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Breaking news: NICE provides new guidance on cost effectiveness of exercise referral

The United Kingdom's, National Institute of Health and Care Excellence (NICE) has just released key recommendations for health care commissioners, providers and professionals on exercise referral schemes.

The 3 key recommendations can be summarised as:

1. Policy makers and commissioners should not fund exercise referral schemes      for people who are sedentary or inactive but otherwise apparently healthy.

Primary care practitioners should not refer people who are sedentary or inactive, but otherwise  apparently healthy, to exercise referral schemes.

2. Policy makers and commissioners should only fund exercise referral schemes for people who are sedentary or inactive and have existing health conditions or other factors that put them at increased risk of ill health if the scheme:

Incorporates the core techniques outlined in recommendations of 'Behaviour change: individual approaches' NICE public health guidance 49. This includes: 

    • recognising when people may or may not be more open to change agreeing goals and developing action plans to help change behaviour 

    • advising on and arranging social support tailoring behaviour change techniques and interventions to individual need

    • monitoring progress and providing feedback 

    • developing coping plans to prevent relapse 

  • Collects data in line with the 'essential criteria' outlined in the Standard Evaluation Framework for physical activity interventions. Specifically: programme details, evaluation details, demographics of individual participants, baseline data, follow-up data (impact evaluation) and process evaluation.

  • Makes the data collected available for analysis, monitoring and research to inform future practice.

  • Primary care practitioners should only refer people who are sedentary or inactive and have existinghealth conditions or other factors[1] that put them at increased risk of ill health to an exercise referral scheme if it conforms to the above criteria.

3. Public Health England should develop and manage a system to collate local data on exercise referral schemes. This system should:

Our comment:

These stricter criteria can only improve and drive better standards in access and standards within the exercise referral schemes. Whilst many patients who are unfit, sedentary, inactive but otherwise healthy are no longer recommended for being referred to the schemes, this does mean that many more patients with long term diseases and health conditions can now be actively recruited from primary care into local exercise referral schemes.

This new guidance points out that the NICE guidance PH44 is considered to provide the best health economic methods of supporting patients to take daily exercise. We have always and will continue to endorse brief intervention as the best way of promoting physical activity within both primary and secondary health care populations!

By Ann Gates, Founder of Exercise Works!


Save Bont playing field via @SaveBontField

We want to save school fields for future generations to play their sports and follow their dreams!


It’s no real news, unless you’re an out of touch politician. The children and young people in our society need land in their communities where they can practice their sports, play sports in team events and where they can play with their friends. It’s something we’ve all taken for granted as adults in the past; the right to play and enjoy the freedom that is lush green fields to keep us fit and healthy. 

The City and County of Swansea Council in Swansea have proposed the sale of land at many of its primary and secondary schools in Swansea. We can’t speak for all of them, but as a community in Pontarddulais we’ve established an organised committee of parents, school governors, local business owners, sports club representatives and local people who are concerned about the health and wellbeing of future generations in Pontarddulais and those who are current pupils’ at Pontarddulais Primary School. 

The school land in used day-in and day-out. The field is used for football, rugby, athletic sports and as a place to discover nature. The field is a terrific resource and is an asset to the pupils and teachers who use it for their lessons to benefit the children and young people who attend the school. It’s also a vital facility for the local community who use it for sport and in the school holidays when an organisation use it to run a holiday club for children from the locality to keep up with their play and fitness whilst on a school break. 

Without sport and fitness in school, what would we be? The school boasts ex-pupils who have gone on the represent Wales at national and international levels. This is because the ex-pupils of Pontarddulais Primary School have been given the opportunities that the council are trying to take away. Why should the pupils’ of tomorrow have their dreams of a career in sport smashed to smithereens when the financial mistakes that have been made did not involve them? 

We live in a society where we’re advised to eat healthily, exercise more and participate in sport. We also live in a society where childhood obesity is at a dangerous high and this statistic is continuing to grow as you read this blog. 

Play and exercise are proven to improve the lives of children. If children and young people do not currently get enough exercise at home, surely we should be encouraging this more at school? 

Our message is clear. We want to keep the land at our school in Pontarddulais. We are shocked that the City and County of Swansea Council describe the land as ‘surplus’ as the school teacher’s, pupils and community member’s work hard to make use of it every day. 

Pontarddulais Sport & Recreation Committee @savebontfield

Blog Moderated by Ann Gates MRPharmS, Founder of Exercise Works!


Make YOUR child's summer one of active play!




It's time to set a new trend this summer. I'm not talking about fashion or football here... I'm talking about helping all children access fun, active play!

Children NEED at least 60 minutes of physical activity every day (aged 5-18 years).

Make it a summer to remember!

Help them choose and access swimming, snorkelling, walking, hiking, running, cycling, sport, leisure.... activities shared with friends and family works.

Ann Gates MRPharmS, Founder of Exercise Works!