Exercise professionals in extended scope of practice roles: a qualitative exploration of a new model of rehabilitation

McCormick, Sheree ORCID: https://orcid.org/0000-0002-4920-1431, Cukic, Iva, Alexanders, Jenny, Yeowell, Gillian ORCID: https://orcid.org/0000-0003-3872-9799, Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953, Kelly, Benjamin M, Fitzgerald, Victoria, Cable, Tim, Doherty, Patrick, Deniszczyc, Davina and Michael, Panayiotis ORCID: https://orcid.org/0009-0003-7902-9630 (2025) Exercise professionals in extended scope of practice roles: a qualitative exploration of a new model of rehabilitation. BMJ Public Health, 3 (2). bmjph-2024. ISSN 2753-4294

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Abstract

Background: There is a need to provide greater patient choice through accessible and sustainable rehabilitation for people with long-term conditions. New models of rehabilitation employing non-clinical healthcare workers in extended service practice roles are developing. Little research has investigated the experiences of non-clinical health workers, such as exercise professionals, in extended scope of practice roles. This research explored the experiences of stakeholders and beneficiaries (exercise professionals in extended scope of practice roles, allied health professionals and people with Long COVID) participating in a new model of rehabilitation delivered online from selected Fitness and Well-being Centres of a UK charity. Methods: A qualitative design using in-depth semistructured interviews was undertaken to explore the experiences of triage physiotherapists, specialist trained exercise professionals, referred to as rehabilitation specialists and people with Long COVID participating in the new model of rehabilitation involving exercise, education and well-being support. Results: Five triage physiotherapists, two rehabilitation specialists and three people with Long COVID were recruited. Facilitators, barriers and opportunities were identified as key themes. Facilitators related to ‘it isn’t just exercise’, ‘condition specific needs are met’ and ‘dedicated team who make a difference’. Barriers related to ‘supporting staff training needs’ and ‘optimising resources/mode of delivery for clinical population’. Opportunities related to the provision of a ‘stepped-down approach at programme end’, ‘building and developing the team’, and ‘identifying and evaluating emerging trends through process evluations’. Conclusions: This novel model of rehabilitation provided positive experiences for people living with Long COVID. Some aspects of the role provided job satisfaction for the delivery team but mentorship, support and additional training in psychological skills and mental health are important when considering sustainability and expansion of the programme. Scaling out to other clinical populations and areas where access to conventional services is sparse could provide a viable public health strategy to improve access to services, thereby reducing mainstream healthcare costs.