In the UK, an estimated 15 million people are living with at least one long-term health condition. This number is rising year-on-year, placing a huge burden on the NHS, social care providers and the economy.

As we start to emerge from the COVID-19 crisis, people with complex health needs are even more vulnerable, as their non-urgent health care requires them to wait their turn.

The NHS Long-Term Plan has placed a significant focus on prevention rather than cure and social prescribing and other initiatives look to take some of the pressure off front-line healthcare staff, by asking health and physical activity professionals to support the agenda, get the nation moving and encourage people to make healthier lifestyle choices.

Expertly developed training
So how can the industry support this plan? CIMSPA has announced a new professional standard – Working with People with Long-term Conditions – which identifies the knowledge and skills needed to work with this client group in a range of settings.

The qualification includes the latest thinking and current best practice when managing a variety of long-term conditions which are increasingly being encountered by exercise referral specialists, including:

• Diabetes and metabolic conditions
• Cardiorespiratory conditions
• Musculoskeletal conditions
• Cancer
• Dementia
• Fibromyalgia
• Mental health conditions
• Hypo/hyperthyroidism
• Connective tissue disease
• Neurological conditions, such as Stroke, Multiple Sclerosis and Parkinson’s Disease

Higher skillset
The greater depth of content, combined with the deeper understanding and higher skill set to support this client group, enables fitness professionals to cover the majority of conditions likely to be presented by referred clients.

Further valuable insight when working with clients who need to modify their behaviour and lifestyle to accommodate their health condition comes in the form of behaviour change techniques including ‘motivational interviewing’.

“Exercise can be a hugely impactful intervention for those suffering from a variety of long-term health conditions, as our flagship programmes have shown,” says Justin Jones, head of physiology and clinical development lead at Nuffield Health. “This qualification will help to equip fitness professionals with the knowledge and skills required to support their clients in achieving the level of health and fitness they aspire to, whether that be maintaining, developing or recovering.”

Major change
“The is one of the largest changes to the exercise referral qualification in over ten years, with more conditions now included, the qualification is far more comprehensive,” says Dr Dane Vishnubala, chief medical advisor for Active IQ. “The move away from calling it exercise referral is an important one.

“Many clients who use personal trainers or members who use the gym have long-term conditions and, therefore, having the knowledge and skills to manage these should be an essential skill for all fitness professionals.

“Our industry can play a huge role in helping to treat long-term conditions through exercise and be a key partner to health care professionals. I hope in years to come this is a qualification that will help to transform the health of the millions of patients who we see in the NHS with long-term conditions.”

Social prescribing
“As fitness professionals, we are the experts in exercise, and this is where we can add the most value,” says Jones. “The very best personal trainers recognise their own professional limitations and stick to their scope of practice.

“Getting to know the other supportive resources within their local community could help them actively signpost those in need to further support and this more holistic approach to an individual’s wellbeing presents a massive opportunity for fitness professionals.”

Nuffield Health has a multidisciplinary team of health and wellbeing professionals working within its fitness and wellbeing clubs, many of whom have access to an integrated medical centre. “Seamless referrals between colleagues, including GPs, physiologists, emotional wellbeing therapists, and physiotherapists fully supports a 360-degree approach to physical health recovery and emotional wellbeing,” explains Jones.

Making the connection
“The medical profession is increasingly aware of the power of exercise in supporting a wealth of long-term conditions. Uniting the health and fitness sector with the medical world is more important than ever,” he says.

“Being able to refer patients and clients to fitness professionals with specific skills working with people who have long-term conditions is the final piece of the jigsaw.”

Jenny Patrickson, managing director of Active IQ says: “Bringing together allied health professionals at Nuffield Health and our chief medical advisor, Dr Dane Vishnubala, to create this new qualification has successfully aligned the health and fitness and medical sectors.

“Social prescribing presents a huge opportunity for the leisure industry to meet growing health demands within society. This new qualification will give fitness professionals the skills and confidence they need to help make a difference to people’s health.

“Conversely, training fitness professionals to this higher level will also give community healthcare professionals the confidence to refer their patients to physical activity facilities.”

“It’s important to recognise that while exercise is good for us all, you can’t prescribe the same exercises to everyone and expect the same outcome. In fact, it may be dangerous to do so,” warns Jones.

“This is why we need highly skilled PTs who are able to adapt the principles of exercise to the client in front of them, depending on their aims, goals and comorbidities.

“This qualification will teach exercise professionals about the limitations of long-term health conditions, the consequences of taking certain medications and how to adapt training programmes accordingly,” he concludes.