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From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales

Morgan, Kelly ORCID:, Lewis, Jennifer, Hawkins, Jemma ORCID: and Moore, Graham ORCID: 2021. From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales. BMC Health Services Research 21 , 1232. 10.1186/s12913-021-07266-7

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Background: Over ten years on from a randomised controlled trial and subsequent national roll-out, the National Exercise Referral Scheme (NERS) continues to be routinely delivered in primary care across Wales, UK. Few studies have revisited effective interventions years into their delivery in routine practice to understand how implementation, and perceived effects, have been maintained over time. This study explores perceptions and experiences of referral to NERS among referrers, scheme deliverers and patients. Methods: Individual, semi-structured interviews were conducted with 50 stakeholders: scheme referrers (n = 9); scheme deliverers (n = 22); and referred patients (n = 19). Convenience sampling techniques were used to recruit scheme referrers and purposive sampling to recruit scheme deliverers and patients. Thematic analysis was employed. Results: Analyses resulted in five key themes; referrer characteristics, geographical disparities in referral and scheme access, reinforcements for awareness of the scheme, patient characteristics and processes and context underpinning a referral. Overall there was a high concordance of views between all three stakeholder groups and barriers and facilitators were found to be entwined within and across themes. Referral barriers persisting since the earlier trial included a lack of consultation time and a lack of referral feedback. Newly identified barriers included a lack of scheme awareness and a referral system perceived to be time intensive and disjointed. Key referral facilitators included patient self-referrals, a growing scheme reputation and promotional activities of scheme deliverers. Conclusions: Findings provide evidence that could inform the further development of NERS and wider exercise referral schemes to ensure the referral process is timely, efficient and equitable.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License
Publisher: BioMed Central
ISSN: 1472-6963
Date of First Compliant Deposit: 25 November 2021
Date of Acceptance: 29 October 2021
Last Modified: 08 Jul 2023 19:03

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