Active Endorsement
National Occupational Standard
CPD Mapping Toolkit
D518
CPD Mapping Toolkit
© SkillsActive 2013
Design, agree and adapt
a physical activity
programme for adults
with cardiac disease
Page 1
Mapping CPD Courses to National Occupational Standards (NOS)

NOS or ‘standards’ establish the benchmark of competence required in different
fitness industry roles/skills. Each NOS consists of a detailed breakdown of the
minimum skills and knowledge needed to be competent.

Developed in conjunction with technical experts and employers, NOS act to ensure
employability skills are reflected in qualifications and CPD.

Training providers are required to part-map CPD courses to demonstrate
occupational relevance (e.g. to the learner and employer). N.B. There is no
requirement to fully-map CPD to the NOS.
How to Complete this Mapping Toolkit
1.
Review the content of your course (including learning outcomes and assessment
criteria) in relation to the NOS contained within this mapping toolkit.
2.
Demonstrate how and where your CPD course covers the NOS by completing
the relevant sections within the ‘Mapping Evidence’ column throughout this
mapping toolkit.
3.
Mapping need only be completed for elements of the NOS where there is a clear
link to content and/or assessment covered by the CPD course. All areas that are
not covered by the CPD should be left blank or denoted as not applicable (N/A).
You will not be penalised for leaving mapping blank where it is irrelevant to your
course.
4.
The information you add to the ‘Mapping Evidence’ column can include any
aspect of course delivery/resources/assessment etc such as, PowerPoint
presentations, course manuals, handouts, assessments, lesson plans. It is,
however, important that you are able to submit anything you have mapped as
evidence for the endorsement process.
CPD Mapping Toolkit
© SkillsActive 2013
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D518
Design, agree and adapt a physical activity
programme for adults with cardiac disease
Summary
Many exercise referral schemes exclude patient/clients with established cardiac disease. Ongoing
maintenance of exercise behaviour (Phase IV cardiac rehabilitation) allows patient/clients with stable
cardiac disease who have either been transferred from clinically-based rehabilitation (Phase III) or
referred by primary care to be offered exercise. Delivery of this service should follow current
guidelines which provide guidance on patient/client inclusion and exclusion criteria and competency
of instructors to protect both the interests of patient/clients and instructors.
Therefore general practitioners and other healthcare professionals may specifically direct a patient/client to
suitably trained instructors and facilities where a structured and individualised physical activity programme can
be designed and delivered for them, including home exercise.
Advanced instructors who are responsible for designing and delivering structured and individualised physical
activity programmes for a patient/client with cardiac disease or assigning them to an appropriate physical
activity must have a range of appropriate knowledge and skills specific to current guidelines and monitoring the
effects of the programme on the condition. These instructors should have established close liaison with
cardiac rehabilitation health professionals in their local area.
Tailoring an exercise programme will use many of the core aspects of programme design and delivery such as
communication skills, principles of training and guidelines for teaching. In addition, there are specific
knowledge and skills related to working practice and the technical exercise aspects to consider in programme
design including: understanding of the disease process and how it is managed; how physical activity influences
the disease process; the positive and negative aspects of physical activity on cardiac disease; an
understanding of cardiac medications and their influence on the individual's ability to exercise and also psychosocial issues,.
This unit is designed to cover cardiac disease and includes the skills and knowledge required to prescribe safe
and effective exercise programmes for this client group.
Elements covered:
D518.1
D518.2
Design and agree a physical activity programme for patients/clients with
cardiac disease
Deliver, review and adapt a physical activity programme for
patients/clients with cardiac disease
D518.1
Design and agree a physical activity programme for patients/clients with
cardiac disease
Competencies/Skills
1
establish an effective working relationship with your patients/clients
and appropriate health care professionals
2
collect, record and interpret information about your
patients/clients with cardiac disease using safe, appropriate and
recognised methods
CPD Mapping Toolkit
© SkillsActive 2013
Mapping Evidence
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Information to cover:
a) personal goals
b) referral form
c) informed consent to participate to transfer medical
information
d) medical history and medication
e) current and previous physical activity history and
preferences
f) social and psychological considerations
Methods to cover:
a)
b)
c)
d)
e)
3
reports
interview
questionnaire
observation
functional assessments
stratify and manage risk according to appropriate guidelines and
protocols
4
follow the correct procedures and protocols for liaising with health
care professionals, including those for confidentiality
5
establish and agree the patient/client’s readiness to participate
6
plan and agree goals that are appropriate to your client and their
current level of ability
7
plan and prepare objectives, activities and delivery methods that are
appropriate to your client’s goals and condition
8
design and agree a programme adapted to your patient/client using
relevant principles of training
D518.2
Deliver, review and adapt a physical activity programme for patients/clients
with cardiac disease
Competencies/Skills
1.
assess, monitor and manage risk to your patient/client throughout
the programme
2.
manage medical complications and emergencies until appropriate
medical help is available
3.
deliver planned activities to your patient/client with cardiac disease,
