Improving equity in prehabilitation before cancer surgery: consensus-based considerations for leaders and practitioners: a nominal group technique study.

Authors

X Zhang, L Ashmore, C Hadley, C Kullikowski, S Stanley, H Stewart, L Wareing, C Gaffney, A Partridge, A Smith, J Rycroft Malone, C Shelton

Published in

Anaesthesia reports. Volume 14. Issue 2. Pages e70085. Epub Jul 14, 2026.

Abstract

Prehabilitation aims to improve physical, nutritional and psychological health before surgery. Despite its potential benefits, inequitable access remains a concern. The wider PARITY study aimed to identify and help address inequalities in prehabilitation before cancer surgery using a mixed-methods approach. This report describes the end-of-study prioritisation workshop, which brought together professional, public and patient participants to prioritise considerations to promote equity in prehabilitation services using a nominal group technique. Before the workshop, 42 considerations identified from preceding work, including co-design, Delphi, service mapping and case studies, were shared with participants for review. Participants (n = 15) discussed and prioritised these considerations according to perceived impact and feasibility of implementation. Considerations were ranked by perceived priority and categorised by level of implementation. Forty-two considerations were prioritised and categorised as system level (n = 15), service level (n = 22) and practitioner level (n = 5). The six highest-priority considerations relate to: understanding how prehabilitation and surgery may affect each patient's life; adapting delivery to individual needs; making services available at a system-wide level; contacting patients who are not engaging; providing interpreters where needed; and training care teams in equality and diversity issues. These findings provide consensus-based considerations to support more equitable prehabilitation before cancer surgery, at a time when prehabilitation is increasingly prominent in national guidance.

PMID:
42459925
Bibliographic data and abstract were imported from PubMed on 16 Jul 2026.

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