Cancer prehabilitation in Scotland: 2025 survey findings report

9. Appendices

Appendix A: Breakdown of respondents

Please note: Percentages in some tables may not total 100% due to rounding.

Appendix B: Survey questionnaire

About You

Q1. Please tell us about your:

Organisation:

• Health & Social Care Partnership
• Local Authority
• NHS Board
• NHS Primary care
• Third Sector
• Other (please describe)

Q2: Place of Work:

• Acute Care
• Community Care
• Local Authority
• Third Sector
• Other (please describe)

Q3: Job Title/Role:

• Dietitian
• Exercise Specialist
• Macmillan Improving the Cancer Journey
• Nurse
• Occupational Therapist
• Physician – Primary Care
• Physician – Secondary/ Tertiary care
• Physiotherapist
• Psychologist/ Counsellor
• Radiographer
• Senior Leader/ Service Manager
• Speech and Language Therapist
• Project/ Improvement Manager
• Other (please describe)

Q4: As a Senior Leader/Service Manager, are you actively engaged in or leading local activities that will see cancer prehabilitation embedded in ways of working and/or pathways of care?

• Yes / No

Q5: If yes, please provide details

(free text response options)

Q6: In which Health Board area is your place of work located?

(the 14 NHS Territorial Boards were listed as response options)

• Prehabilitation
• For the purposes of this survey, prehabilitation constitutes nutrition, physical activity/exercise and psychological support and the associated interventions delivered before definitive cancer treatment. Prehabilitation is proactive and personalised.

Q7. The ‘Key Principles for Implementing Cancer Prehabilitation in Scotland’ were published in April 2022.

How would you describe your awareness of the Key Principles?

• Scale of 1-5: Not aware at all …. Very aware

Q8: Are any cancer prehabilitation activities being offered in your local area

(intervention before definitive treatment)?

• Yes / No / Don’t Know

Q9: To what extent do the following statements, reflecting the ‘Key Principles for Implementing Cancer Prehabilitation in Scotland’, underpin the delivery of prehabilitation activities in your local area?

Scale shown for all statements: 1 = strongly disagree 5 = strongly agree

• + Don’t Know
• a. Prehabilitation activities start as early as possible and in advance of any cancer treatment
• b. Prehabilitation activities run in parallel with usual decision making processes so it does not have an adverse effect on cancer waiting times nor delay the start of treatment
• c. Prehabilitation activities are part of the rehabilitation continuum
• d. Prehabilitation activities are multi-modal including exercise/activity, nutrition and psychological support
• e. All patients are screened to determine the level of prehabilitation required (universal, targeted, specialist)
• f. Completion of prehabilitation screening should be recorded at cancer multidisciplinary team meetings alongside performance status
• g. All patients (receiving universal, targeted and specialist interventions) have a co-produced personalised prehabilitation care plan
• h. Validated tools are used for individualised assessment, care planning and outcomes measurement when patients are receiving targeted and specialist interventions

Q10: What staff or volunteers are involved in the delivery of your prehabilitation activities in your local area? Please select all that apply.

• Nurse
• Physiotherapist
• Dietitian
• Occupational Therapist
• Clinical Psychologist
• Counsellor
• NHS Technical Instructor/Support worker
• Fitness Instructor (Local Authority/Move More etc.)
• Volunteer/Buddy/Peer Supporter
• Don't Know
• Other (please describe)

Q11: How closely do staff providing prehabilitation work within the care team and patient pathway (for instance, in a multidisciplinary team, or with prehab being a core part of a patient pathway/clinical management guideline)?

• Free text response.

Q12: How are the following aspects of your prehabilitation activities monitored?

• Patient uptake (e.g. of patients referred, who joins the programme).

Q13: Patient adherence (e.g. number of sessions attended by patients).

Q14: Patient experience (e.g. patient feedback on the programme).

• Free text response for each.

Q15: Are outcome measures being used to determine the effectiveness of your prehabilitation activities?

• Yes / No / Don’t know / Not applicable

Q16: What outcome measures are being used?

• Free text response.

Q17: Do your prehabilitation activities have:

• Permanent funding
• Temporary funding (If temporary, when is funding expected to cease?)
• I don't know about funding
• No funding
• Other (please describe)

Q18: Do you personally refer people to prehabilitation activities?

• Yes / No / I provide prehabilitation services

Q19: How routinely would you refer people to prehabilitation activities?

• Sliding Scale shown: 1 = never 5 = always

Q20: Is your service screening or triaging patients for perceived risk associated with: Nutrition?

• Yes / No / Don’t know

Q21: Please describe how your service is doing this.

• Free text response.

Q22: Is your service screening or triaging patients for perceived risk associated with: Physical activity/exercise?

