Healthcare professionals and physical activity, working together for exercise referral: a scoping review

Abstract Aim To explore how healthcare professionals collaborate in the context of exercise referral, the supporting mechanisms for this and how specialised physical activity (PA) programmes are designed and delivered, to promote PA in patients and the wider community. Subject and methods This scoping review followed the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines. PubMed, CINAHL, and SCOPUS databases were searched to identify literature, within the scope of the research questions, published from 1st January 2013 to 23rd October 2023. Data was extracted using a standardised data charting form, all authors were involved in thematically and visually representing the data, and a narrative synthesis summarised the evidence. Results Thirty-nine studies were included in this review. Three themes were identified in relation to the research questions: 1) confidence of health care professionals (HCPs); 2) person-centred approaches; 3) joined-up systems. Sub-themes were identified within these three broader themes. Conclusion The findings of this review highlight the need to move beyond viewing exercise referral schemes (ERS) as a linear referral pathway and instead conceptualise it as a dynamic, interconnected network embedded within the wider system (i.e., healthcare, leisure, community). Ongoing collaboration, stakeholder engagement, and feedback mechanisms are essential to building and maintaining trust, increasing awareness, and ensuring referral pathways remain both active and effective. A more connected and adaptive approach to ERS can better support diverse needs, reduce inequalities, and facilitate sustained long-term PA behaviour change.