Clinical Exercise Physiologist

Clinical exercise physiologists are AHCS-registered healthcare scientists who apply exercise science to the assessment and rehabilitation of people with chronic health conditions. This is a distinct clinical role — not personal training or sport coaching — requiring a thorough understanding of pathophysiology, pharmacology, and clinical risk management. Your primary settings are NHS cardiac rehabilitation (CR), pulmonary rehabilitation (PR), cancer rehabilitation, and long COVID rehabilitation services.

In cardiac rehabilitation, you conduct pre-exercise clinical assessments (including ECG interpretation, exercise tolerance assessment, and risk stratification), design individual and group exercise prescriptions for patients post-acute coronary syndrome, post-cardiac surgery, and with heart failure, and deliver supervised exercise sessions while monitoring for adverse responses including arrhythmia and ischaemia. In pulmonary rehabilitation, you deliver group exercise training for COPD, pulmonary fibrosis, and other chronic respiratory conditions, using outcome measures including the six-minute walk test (6MWT) and incremental shuttle walk test (ISWT). In cancer rehabilitation and long COVID services — growing areas of NHS practice — you apply exercise as an adjunct to treatment and recovery, drawing on evidence for fatigue management, functional improvement, and psychological benefit.

You conduct cardiopulmonary exercise testing (CPET) to assess aerobic capacity and guide prescriptions, collaborate with cardiologists, physiotherapists, dietitians, and nurses within multidisciplinary teams, and provide health education and behaviour change support to participants. At Band 6, you may lead a rehabilitation programme, supervise exercise assistants, and contribute to service audit and quality improvement.

Cardiac rehabilitation is an evidence-based NHS-commissioned service shown to reduce mortality and readmission after heart attack, and is a clinical priority under NHS England's Long Term Plan. Pulmonary rehabilitation is similarly commissioned and has a strong evidence base for COPD. Both services require clinical exercise physiologists who can manage the complexity and risk of exercising people with significant comorbidities — a capability that generic fitness professionals cannot provide.

Long COVID rehabilitation created a new clinical demand that is sustained by the estimated two million people in the UK with ongoing COVID symptoms, and cancer survivorship programmes are growing as cancer treatment outcomes improve and survivorship numbers increase. AHCS statutory registration protects the clinical exercise physiologist title and provides the accountability framework employers require. The integration of exercise as medicine into NHS pathways — supported by NHS England's Moving Medicine programme and the Royal College of Physicians — positions clinical exercise physiology for continued growth.

Morning: lead the group cardiac rehabilitation exercise session — eleven participants at various stages of their six-week programme, including three post-MI patients, two post-CABG, and one with heart failure with preserved ejection fraction (HFpEF). Monitor HR, BP, and perceived exertion, and watch for adverse responses. Conduct an individual pre-programme assessment for a new referral — 12-lead ECG, exercise tolerance assessment, risk stratification, and exercise prescription. Afternoon: long COVID rehabilitation group — ten participants with post-exertional malaise; apply pacing and graded activity principles, deliver education on energy management. Document in SystmOne. Attend the monthly MDT meeting with cardiology, physiotherapy, and nursing.