Resources  |  Responsive Prehabilitation- Medway SPEP

Responsive Prehabilitation- Medway SPEP

 T. Rampal   M. Shah   R. Laza-Cagigas 

Initiatives to improve patient outcomes through pre-operative education and intervention are being recognised in the health care settings. Healthcare organisations are establishing prehabilitation services based on pre-existing service models.

We suggest in accordance with the ethos of collaborative decision making, Prehabilitation needs to move in the direction of being patient led rather than simple adoption of pre-existing models. This strategy would be tailored to the needs and expectation of the local population.


We conducted a pre-operative patient questionnaire survey of their expectations and needs form an education programme to improve post-operative outcomes. We launched our programme following our initial survey incorporating physiotherapy, nutrition and life style advise, psychological support. It was very well received.

Based on the patient feedback and insight form peer patient members into our prehabilitation service, we developed links with public health. We have incorporated healthy lifestyle advise especially smoking cessation and alcohol moderation in our programme.

Further on, guided by patient requests, we developed a series of educational videos and embedded them in our Trust’s website.

Additional feedback has led us to focus on prehabilitation diaries to maintain patient motivation.

With a view to minimise costs on a financially stretched service and improve accessibility, we have kept majority of the educational tools in the form of electronic resources.

We continue quarterly review and adaptation of our prehabilitation service based on the needs of our local community.


100% of the attendees find our model inclusive, relevant and accessible.


Patient feedback has been highly encouraging. 100% of the attendees find our model inclusive, relevant and accessible. 100% of attendees would recommend our model to fellow patients. We have received endorsements from Medway Public Health and the Member of Parliament representing Medway (Mr. Chishti).

Patient survey results


Patient involvement in the design of prehabilitation service is the key to keep engagement and compliance with the education programme for patients awaiting major surgery.

As clinicians and healthcare providers we may need to reconsider our approach to multimodal prehabilitation. In order to have “buy in” from the patients, we need to listen to their needs.

Prehabilitation service had to be adaptive and responsive to the feedback and the education needs of every community vary based on health literacy and local issues.


  • Carli, F. and Scheede-Bergdahl, C., 2015. Prehabilitation to enhance perioperative care. Anesthesiology clinics, 33(1), pp.17-33.
  • Levett, D.Z. and Grocott, M.P., 2015. Cardiopulmonary exercise testing, prehabilitation, and enhanced recovery after surgery (ERAS). Canadian Journal of Anesthesia/Journal canadien d’anesthésie, 62(2), pp.131-142.
  • Minnella, E.M., Bousquet-Dion, G., Awasthi, R., Scheede-Bergdahl, C. and Carli, F., 2017. Multimodal prehabilitation improves functional capacity before and after colorectal surgery for cancer: a five-year research experience. Acta Oncologica, 56(2), pp.295-300.

Share this resource Twitter LinkedIn Facebook

Would you like us to help you shape your prehab offering?

Start changing lives