Prehabilitation services for people diagnosed with cancer in Scotland - Current practice, barriers and challenges to implementation.

BACKGROUND: Prehabilitation is the practice of enhancing a patient's functional and psychological capacity before treatment commences. It is of interest in the cancer context because of the impact of treatments on quality of life and cancer survivorship. This work aims to document current practice, barriers and challenges to implementing prehabilitation to inform the development of a national framework. METHODS: A mixed-methods approach was applied: an on-line survey was sent to stakeholders in cancer care across Scotland, supplemented by in-depth interviews. Key domains explored were the perceived importance of prehabilitation, availability, delivery and content of services, outcome measures, referral processes and funding. FINDINGS: A total of 295 survey responses were obtained and 11 interviews completed. Perceived importance of prehabilitation was rated highly. There was uncertainty over the definition of prehabilitation and most respondents did not know if local services were available. Where services were described, a range of health professionals were involved, different outcome measures were utilised and frequency of referrals varied. Respondents highlighted short time frames between referral and treatment, concerns about patient engagement, the evidence base for action and funding priorities. Respondents also commented on which context a referral should be made and to whom, and the need for equity of service across the country. CONCLUSIONS: The current work found clear evidence of the perceived importance of prehabilitation in cancer patients. However, issues and key gaps were identified within current services (including issues arising from COVID-19) which must be addressed to enable wide-spread development and implementation of equitable programmes.

Can webinars support the implementation of video consultations at pace and scale within the allied health professions?

Background/aims: In an attempt to reduce the impact of COVID-19 and support remote working, many allied healthcare professionals were equipped with video consultation technology. To support this new way of working, profession-specific webinars were delivered and attended by over 50% of the total allied healthcare professional workforce in Scotland. This study aimed to evaluate the impact of these webinars on the knowledge and confidence of allied health professionals in delivering services via video conferencing. Methods: Attendees knowledge and current video conferencing use were ascertained immediately before and after webinars. Surveys were also completed at 4 and 8 weeks after the webinar to establish any impact on clinical practice. Results: Levels of understanding, knowledge and confidence increased considerably (P<0.001). Follow up at 8 weeks post webinar identified that 75.5% of attendees were using video conferencing, with allied healthcare professional video conferencing activity representing 17% of all national activity by June 2020. Conclusions: Upskilling a diverse and dispersed workforce at pace and scale to enable safe remote working has been critical throughout the pandemic. Webinars have proven to be popular with staff to increase their knowledge of and ability to confidently use video conferencing to provide allied healthcare professional services across Scotland.