Exercise referral requirements for multiple level 4 qualifications

Existing REPs level 4 Specialist Instructors wanting to undertake an additional level 4 category qualification will not have to undertake the level 3 Exercise Referral qualification. Currently instructors wishing to move to level 4 must achieve the level 3 Exercise Referral qualification from a SkillsActive endorsed training provider as a prerequisite before they can embark on a level 4 specialist instructor course. However, the level 4 steering group, comprising representatives from SkillsActive, the Register of Exercise Professionals and the fitness industry’s Technical Expert Group have decided that this will not apply to existing REPs level 4 specialist instructors

Here, Nichola Curran, who sits on the SkillsActive Techincial Expert Group, and level 4 Panel, explains the rationale behind the decision.

Q1.  Why is Exercise Referral a pre-requisite for Level 4 qualifications?

As of 30th September 2011 Level 3 Exercise Referral is a mandatory pre-requisite for all those who wish to undertake a Level 4 Specialist Instructor qualification for the first time. Examples of such courses include, Back Pain, Obesity and Diabetes, Cardiac Disease, Mental Health, Chronic Respiratory Disease, Cancer Rehabilitation, Long Term Neurological Conditions, Falls Prevention and Stroke.

This decision has not been made lightly and is based on extensive review and comparison of the knowledge and skills gained from undertaking Level 3 Personal Trainer qualifications to those gained through Level 3 Exercise Referral. A panel of experts unanimously agreed that a Level 4 Specialist Instructor should have an understanding of the referral process and common medical conditions. It is highly likely a client will present with more than one medical condition (comorbidities) which must also be taken into consideration when prescribing exercise. The Exercise Referral qualification provides this information which is not covered in the Level 3 Personal Training Certificate.

Q2. What happens if I have a Level 4 qualification but do not have a Level 3 Exercise Referral qualification?

If you achieved a recognised level 4 qualification prior to 30th September 2011, you WILL NOT be expected to go back and complete Level 3 Exercise Referral.  You WILL be able to go on to do other Level 4 Specialist Instructor qualifications.

Q3. What conditions are now covered in the Level 3 Exercise Referral Qualification?

After much debate and consultation, some conditions have now been removed from this qualification; based on the complexity of the condition and the specialist skills required to prescribe safe and effective exercises.  The conditions now covered, and those you will be qualified to work with, are:

  • Hypertension
  • Hypercholesterolaemia
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Diabetes Type 1 & 2
  • Obesity
  • Osteoporosis
  • Osteoarthritis
  • Rheumatoid Arthritis
  • Joint Replacement
  • Simple Mechanical Back Pain
  • Depression
  • Stress and Anxiety

Q4. What qualifications do I need before I can do a Level 3 Exercise Referral course?

You can access this course with a recognised Level 2 qualification e.g. Gym Instructor or Exercise to Music etc.  Exercise Referral now includes Level 3 Anatomy & Physiology ensuring you cover the necessary knowledge previously gained by completing either Level 3 Advanced Fitness Instructor or Level 3 Personal Trainer.  It must be stressed, however, once you successfully complete this qualification, you will only be able to deliver sessions to referred clients within the context of your Level 2 qualification.  For example, a qualified ETM instructor can deliver referral sessions within a studio setting but NOT within a gym based setting and vice versa.   Instructors who hold both Level 2 qualifications can obviously deliver either type of referral session.

Nichola is the MD of Evolve Leisure http://www.evolveleisure.co.uk and has more than 21 years’ experience in fitness including exercise referral.

6 responses to “Exercise referral requirements for multiple level 4 qualifications

  1. what happens if you are currently studying a level 4 (premier masters pathway) but don’t have a level 3 exercise referral qualification??? i will qualify at the beginning of December.
    does this mean i will end up having a qualification i then cant use?

  2. binnie barnes

    Hi, this is a great idea – I work in Phase 3 leading cardiac rehab exercise and have had increasing concerns about patients on some schemes not been properly screened for other conditions that might limit exercise – I keep saying patients are not just ‘hearts’ and that they might be more at risk from a muscular skeletal injury sometimes than from a heart event.

