Table 2 Referrer characteristics – sub-themes (Theme 1)

Interpersonal traits

The age of the doctor makes a big difference, the older the GP generally, they’re not interested, or they don’t refer as many, it’s more the young, progressive doctors that do it, and so, and they understand the importance of it anyway. (21)

I think it definitely goes on what especially the GP’s are into themselves. This is what I found anyway, you know the GP’s that are into sport themselves, because they’re the ones that are referring through you know. (22)

It’s down to the practice nursing staff, if they have very high BMI’s, I found that a lot of them won’t refer because it’s things like, well if I’m overweight, then you are overweight, but you’re telling me to go, why don’t you go? (21)

Perception of scheme

It’s usually if it’s just that GP’s belief, you hear the odd time, patients come into the Leisure Centre and they’ve gone, “oh we didn’t know about it and the GP wasn’t keen about sending us, but it was only because we pushed about”, so it’s usually the barriers being the odd GP, who’s not been keen. (1)

I think you’ve got be able to see the value in it, you know. So you’re not going to do something you don’t think is, is worthwhile. And I think this is worthwhile. (1)

Awareness of scheme

But also the fact that the scheme is better known now, means that more health professionals are likely to refer into it… (7)

All the GP’s should be aware of us. We do have them occasionally saying they’ve never heard but they tend to be new GP’s coming into post or locums. So that tends to be the issue. (12)

No, I know my doctor, when I told him I was waiting, he didn’t seem to know anything about this referral card, and he’s the head of the practice, he’s been there, you know… for a long time. (9)

I haven’t had interaction with it at all. So when I started at my previous surgery I assumed that there was an exercise referral so I had asked my colleague, and she said, “Oh we don’t do that anymore.” So I just took her word because I was brand new to practice nursing and obviously didn’t know anything. I was only relying on my colleague to let me know what was happening. So I took it as … ‘oh it can’t be going anymore. It must have ceased’, just finding this quite frustrating because there were a lot of patients that would’ve benefited from being referred. (5)

One thing I find hard is not knowing what they will do … just as comparison, like the expert patient program for diabetes with the dieticians. They explain to you exactly what goes on in each session and what the patient can expect, and how long it lasts, whereas with this one I don’t feel I know enough about it. (7)