RETHINKING EXERCISE REFERRAL SCHEMES

With funding becoming increasingly limited, it’s time to treat exercise referral schemes as a commercial service that can boost membership, retention and financial performance, says Stuart Stokes, Managing Director of ReferAll

Exercise referral schemes have been a feature of public leisure provision for more than 30 years. Historically funded by local authorities and the NHS, these schemes have seen health and fitness operators work in partnership with health professionals to play an important role in increasing activity levels, reducing obesity and tackling chronic disease. But with funding for exercise referral programmes dwindling, some believe these schemes are at risk of being cut back or lost altogether. I disagree. Indeed, now is the time for operators to position these valuable programmes as a commercial service and reap the returns they can offer for both their customers and their bottom line.

DELIVERING VALUABLE RETURNS Across the sector, there are examples of operators who continue to run successful programmes after funding has come to an end, because they recognise the social and commercial value the schemes offer and how they can support organisational aims. Ultimately, they know they make business sense.

This is supported by our own analysis, which shows that people who join a facility through a long-term condition or exercise referral programme and go on to become mainstream gym members stay for around seven months longer than other members. That translates into significant financial return.

This can be explained by the unique nature of these schemes. When someone is referred to a physical activity programme, they have typically already had a meaningful conversation with a healthcare professional. This often increases their motivation to become more active. And when that motivation is met with a high quality, supportive service by the operator, it can help overcome some of the most common barriers to activity and convert participants into long-term members.

A FINANCIALLY SUSTAINABLE MODEL Following the recent withdrawal of funding for its Fresh Start Exercise Referral Programme, Debra Weekes, Partnerships Manager at Mytime Active, developed a business case for the Senior Leadership Team to demonstrate the value of continuing the programme.

To ensure the scheme remained financially sustainable, she recommended:

Introducing a subsidised attendance fee of £7.20 for each Fresh Start session, from January 2026, while continuing to offer the initial assessment free of charge.

Taking a more proactive approach to promoting the Health Membership to participants of Fresh Start, a subsidised membership for people with a medical condition.

By adopting these recommendations and standardising session times and staff hours, Weekes calculated the referral programme could be delivered without ongoing subsidy from Mytime Active or external partners.

Although it’s still too early to fully assess the financial impact – some clients were still accessing Fresh Start for free until April 2026 – early indications are encouraging, says Weekes. “I recently attended a Fresh Start session and all four participants told me they would never have entered a gym if it hadn’t been for Fresh Start. They were all also going to buy a Health Membership when they’d completed Fresh Start.”

Paying for a service can encourage attendance and adherence

Mytime Active is already enjoying success with the self-funded ESCAPE-Pain scheme. The 12-session programme delivered over six weeks combines physical activity with education to help people manage pain. A high number of clients convert to Health Memberships following the programme, which Weekes believes is thanks to the peer to peer support the scheme offers.

THE CASE FOR COMMERCIALISATION So, why aren’t more operators running these schemes commercially? Some boards may feel that treating exercise referral and long-term condition programmes as commercial services goes against their objectives, especially if the organisation is charitable. But if their focus is on improving health outcomes, and revenue is merely a by-product of that, perhaps more operators would feel confident about combining positive health outcomes with commercial benefit. After all, these programmes can help more people become active while also strengthening the long-term sustainability of the facilities that host them.

Charging for exercise referral programmes can increase their perceived value. We know that when schemes are free or very low-cost, participants find it easier to drop out. Paying for a service can encourage attendance and adherence. Exercise referral programmes usually involve highly qualified staff, closer supervision and additional resources. In many cases, the relationship between staff and participants resembles the personal training model, so it’s entirely reasonable to charge a higher fee for the service. That doesn’t mean programmes must always be full price; operators can still make concessions for people on low incomes or those who need subsidised access.

There are other benefits to commercialising these programmes: exercise referral schemes allow operators to differentiate themselves from their private and low-cost competitors. Whilst some private operators offer dedicated health conditions programmes, exercise referral schemes are still primarily delivered by public leisure providers, which can provide the community, support and connection that participants need. It makes sense for operators to embrace the opportunity to support people with long-term health conditions or those who need greater guidance and reassurance.

It’s worth noting that funded programmes often come with strict delivery requirements for operators to adhere to. These guidelines can dictate how a scheme is delivered, the setting in which it takes place and the data that must be collected. Completion criteria are often prescribed and can vary considerably. For example, a participant may be classed as a ‘completer’ after attending nine of 12 sessions rather than all 12, or someone who has attended nine of 12 sessions and completed an exit questionnaire. Over the years, we’ve seen almost every variation of these requirements. While they don’t necessarily stifle innovation, they can restrict the flexibility needed to introduce new software, technology or staffing models that could help address challenges such as growing waiting lists, increasing service demand or operational inefficiencies.

SUPPORTING MORE LOYAL MEMBERS I believe it’s time for operators to take a different approach to exercise referral programmes. As funding becomes more constrained, there is an opportunity to assess existing services and ensure they are designed around the needs of participants rather than simply being used to fi ll spare capacity during quieter periods. This will ensure programmes are more engaging, effective and sustainable.

These programmes can help more people become active while also strengthening the long-term sustainability of the facilities that host them

For many people, a long-term health condition creates fear or uncertainty about physical activity. When operators give them the right support, build their confidence and, crucially, help them understand that doing some physical activity is far better than doing none, participants are more likely to stay engaged for longer.

Exercise referral and long-term condition programmes would not exist without the commitment of operators, instructors and participants. Even where direct funding has been reduced, I believe operators should continue to deliver these schemes to boost membership, retention and financial performance, while improving the health and wellbeing of individuals with most need of support.