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An Evaluation of the Effectiveness and Cost Effectiveness of the National Exercise Referral Scheme in Wales, UK

May 2012

Simon Mark Murphy, Rhiannon Tudor Edwards, Nefyn Williams, Larry Raisanen, Graham Moore, Pat Linck, Natalia Hounsome, Nafees Ud Din, Laurence Moore


This was a randomized experiment with the goal of evaluating the National Exercise Referral Scheme (NERS), a program set up in Wales to increase physical activity by proving exercise instruction, group exercise classes, and motivation and goal-keeping consultations with professionals. This experiment consisted of randomly assigning a group of patients diagnosed with either coronary heart disease, or a mental-health condition, to either a treatment group that participated in the NERS, or the control group that did not. Results found significantly higher levels of activity for coronary heart disease patients, and significantly lower levels of depression and anxiety for mental health patients.

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Policy Implications

This experiment suggests that referrals to a exercise “scheme,” where patients are encouraged by professionals, offered guidance and group classes, and directed to create and meet goals will significantly increase the level of exercise for those patients suffering from heart conditions. It also offers evidence of exercise programs as effective treatments for mental health conditions. Additionally, the experiment determines exercise schemes to be highly cost effective.

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