A bowl of porridge

Prehabilitation frameworks in Scotland

Published: 13 October 2022

This initiative is developing and evaluating prehabilitation activities in Scotland to help give people affected by cancer better access to high quality information and rehabilitation support.

Debbie Provan Dietitian, who worked as an adviser to the Scottish Government

The initiative

This initiative aimed to :
  • make best use of workforce skills, technology, and service innovation to improve cancer services and patient outcomes
  • ensure equitable access to care wherever a person may live; especially whilst the risks of COVID-19 persisted.

This included developing and evaluating the standard for prehabilitation in Scotland.

What we did

  • Funded a pilot with Maggie’s which offered a universal prehabilitation workshop through their 8 centres across Scotland.
  • Agreed key principles for implementing cancer prehabilitation across scotland which were launched in April 2022.     
  • Developed a national psychological support framework for the full cancer pathway which was launched in April 2022.
  • Developed and launched the Prehabilitation for Scotland website that supports the delivery of universal prehabilitation.
  • Developed a nutrition framework for the full cancer pathway which will be launched in November 2022.
  • Ran a survey to understand attitudes towards cancer prehabilitation and rehabilitation across Scotland and also current provision and future plans for service development.

Impact and outcomes

  • More than 900 people affected by cancer accessed the Maggie’s pilot in year 1. Satisfaction levels are high with improvements in activation and wellbeing reported. 
  • Focus groups have been run with people with lived experience to help develop the offer.     
  • Recommendations and a report from the focus groups has been shared with the action group leading on delivery and they are also published online.
  • Work is ongoing to embed the key principles and frameworks in core clinical pathways across Scotland with continual improvement and evaluation built in to the process.     
  • Survey findings and other outcomes data are informing future work.

Future aims

  • To give patients better access to high quality information and support that will improve outcomes and experience.
  • To improve knowledge across the whole workforce and share best practice through collaboration. 
  • It’s important to look at how this initiative can make a difference to national policy. In Scotland there in an integrated health social care system and England is moving toward this model to maximise quality, capacity and sustainability.

Find out more

You can contact the team by emailing Debbie Provan at Debbie.Provan2@gov.scot.

You can follow Debbie on Twitter @DebbieProvanRD.

Debbie has also contributed to a ScienceDirect report: Prehabilitation services for people diagnosed with cancer in Scotland - Current practice, barriers and challenges to implementation.

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