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Exercise Referral

What is an Exercise Referral?

An Exercise Referral is a specific and formalised programme whereby a medical professional refers a patient to a fitness programme, often based within the community. It is not the same as a ‘recommendation’ to exercise. A formal agreement will exist between the referrer and the exercise project. Usually (though not exclusively) run by local authority leisure centres, they will typically ensure a 12 week supervised programme of physical activity tailored to suit the needs of the referrer and the referred client, with a view to improving their state of health.

The principal of referral to exercise was established in the early 90s and since that time a range of qualifications and competencies have been developed to ensure the safe and effective programming for clients with a range of medical conditions.

What level of instructor can work with referred clients?

The Exercise Referral Instructor (Level 3)

  • An exercise referral instructor’s role includes designing, monitoring, adapting and implementing exercise programmes for individual clients with a range of medical conditions.

Occupational Role

  • Assess, monitor and manage risk to clients arising from exercise participation throughout the referral period
  • Analyse information relating to individual clients with regard to safe and effective programme design
  • Identify, agree and review short, medium and long term goals to ensure the effectiveness of exercise programmes
  • Promote a range of physical activity opportunities in accordance with the needs and health status of the clients
  • Tailor progressive exercise appropriate to the medical condition using results from the physical/exercise assessments, medical information, national guidelines and client goals and objectives
  • Develop and apply strategies to motivate clients to adhere to an exercise programme during the referral period
  • Keep up to date with health and fitness industry developments and exercise guidelines for medical conditions
  • Make the appropriate decisions relating to clients, where required, refer the client to a more appropriate professional

Occupational Competence

  • Exercise Referral Instructors are aware of their professional role boundaries and are able to support clients with the following medical conditions

Respiratory Conditions

  • Asthma
  • Chronic obstructive pulmonary disease (COPD)

Musculoskeletal Conditions

  • Osteoarthritis
  • Rheumatoid arthritis
  • Joint replacement
  • Simple mechanical back pain
  • Osteoporosis

Cardiovascular Conditions

  • Hypertension
  • Hypercholesterolaemia

Psychological/Mental Health Conditions

  • Depression
  • Stress
  • Anxiety

Metabolic/Immunological Conditions

  • Diabetes Type I and Type 2
  • Obesity

What is a Specialist Exercise Instructor (Level 4)?

The specialist exercise instructor is able to demonstrate that they have met the Level 4 National Standards in one or more medical areas. Specialist exercise professionals are working within the healthcare sector and are also providing an interface between clinically-led exercise and community-based exercise programmes by designing, delivering, monitoring and evaluating structured, individualised physical activity programmes for clients. Additionally, they have a range of appropriate knowledge and skills that are aligned with current evidence-based, best practice guidelines regarding the affects of exercise on the specific condition/s for which they are qualified to work.

Specific medical areas covered by the specialist exercise instructors:

  • Cardiac Rehabilitation
  • Falls Prevention
  • Low Back Pain
  • Stroke
  • Cancer
  • Accelerated Rehabilitation Exercise (military only)
  • Obesity and/or Diabetes
  • Mental Health
  • Chronic Respiratory Disease
  • Strength and Conditioning

Guidance on how to join REPs at Level 4, or add a Level 4 specialism to an existing membership, is available here.

Do I have to complete a Level 3 Exercise Referral before taking another Level 4 qualification?

Exercise Referral is not a requirement for Level 4 Strength and Conditioning but post September 2011 it became a requirement for Level 4 medical conditions. The only exception for this is if you were registered at Level 4 pre September 2011 you do not require to complete Level 3 Exercise Referral to take any other Level 4 medical conditions.