What is it about?
Prehabilitation is a personalised programme where a person focuses on their physical fitness, nutrition, mental health and lifestyle before and during a major health event such as surgery or cancer treatment. As our world population ages, the number of cancer diagnoses are rising and there are more people than ever before suffering with obesity and long term health conditions undergoing surgery. This article explores the barriers to the availability of prehabilitation in the United Kingdom. The authors found the three most significant barriers were cost-effectiveness, workforce shortage and lack of national policy at the time of publication.
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Why is it important?
This article is a rapid review of the available prehabilitation evidence base which has been in clinical settings for over 15 years, but has yet to become a standard part of all major surgical and cancer care pathways nationwide. The rapid review has a search strategy focused on barriers, challenges and cost as a way of investigating possible challenges to the future development of prehabilitation services. Many clinicians and researchers highlight the lack of or conflicting evidence around cost-effectiveness and prehabilitation so we need more research to evaluate the implementation of these programmes. Clinicians identified a lack of access to trained prehabilitation professionals, especially within the field of dietetics and psychology, which is another barrier to the implementation of a complete prehabilitation service. At the time of publishing Wales is the only devolved nation in the UK to explicitly mention prehabilitation in cancer or health policies (Bloom, 2017) . National policymaking is pivotal to the successful implementation and sustainability of prehabilitation programs in the UK. Policymakers can ensure that prehabilitation becomes a standard part of surgical care, ultimately improving patient outcomes and reducing healthcare costs.
Perspectives
This article was written to highlight the barriers faced by many clinicians and researchers in the fight for making prehabilitation a standard of care. In order to avoid the failure of many pilot prehabilitation programmes, both clinicians and researchers need to focus on cost effectiveness of their programmes and their staff that provide the services. Digital prehabilitation offers a promising avenue to address cost and staffing challenges but a lack of national policy support hampers the integration of multimodal prehabilitation as a standard part of both the prevention and digital transformation agenda in the United Kingdom.
Shana Tribe
King's College NHS Foundation Trust
Read the Original
This page is a summary of: Barriers to Implementation of Prehabilitation, British Journal of Hospital Medicine, November 2025, Mark Allen Group,
DOI: 10.12968/hmed.2024.0817.
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