• Yes / No / Don’t know

Q23: Please describe how your service is doing this.

• Free text response.

Q24: Is your service screening or triaging patients for perceived risk associated with: Psychological need?

• Yes / No / Don’t know

Q25: Please describe how your service is doing this.

• Free text response.

Q26: How have prehabilitation activities offered in your local area changed in the last 18 months? (You may wish to comment on activities that have decreased; plans to increase activities that were cancelled / scaled back; new activities started or planned; delivery mode e.g. digital/face-to-face).

• Free text response.

Q27: Do you have any other comments on the prehabilitation activities offered in your local area? You may wish to comment on referral/access route, inclusion/exclusion criteria including patient group and planned treatment type, screening and assessment process, location and duration of intervention.

• Free text response.

Q28: Are there any plans to introduce or add to the prehabilitation activities in your

• local area?
• Yes
• No
• Don’t know

Q29: Please share your thoughts on how local pathways could be changed to support prehabilitation and optimise patients for treatment, including while they are on waiting lists (you may wish to comment on local barriers and/or enablers to prehabilitation, including leadership, staffing and multidisciplinary team (MDTinvolvement).

• Free text response.

Q30: How important do you think prehabilitation interventions are for people about to undergo cancer treatment?

• Sliding Scale shown: 1 - not important at all; 5 - crucial

Learning resources

Q31: Do you utilise the national prehabilitation website - Prehab and Me – Prehabilitation for Scotland either for your own learning/access to resources or to support patients?

• Yes / No

Q32: In what way do you make use of this website? I use it to…(select all that apply)

• Signpost patients to information that will help them understand and engage in prehab
• To help answer specific questions the patient has about elements of prehab/suitability for prehab
• To help patients learn what additional support is available to them
• To help a patient set their own prehab goals
• To learn more about prehab and how I can support patients to prepare for what lies ahead
• Find out what education and training is available to develop my knowledge and skills in prehabilitation
• Access the Key Principles for Implementing Cancer Prehabilitation to guide my work/prehab service
• Access the Frameworks (nutrition, physical activity and psychological support) that guide my work/prehab service
• Other

Q33: Why do you not make use of the website? Please select all that apply.

• We have a local website
• I don’t think it’s useful/contains the right information
• I wasn’t aware of the website
• I don’t have enough time in a consultation to discuss the website
• Other

Q34: The following are designed to help improve knowledge, skills and competencies in prehabilitation. Please indicate those you are aware of.

• Prehab, Rehab and Personalised Care Programme (PRosPer)
• The Nursing, Midwifery and Health Professions (NMaHP) Perioperative Education and Development site
• Enhanced Recover After Surgery (ERAS) in Scotland TURAS pages
• Perioperative Medicine in Action
• Nutrition Framework Education and Training Grid (Appendix 3)
• Psychological Therapies and Support Framework Education and Training Grid (Appendix 3)
• Actify
• Homepage - Moving Medicine Scotland

Rehabilitation

For the purposes of this survey, rehabilitation constitutes nutrition, physical activity/exercise and psychological support and the associated interventions delivered after definitive cancer treatment. Rehabilitation is proactive and personalised.

Q35. Scottish Government published the Once for Scotland Approach to rehabilitation in June 2022, based on six principles of good rehabilitation.

How would you describe your awareness of the principles?

• 1 = Not at all aware, 5 = Very aware

Q36: Are any cancer rehabilitation activities being offered in your local area (i.e. interventions following treatment)?

• Yes / No / Don’t know

Q37: Please describe the cancer rehabilitation activities offered in your local area.

You may wish to comment on referral/access route, inclusion/exclusion criteria including patient group and treatment type, screening and assessment process, location and duration of intervention.

• Free text response.

Q38: To what extent do the following statements, reflecting the ‘Six Principles of Good Rehabilitation’, underpin the delivery of cancer rehab activities in your local area?

Scaled for strongly disagree to strongly agree options + Don’t Know

• Easy to access for every individual
• Provided at the right time
• Realistic and meaningful to the individual
• Integrated
• Innovative and ambitious
• Delivered by a flexible and skilled workforce

Additional Comments

Q39: If you have any additional views or comments on prehabilitation or rehabilitation please use the field below to share them.

• Free text response

Q40: Would you be willing to take part in a follow-up online focus group (lasting no more than 60 minutes) to discuss prehabilitation in more detail? This would be carried out no later than Spring 2026.

• Yes / No

Q41: To enable us to contact you for the focus group, please provide your contact details below. Please note that not everyone who volunteers will be invited to participate and your personal information will not be used for any other purpose. A Privacy Notice outlining how your information will be used can be found here: https://www.prehab.nhs.scot/cancer-prehabilitation-survey-2025-privacy-notice/