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

Abstract 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 i...

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Autores principales:	Kelly Morgan, Jennifer Lewis, Jemma Hawkins, Graham Moore
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Physical activity Exercise Referral Referral system Primary care UK Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/480de2a2414e4bdf910cd67820278b56
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spelling	oai:doaj.org-article:480de2a2414e4bdf910cd67820278b562021-11-14T12:09:53ZFrom a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales10.1186/s12913-021-07266-71472-6963https://doaj.org/article/480de2a2414e4bdf910cd67820278b562021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07266-7https://doaj.org/toc/1472-6963Abstract 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.Kelly MorganJennifer LewisJemma HawkinsGraham MooreBMCarticlePhysical activityExercise ReferralReferral systemPrimary careUKPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-14 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Physical activity Exercise Referral Referral system Primary care UK Public aspects of medicine RA1-1270
spellingShingle	Physical activity Exercise Referral Referral system Primary care UK Public aspects of medicine RA1-1270 Kelly Morgan Jennifer Lewis Jemma Hawkins Graham Moore From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales
description	Abstract 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.
format	article
author	Kelly Morgan Jennifer Lewis Jemma Hawkins Graham Moore
author_facet	Kelly Morgan Jennifer Lewis Jemma Hawkins Graham Moore
author_sort	Kelly Morgan
title	From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales
title_short	From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales
title_full	From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales
title_fullStr	From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales
title_full_unstemmed	From a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the National Exercise Referral Scheme (NERS) in Wales
title_sort	from a research trial to routine practice: stakeholders’ perceptions and experiences of referrals to the national exercise referral scheme (ners) in wales
publisher	BMC
publishDate	2021
url	https://doaj.org/article/480de2a2414e4bdf910cd67820278b56
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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

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