Cancer prehabilitation survey: findings report

5 Rehabilitation Findings

5.1 Attitudes and Awareness

5.1.1 Importance of Rehabilitation

172 out of 187 potential respondents answered this question, which was also asked in 2019. Details are shown in Table 13.

Of those who answered the question, 95% selected 4 or 5, indicating that they attached high importance to rehabilitation. Findings were similar for all the cancer networks. 62% of those respondents selected 5, 'crucial', similar to the 2019 finding for this question. 8% of survey respondents did not answer this question, implying that they did not know.

Of all survey respondents, more attached high importance to rehabilitation (88%) compared with prehabilitation (77%). This could reflect their greater experience of rehabilitation, and their awareness of barriers which would need to be addressed to support effective prehabilitation, as discussed earlier.

5.2 Service Availability and Resourcing

5.2.1 Availability of Local Rehabilitation Activities

Respondents were asked whether any cancer rehabilitation activities were being offered in their local area. 186 out of 187 survey respondents answered, with details shown in Table 14.

These findings are similar to those from the question about local prehabilitation activities. 62 respondents answered 'yes' to both questions, representing around two thirds of 'yes' respondents to each question.

There was some variation among the cancer networks. WoSCAN had the highest proportion of respondents selecting 'yes' to this question (58%) and NCA the lowest (45%). The proportion for SCAN was 53%.

Respondents with locally available rehabilitation services (n = 98) were asked further questions about those services. They discussed a range of rehabilitation services available from the NHS, third sector organisations and local authority leisure centres. Some respondents highlighted challenges relating to staffing and funding, the sub-themes discussed in Section 4.2.

5.3 Service Delivery and Pathways

5.3.1 Referrals

Respondents were asked if they personally referred people to rehabilitation activities and how routinely they did so. This question was also asked in the 2019 survey. All 98 potential respondents answered it, as shown in Table 15.

48% of respondents referred to rehabilitation services, similar to the 2019 finding of 47%. The proportion who provided services, at 20%, was higher compared with the 2019 finding of 14%.

All 47 respondents who answered Yes answered the follow-up question about how routinely they referred people.

• 40% selected 4 or 5 (more likely to or always refer).
• 47% selected 3 (medium likelihood of referring).
• 13% selected 1 or 2 (less likely to refer).

Qualitative findings highlighted the need for routine and timely referral to rehabilitation services, similar to the prehabilitation findings discussed in Section 4.3.

5.3.2 Rehabilitation Continuum

This sub-theme links to the prehabilitation 'Key Principle' that "Prehabilitation activities are part of the rehabilitation continuum." As discussed in Section 4.3, around half of respondents with local prehabilitation and rehabilitation services in place agreed that this principle underpinned them. However most did not describe how their continuum worked in practice. Therefore, the extent to which their patients moved along a seamless pathway from prehabilitation to treatment and then rehabilitation was generally not clear. However some third sector providers of both prehabilitation and rehabilitation did describe service delivery through the whole cancer journey.

5.4 Access to Services

As discussed in Section 4.4, the location of services and the need to consider geographical inequalities were also mentioned in relation to rehabilitation services.