Prehab4Cancer Scheme Expands

Cancer prehabilitation and recovery programme receives a royal visit and expands into Mid and East Cheshire

We are delighted to announce that our pioneering fitness and wellbeing programme to support cancer patients prepare for treatment and surgeries is expanding into Mid and East Cheshire following a successful two-year roll out across Greater Manchester.

Prehab4Cancer is the first UK integrated care service-delivered prehabilitation and recovery programme for cancer patients, via our partnership with GM Cancer Alliance. The programme facilitates cancer patients to engage in exercise, nutrition, and wellbeing assessments and interventions prior to, during and after treatment.

And such is its success, the programme was commended with a royal seal of approval from HRH Princess Anne, who visited the Prehab4Cancer programme being delivered at Worsley Leisure Centre, in Salford, where she was introduced to a number of staff working on the programme, including exercise specialists, people affected by cancer enrolled on the service, its Clinical Director Dr John Moore and its Allied Health Professional (AHP) Occupational Therapist Clinical Lead Zoe Merchant.

Princess Anne at Prehab4Cancer

“We do a lot of strength training to build and optimise muscle as we know that good muscular strength will support function and independence following surgery and treatment.”

Kirsty Rowlinson-Groves, Prehab4Cancer Programme Manager

The Princess Royal, who visited as Patron of the Royal College of Occupational Therapists, was shown several demonstrations of typical prehabilitation assessments and interventions and heard first-hand the impact this programme is having on patients’ physical and mental wellbeing in the lead up to, and after cancer treatment. She also heard how the programme adapted to a virtual delivery model during the Covid-19 pandemic to ensure patients awaiting cancer treatment continued to receive this support.

Since its inception in 2019, Prehab4Cancer has supported 2,500 patients in Greater Manchester and is now aiming to provide for approximately 400 patients living in the east and mid Cheshire Clinical Commissioning Group (CCG) areas – which stretch from Wilmslow in the north to Crewe in the south.

The programme is offered to patients with lung, colorectal (bowel) and oesophago-gastric (often referred to as upper GI) cancers.

Kirsty Rowlinson-Groves, Prehab4Cancer programme manager, says: “Patients are referred to us from the clinical teams at the hospitals where they are being treated. We assign them an exercise specialist, who then undertakes a baseline assessment that creates the prehabilitation process.

“That’s all about optimising the patient’s cardiovascular fitness and working on their muscular strength. We do a lot of strength training to build and optimise muscle as we know that good muscular strength will support function and independence following surgery and treatment. We push them physically to get them in the best condition we can so they are optimised for treatment.

“Once prehab is finished, they are reassessed and that allows us to see what improvement has been gained. They will then go for surgery and we aim to invite them back for a post op assessment around four to six weeks after surgery.”

Co-designed and recurrently funded

Prehab4Cancer is a co-designed transformation programme between GM Active and GM Cancer. What began as a test project in 2019 has now secured recurrent funding to safeguard its future following an independent evaluation report.

Andy King, Chair of GM Active, says: “This programme is designed to empower patients to take an active role in their cancer care. It prepares patients for the treatments and surgeries and aims to provide positive outcomes for patients during recovery and beyond.

“Prehab4Cancer demonstrates just what can be achieved with structured and imaginative co-design and collaborative working between clinical and physical activity providers across Greater Manchester. We hope this approach can be applied to other health conditions and services too so that physical activity can be embedded throughout every relevant care pathway of the NHS.

“It puts our gyms and leisure facilities on the frontline of cancer care and the preventative health agenda and speaks directly to our stated aim of getting more people physically active so they can live healthy, happy and longer lives.”

A pilot scheme running until October 2022, the Cheshire programme is being funded through the Cheshire and Merseyside Cancer Alliance. We have set up a delivery partnership with Everybody Sport and Leisure and Brio Leisure Trusts to allow for the Prehab4Cancer team to deliver the scheme through their sites.

Face-to-face or remote, the patients choose

Patients accepting a referral to Prehab4Cancer can choose how to participate in their exercise prescription.

Face-to-face sessions are delivered in leisure centres run by GM Active members in Greater Manchester, and centres managed by the two leisure trusts providing facilities in Cheshire.

The programme also has what it calls a ‘remote model’ where patients can choose to exercise at home. A tailored home exercise programme is posted out to them with resistance bands for strength training, with sessions supporterd by their assigned exercise specialist either over the phone, or via a video call.

It also offers online exercise classes, Youtube channels and 12 live exercise classes per week that patients can join in with along with other patients at home. All options are supporterd by the exercise specialists and are available to Greater Manchester and Cheshire patients.

Kirsty explains: “Some patients are still understandably nervous about attending leisure centres and find home exercise more acceptable. The ‘remote offer’ also supports patients during the pre-surgery isolation periods where they are required to isolate at home for a period of time before they are admitted to hospital for their surgery”

A 10-strong Prehab4Cancer team consisting mainly of exercise and fitness specialists guide patients through their programmes.

Prehab4Cancer demonstration

Eight out of ten patients accept referrals.

Since January 2021, 1,130 patients have been referred to Prehab4Cancer in Greater Manchester, with an acceptance rate of 82 per cent. With the pilot scheme in its infancy in Cheshire, 20 patients are currently taking part.

From prehab, to rehab, to healthier lifestyle choices

Patients are usually contacted about starting rehabilitation about a month after having surgery, or ending their treatment.

If they agree, they are assessed and then embark on a three-month rehab period, designed to build them up physically. Once that period is over, patients are discharged into community programmes, often at the leisure centres where they did their prehab. They are also directed to community and volunteer organisations, such as allotment societies or walking groups, who can help to keep them fit and active.

Kirsty says: “This time after surgery or treatment is sometimes called a ‘teachable moment’. If you’ve come through cancer treatment, or cancer surgery, your health is more important to you afterwards so healthier options and healthier lifestyles are what you are drawn to.

“In our 12-week rehab period, the role of our team is to educate and build that behaviour change, and increase the patient’s confidence in making healthier, more active choices and give them confidence to access the services that will help them.”


“Dear Prehab4Cancer, I just want to say how wonderful this service is.

“Exercise was, to be honest, the last thing on my mind when I was diagnosed!

“However, Sarah from PrehabCancer explained the importance of exercise and fitness both before and after the operation.

“This proved lifesaving for me both mentally and physically. It gave me something to focus on before and then when I was discharged from hospital it became a tool to regain my strength and start my new journey.

“Unfortunately, I had CDiff when I was in hospital and couldn’t even keep food down etc. I ended up so weak I had to have the rehabilitation team in to provide me with aids etc to assist my basic daily living.

“My wound took along time to heal so I had district nurses for over two months visiting me at home.

“Sarah has kept in contact throughout. She has sent me exercises and a band which I use regularly and talked me through how to gradually build up my strength and mobility.

“I am now, thanks to her constant and enthusiastic contact, back up to a level of fitness I was before. I now go for walks in the park and next month will return to the gym.

“Before I didn’t really enjoy exercise but Sarah’s approach has altered my perception so much I actually want to exercise because I enjoy it and I am feeling the benefits.

“Thank you so much for giving me this opportunity. A cancer diagnosis is certainly life changing but it is also an opportunity to make life changes too.”

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