offers some best practice principles for all those involved in the delivery, management and commissioning of exercise referral schemes. It is for individual schemes to consider whether the implementation of these principles will improve the design, delivery and effectiveness of their scheme, given the capacity and resources available.
Many schemes may already be meeting the recommendations outlined within the toolkit, in which case the toolkit can be used as a resource for professionals to take a fresh look at their scheme or as a guide for on-going reflection.