adapting activities according to their individual needs
4.
communicate and consult with your patients/clients on issues to do
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Mapping Evidence
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with their physical activity programme and progress
5.
provide appropriate attention to your patients/clients with common
co-morbidities
6.
support your patient/client in a way which will promote sustained
change in physical activity level
7.
enable your patients/clients in self-management
8.
monitor your patient/client’s progress against agreed goals and
adapt the programme accordingly
9.
provide ongoing reports to communicate outcomes to the
appropriate health care professional.
D518
Design, agree and adapt a physical activity
programme for adults with cardiac disease
Knowledge and Understanding
Mapping Evidence
K1 Government policy and published national guidelines for cardiac
rehabilitation.
K2 Awareness of national agencies, organisations and literature
relating to cardiac disease.
K3 Relevant medico-legal requirements.
K4 How to interact appropriately with general practitioners, other
health care professionals and personnel involved in the process of
cardiac rehabilitation.
K5 Ensure the patient/client’s information and consent, meeting
recommended guidelines, is received prior to advising, prescribing
or instructing exercise.
K6 The protocol to follow when dealing with the patient/client who
have been transferred from clinically-based rehabilitation (Phase
III) or primary care to ongoing maintenance of exercise behaviour
(Phase IV cardiac rehabilitation).
K7 Understand the importance of an agreed link with a named
specialist from the hospital and/or community cardiac
rehabilitation team.
K8 Barriers to communication with the referred patient/client and
the communication skills needed to overcome these.
K9 How to identify when the patient/client needs to consult health
care professionals.
K10 Ethical considerations involved in ongoing maintenance of
exercise behaviour (Phase IV cardiac rehabilitation), including
respecting inter-professional boundaries and patient/client
confidentiality.
K11 Methods of information collection and interpretation, appropriate
storage of confidential records and management processes
encountered in running ongoing maintenance of exercise
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© SkillsActive 2013
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behaviour (Phase IV cardiac rehabilitation).
K12 Current relevant structures of the National Health Service, the
names and functions of different relevant medical organisations
and service providers.
K13 Process of atherosclerosis.
K14 Risk factors for cardiac disease.
K15 How physical activity may influence the other risk factors.
K16 Anatomy and physiology of the cardiovascular system.
K17 Causes, presentation, diagnosis and treatment of the following:
a. Angina
b. Acute Coronary Syndrome-Angina/Myocardial Infarction
(STEMI/NSTEMI)
c. Heart Failure
d. Valvular Heart disease
e. Arrhythmias
f. Cardiomyopathy
K18 Investigations for cardiac disease.
a. Resting and exercise electrocardiogram
b. Echocardiogram
c. Angiogram
d. Nuclear Imaging
K19 Interventions for cardiac disease, for example:
a. Revascularisation – Percutaneous coronary Intervention (PCI)
and coronary artery bypass grafting (CABG)
b. Implantable devices
c. Valve surgery
d. Transplantation
K20 The range of cardiac medications and their exercise
considerations.
K21 Components of inpatient and outpatient cardiac rehabilitation
(Phases I-III)
K22 Individual’s cardiac risk stratification using recognised guidelines.
K23 Acute responses and chronic adaptations to endurance and
strength training and implications for the individual with cardiac
disease.
K24 Beneficial effects of physical activity on cardiac disease.
K25 Contra-indications to exercise which need to be taken into
account for the patient/client with cardiac disease.
K26 Initial assessment including appropriate assessment of exercise
level using recognised sub-maximal tests.
K27 On going screening process prior to each exercise session.
K28 How to set up and manage a safe physical activity environment
relevant for a patient/client with cardiac disease.
K29 Both group and individual exercise programming principles for the
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patient/client with cardiac disease following guidelines.
K30 Monitoring intensity methods, e.g. heart rate and perceived
exertion.
K31 Exercise considerations for the patient/client with, for example:
 Complex cardiac patient e.g. associated heart failure, ICDs and
PPM
 Diabetes (Type 1 and Type 2)
 Hypertension
 Obesity
 Peripheral Vascular Disease
 Pulmonary disease
 Osteoarthritis/Rheumatoid arthritis/osteoporosis
K32 How to manage dietary needs in and around the exercise session.
K33 How to determine and adapt appropriate progressive physical
activity programmes appropriate to the condition using results
from the physical / exercise assessments, medical information,
national guidelines, consultation and patient/client aims.
K34 The motivational processes, models and techniques involved in
behavioural change for the referred patient/client to encourage
beneficial lifestyle changes and providing appropriate support to
sustain such changes.
K35 Mental health and mental health promotion in a cardiac
population.
K36 How to communicate and consult effectively with the referred
patient/client about their programme and progress.
K37 How to manage medical complications e.g. angina, arrhythmias
until appropriate medical help is available.
K38 How to respond safely and appropriately to emergencies e.g.
myocardial infarction, hypoglycaemia until appropriate medical
help is available.
K39 The management, evaluation and reporting of information, in
verbal and written formats.
K40 How to use and adapt a system for monitoring and recording the
patient/clients progress and updating their physical activity
programme.
K41 How to evaluate the effectiveness of ongoing maintenance of
exercise behaviour (Phase IV cardiac rehabilitation) service.
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