Cancer prehabilitation in Scotland: 2025 survey findings report

6. Rehabilitation findings

This section presents staff awareness of the national approach for good rehabilitation, and perspectives on rehabilitation pathways and delivery.

Awareness

All respondents were asked to rate their awareness of the Once for Scotland Approach to Rehabilitation published in June 2022. This was a new question in the 2025 survey. 297 responded, of which:

• 26% of respondents selected 4 or 5 (high awareness)
• 25% of respondents selected 3 (medium awareness)
• 48% of respondents selected 2 or 1 (low awareness or not aware at all).

Awareness varied only slightly by Cancer Network, with a higher proportion of respondents reporting high awareness in NCA (29%) and WoSCAN (27%), than in SCAN (21%). Due to the sampling limitations, caution should be exercised in interpreting this slight variation in awareness between the different networks.

Nurses and AHPs were slightly more likely to indicate high awareness (34% and 30% respectively) compared to Physicians and respondents in other professional groups (both 21%). Again, this slight difference should be interpreted with caution.

Service availability

Respondents were asked whether any cancer rehabilitation activities were being offered in their local area. 300 out of 302 survey respondents answered, with details shown in Table 16.

Around one in three respondents (33%) reported that there were cancer rehabilitation activities being offered in their local area in 2025. This is a decrease from 53% reported in 2022, with a corresponding increase in the proportion of people selecting 'Don't Know', from 33% to 57%. This could suggest greater uncertainty around, or less awareness of, local rehabilitation activities amongst 2025 survey respondents compared to 2022, although any comparison across years should be interpreted with caution due to differences in the sample of staff respondents.

There was little variation in the likelihood of reporting local rehabilitation activities between Cancer Networks (all between 31% and 34%). Having both prehabilitation and rehabilitation activities locally was reported by 67 respondents, representing 22% of the overall sample.

Respondents with local rehabilitation activities were asked further questions about those services. 86 of a potential 98 individuals responded. They discussed a range of rehabilitation services available from NHS Boards, Third Sector organisations and Local Authority leisure centres. Some services were described as resembling the prehabilitation pathway or forming part of standard post-operative care. Most offerings were physical activity-based, though other forms of support, such as dietary, physiological, emotional support and financial advice, were also mentioned. Delivery was primarily in-person through clinics or drop-in centres, with some examples of online or telephone-based support provided.

Service delivery and pathways

Local delivery underpinned by a Once for Scotland approach

Respondents were presented with the Six principles of Good Rehabilitation and asked about the extent to which each principle underpinned the delivery of rehabilitation activities in their local area. 95 out of a potential of 98 respondents evaluated these statements.

As shown below, a majority agreed that local services are realistic and meaningful to the individual, and that they are delivered by a flexible and skilled workforce. Statements about the integration and ease of access to services for every individual received more disagreement:

• 49% agreed that their local services are easy to access for every individual, while 25% disagreed;
• 44% agreed that services are provided at the right time, while 18% disagreed;
• 59% agreed that services are realistic and meaningful to the individual, while 9% disagreed;
• 44% agreed that services are integrated, while 24% disagreed;
• 40% agreed that services are innovative and ambitious, while 15% disagreed;
• 53% agreed that services are delivered by a flexible and skilled workforce, while 12% disagreed.

Rehabilitation continuum

As discussed in Service delivery and pathways, around two thirds of respondents (64%) agreed that local delivery of prehabilitation activities is underpinned by the principle that they are part of the rehabilitation continuum. In open text responses, however, few provided details of how this continuum worked in practice. One respondent described the benefits of meeting patients and becoming a ‘familiar face’ before surgery so that individuals are comfortable with contacting them afterwards with any further questions. Some Third Sector providers of both prehabilitation and rehabilitation also described service delivery through the whole cancer journey. The need to integrate both prehabilitation and rehabilitation into standard cancer care along the full pathway was emphasised in responses. The importance of effective ways of informing staff about pathways and rehabilitation resources available was also highlighted.