    On a separate note, hope you can comment on the following: I have a (level 4) BACR cardiac rehab exercise instructor qualification but had not got round to applying to be a level 4 Instructor on the Register as I changed jobs. Am now back to doing occasional cardiac rehab exercise instructing, in phase 3 situation. Am covered by hospital indemnity and also have private medical indemnity which I checked and would cover me for my rehab role work.

    I’m a nurse and also did medical referral modules on a sports science masters, but do not have a formal level 3 medical exercise referral qualification. I am also a government approved disability assessor, course approved by university of derby. So I think I have all the right skillbase for considering a wide range of medical conditions and their effects on patients, along with their heart health, but just not the formal medical exercise referral qualification.

    Is there an APL route for the L3 medical exercise referral qualification?

    And, If I rejoin the register now, would I go on at level 4, specialist instructor? Or would I need to do level 3 medical exercise referral qualification first? That would be difficult as I don’t work in a general referral environment with general medical referral clients.

    What I’m tryng to clarify is if the Register thinks of level 4 qualifications and level 4 registration on the Register as synonymous?

    Thanks Binnie Barnes

  3. Dear Sarah,

    Thanks for this post. Whether I agree or disagree with the decision by REPS & Skills Active, an interesting point I would like to bring to REPs attention is regarding the involvement of Nichola Curran, who sits on the SkillsActive Techincial Expert Group, and level 4 Panel. Nichola, in her current position MD of Evolve Leisure displays an obvious conflict of interest?

    At the end of the article there is a link to Nichola’s training company, of whom ‘just happen’ to offer a Level 3, Exercise Referral qualification and will most certainly directly profit from this mandatory pre-requisite (for all those who wish to undertake a Level 4 Specialist Instructor qualification for the first time).

    I am interested to hear your thoughts…

    Kindest regards,

    Director, Zest People

    • Hi Rachel

      Thank you for your comment on the article written by Nichola Curran regarding the information on prerequisites and the level 4 categories of entry onto REPs. I can confirm that REPs often uses experts from training providers to produce articles for the ezine and journal. We are very clear that they are not allowed to promote their organisation within the article but do allow them to state who they are and which organisation they work for in the author’s note separate from the article. This has always been the case and we try to ensure that we do not always use the same training providers for obvious reasons.

      We believe that the expertise demonstrated within the article is the most important factor and this inevitably means that we often ask individuals with expertise from training providers to contribute to the content of our publishing. In this case the fact that Nichola is on the Technical Expert group (TEG) and represents the TEG on the level 4 panel means that she was perfectly placed to bring members this important information re the changes to get to level 4. The level 4 panel is made up of many individuals representing many organisations some of whom are training providers. However the decision to include the level 3 exercise referral as a prerequisite was a consensus decision unanimously agreed by the whole group.

      I do hope this helps to explain the issue. As an aside we actively encourage people to submit article ideas for both the Journal and the e-zine. Of course we can’t guarantee to use them all but we do like to provide a variety of subjects and this system usually does just that.

      With best wishes

      • Hi Sarah,

        Thanks very much for your reply and explanation.

        On one hand I can see why it was felt that Nichola was a perfectly placed member of the panel to deliver this information – being a fitness industry training expert – on the other hand in my professional opinion, this article was best placed coming from the REPs Level 4 Panel as a collective, or an impartial member, leaving no room for conflict of interest. Adding a weblink in the author’s foot note is virtually the same as including it in the article itself…

        With regards to the decision, I agree that to achieve REPs Level 4 there needs to be a robust pre-requisite, however more flexible. The ex.referral level 3 award is primarily delivered as a gym based course and will not be appropriate in many cases, as with the two other people’s comments. Perhaps there is room for an ex.referral Level 3 course with a non-gym based focus? There may be some training company’s already delivering this that I’m unaware of?

        And thanks for actively encouraging article ideas – I will get my thinking cap on!

        Kindest regards,


  4. Attractive section of content. I just stumbled upon
    your blog and in accession capital to assert that I acquire
    in fact enjoyed account your blog posts.
    Anyway I will be subscribing to your augment and even
    I achievement you access consistently quickly.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: