12 Clinical exercise physiologists as part of the cardiac rehabilitation multidisciplinary team

<h3>Background</h3> Alone, physiotherapy cannot cope with the increasing demands placed on the NHS. But physiotherapists are not the only professionals capable of delivering exercise interventions and exercise prescription is not the reserve of the physiotherapy profession. The Chartered Society of Physiotherapy (CSP) welcomes the wider workforce in its pursuit to ensure rehabilitation is accessible to all. Exercise physiologists have worked within many NHS services for several years, so we already know that they possess the necessary knowledge and skills. Furthermore, we know that many patients do not need physiotherapy-specific rehabilitation interventions. <h3>Aim</h3> The purpose of this service delivery evaluation was to explore the training of a Physiotherapist (PT), a Clinical Exercise Physiologist (CEPC and Exercise Physiologists (EPs) in a multidisciplinary Cardiac Rehabilitation team. <h3>Methods</h3> We explored the education and training for one CEP (MSc-equivalent level training), three EPs (1 BSc; 2 MSc) and one PT (Grad.Dip.Phys) in an NHS Cardiac Rehabilitation service. <h3>Results</h3> CEP and EP training at BSc and MSc-level included personalised exercise prescription, graded exercise testing, monitoring and progression of interventions for individuals with chronic disease, special considerations and physiology, biomechanics, motor control, psychology. Learning for MSc-level trained physiologists was supplemented by clinical placements within a Cardiac Rehabilitation service, similar to that of current physiotherapy students. The PT undertook post-graduate training (BSc and MSc-level) to develop similar knowledge and skills. <h3>Conclusion</h3> Standardising the assessment, delivery and supervision of exercise interventions is key, regardless of the profession. There is a need to understand the knowledge and skills that each profession contributes to the delivery of safe and high-quality patient care, ensuring that rehabilitation is accessible to all who need it. Exercise does need to be managed by physiotherapists alone – EPs and CEPs possess the required knowledge and skills to practice safely and competently in an NHS Cardiac Rehabilitation service.