Adaptation of the Welsh National Exercise Referral Scheme (NERS) to virtual delivery: Evaluation of impact and opportunities

Evaluation completed September 2022

What does the research mean for Local Authorities?

The knowledge from this research will provide an understanding of whether and how the Welsh NERS could be delivered virtually in the future (in addition to core face-to-face delivery) and the implications of this in terms of service user uptake, engagement, outcomes, and programme costs. This will take into consideration the learning gained from delivering the programme virtually in response to the Covid-19 pandemic. More widely, the findings may also be of interest to others responsible for developing or managing health improvement programmes who are considering introducing virtual delivery.

What does the evaluation research mean for the Public?

Adding virtual delivery to the Welsh NERS could increase programme accessibility and improve health outcomes e.g. there may be groups of people whose circumstances make face-to-face attendance challenging. This research will help to identify who these groups of people are and how they can be best supported to engage in this way. The findings will inform Welsh NERS programme managers, and those responsible for other types of health improvement programmes, to deliver public services that are increasingly person-centred and flexible. 

How are the public involved in the evaluation?

The public are involved throughout the project in several different ways. This includes a local service user consultation group who develop research questions important to them, assist with data analysis, provide insight when discussing findings and producing outputs. Additionally, throughout all PHIRST Connect projects the Public Involvement in Research group act as a critical friend on key elements of the research process, and in some situations act as co-researchers.   

Lay summary of research

The National Exercise Referral Scheme (NERS) is a Welsh Government programme that operates across the whole of Wales. It aims to help members of the public to improve their physical and mental health and wellbeing by providing access to personalised and supervised physical activity.

The Welsh NERS is aimed at people aged 16 years and over, who are not used to taking part in physical activity or who are at risk of, or currently experiencing, a long-term health condition. People are referred onto the Welsh NERS by a health professional such as a doctor, nurse or physiotherapist, and then take part in a 16-week programme of exercise sessions while being supported by a trained ‘exercise professional’. The sessions are designed to be fun and easy to fit into everyday life.

The Covid-19 pandemic meant that in March 2020 the Welsh NERS programme had to change the way it delivered its services. One of the main changes was that it moved from running exercise sessions face-to-face to running them virtually (for example, with people joining in with live sessions from their own homes while watching their instructor on a smartphone, tablet or computer).

The aim of the study is to understand whether this change in the way that the Welsh NERS has been run has affected:

  • whether people have joined the Welsh NERS in the first place
  • whether people have taken part in the sessions
  • whether people have stayed involved for the full 16 weeks of the programme
  • people’s physical and mental health and wellbeing

The study aims to answer the following, broad research questions: 

  • How has delivering the Welsh NERS virtually affected whether people join the project, take part in exercise sessions, and complete all 16 weeks of the programme
  • Are there things that increase or decrease the chances of people joining and taking part in the Welsh NERS, and what are these for different groups of people?
  • How do the outcomes for service users who experience a virtual version of the Welsh NERS compare to those who experience it face-to-face?
  • How do the costs of running the Welsh NERS virtually compare to the costs of running it face-to-face?
  • What might be the best way to deliver the Welsh NERS in the future and what might be the benefits and downsides of these different options?

The research design includes

1. Asking staff who help deliver the Welsh NERS to take part in group discussions 

2. One-to-one interviews with the Welsh NERS service users and people referred on to the Welsh NERS but who never took it up 

3. Looking at information on health and wellbeing outcomes to see what has changed for those who took part in the Welsh NERS and if this varies for different groups of  service users (for example, those who experienced the Welsh NERS virtually compared to those who experienced it face-to-face, and those with different health conditions)  

4. Looking at how much virtual delivery costs compared to face-to-face delivery 

5. Running a workshop to work together with those involved in the Welsh NERS to explore the best way for the Welsh NERS to be run in the future

Local Authority/Partner(s)

Welsh Local Government Association

Public Health Wales

PHIRST Connect Research Team

Dr Katie Newby, Dr Neil Howlett, Charis Bontoft, Dr Olujoke Fakoya, Imogen Freethy, Nigel Lloyd, Nigel Smeeton, Dr Adam P Wagner, Amander Wellings, Professor Wendy Wills, Professor Katherine Brown

*All PHIRST Connect members input into every project