MacMillian Cancer Research estimates there are almost 3.5 million people living with cancer in the UK (1). While cancer survival rates are improving, the physical and psychological effects of cancer and its treatment can last long after treatments end.
Cancer (p)rehabilitation treatment usually involves advice and support from the multidisciplinary cancer team, focused on physical activity and exercise, healthy diet and weight, and support for mental health and wellbeing (2).
Research shows that focusing on certain lifestyle changes in whatever time is available before treatment starts can help patients with cancer cope better with treatment side effects and improve their long term health (3).
(P)rehabilitation is a proactive approach to help prepare patients for their treatment and support them through their treatment journey. (P)rehabilitation aims to optimise patients’ recovery and enhance quality of life by working to improve their physical and psychological health beforehand.
Bedfordshire, Luton and Milton Keynes (BLMK) integrated care board (ICB) funds the training of personal trainers within the ICB to undertake Level 4 Cancer rehabilitation training. These personal trainers are then qualified to deliver cancer (p)rehabilitation to patients living in the ICB.
Health Innovation East was commissioned to evaluate the service to understand who engages with cancer prehabilitation, what impact the service has on patients’ quality of life and wellbeing and what patients’ experiences of the service were and to discover how they could best support the personal trainers to continue delivering the service. The evaluation also included an innovation horizon scan to identify any eligible innovations which could support the delivery of cancer prehabilitation in the ICB.
Health Innovation East conducted a mixed-methods evaluation across BLMK ICB – running between August 2024 to March 2024.
Three groups of participants were approached to participate in the evaluation:
An online survey was used to collect data from the clinician and cancer patient cohorts about their awareness and engagement of the service and any impact from using the service. Semi-structured interviews were conducted to capture the experience of the personal trainers and any recommendations for improving the service.
Any available data from the personal trainers about the patients attending their sessions, such as usage, engagement and demographics, was also collected.
The final stage of the project was an innovation horizon scan to discover whether there were any suitable innovations to support delivery of cancer prehabilitation.
The evaluation found patients, clinicians and personal trainers agreed that cancer (p)rehabilitation brings a wide range of benefits to cancer patients including improving physical and mental health, provided social benefits and empowered patients.
The majority of patients who responded to the survey were not aware of the service and more than half of eligible clinicians were also unaware.
59% patients and eight out of the nine clinicians were supportive of the role of innovation in delivering cancer (p)rehabilitation. However, personal trainers reported that they do not have capacity to take on many more patients. There is therefore a role for an innovation delivering the service to enable more patients to access the sessions and reach those unable to join in-person .
The horizon scan identified six potential innovations meeting the requirements to support delivery of the service.
Health Innovation East produced a series of six actionable recommendations for the commissioners to develop the work further. We recommended that there is equitable delivery of the service by exploring the role innovations may play and considering ways to engage with more underserved groups to explore their views on the service.
Following the evaluation, BLMK ICB are reforming the cancer (p)rehabilitation working group and are currently training two more personal trainers in Milton Keynes. The ICB continues to work through the recommendations from Health Innovation East to improve the service.
Health Innovation East brought a deep understanding of healthcare innovation, combined with a rigorous and collaborative approach to evaluation. From the outset, they demonstrated a clear commitment to improving patient outcomes, helping to shape a robust framework for assessing the impact of the services.
Their insights were instrumental in identifying key metrics, gathering meaningful data, and translating findings into actionable recommendations. The evaluation not only validated the need for the approach and programme but also highlighted opportunities for further development and scaling.