Pulmonary Rehabilitation and the National Exercise Referral Scheme: A Collaboration


To evaluate the impact of the National Exercise Referral Scheme (NERS) being part of the Neath Port Talbot (NPT) Pulmonary Rehabilitation Service on patient's continued exercise adherence.

Since the beginning of 2017, the NPT Pulmonary Rehabilitation Service has funded 1.0 WTE exercise instructor from NERS to assist in delivering the Pulmonary Rehabilitation courses in NPT and provide dedicated Pulmonary Rehabilitation follow-on exercise classes for patients that have graduated from the courses. Prior to this, patients were offered the option of a NERS referral without having met or developed a rapport with the NERS exercise instructors.

In 2017/18 attended their assessment session, compared with 40% in 2015/16.


A review of the NERS database to assess the difference in referral numbers and evaluate patient compliance at assessment, 16 weeks and 52 weeks.


The number of patients agreeing to a NERS referral increased by 340% and 373% for the years 2017/18 and 2018/19 respectively compared with the total of 15 referrals made in 2015/16 when NERS exercise instructors were not part of the Pulmonary Rehabilitation team.

In 2017/18 with NERS exercise instructors in place, 90% of those referred attended their assessment session, compared with 40% in 2015/16.

At 16 weeks and 12 months, 76% and 71% respectively were still exercising in 2017/18 compared with 13% and 6%, one patient, in 2015/16.

Despite an improved 72% of referred patients attending their assessment session, only 13% were still exercising at 16 weeks and 3%, one person, continued to exercise at 12 months. Data for 2018/19 is incomplete at present as those referred at the end of this period have not yet reached their 16 week and 12 month milestones, however it appears that the improved trends are continuing.

The close working relationship between the NPT Pulmonary Rehabilitation Service and NERS has increased uptake of the follow-on exercise classes and increased compliance with attending, completing 16 weeks of exercise and maintaining long-term adherence one year from graduating from Pulmonary Rehabilitation.


The collaboration between the NPT Pulmonary Rehabilitation Service and NERS is impacting positively on the attitudes towards exercise and activity in the chronic respiratory disease patients using the service.

Compliance with healthy lifestyle choices in this patient group can be challenging and the improvements demonstrated by this review are very positive. The potential health benefits of this patient group maintaining active lifestyles could lead to reduced need for medication, fewer exacerbation's of their condition and reduce hospital admissions.

Funding acknowledgements

No funding was provided to undertake this research.

Additional notes

This work was presented at Physiotherapy UK 2019