South Tees initiative pledges £500k to UK’s first community-based prehab project

A Sport England pilot is providing £500,000 in funding to an innovative project that improves the fitness, health and wellbeing of patients before they undergo major surgery.

Funded by You’ve Got This the PREP-WELL project was initially introduced in January 2018 and, at the time of its inception it was the first comprehensive, community-based programme of its kind in the UK.

The programme was initially based on the success of the national cardiac rehabilitation footprint and uses the emerging health care concept of prehabilitation. This involves coordinated lifestyle and wellbeing support for patients in advance of surgery to improve preoperative physical and mental health for a speedier recovery from surgery.

PREP-WELL is delivered by a team of healthcare and public health specialists in South Tees (South Tees Hospitals NHS Foundation trust and Public Health South Tees).

Each patient participating in the programme has an initial assessment examining their current health and lifestyle risk factors for surgery. Following this, a tailored package is put together based around their specific requirements.

Key components of this include supervised exercise, smoking cessation and alcohol reduction support, healthy eating and mental wellbeing support. This is crucial as the team’s research has demonstrated that up to ninety percent of patients presenting for surgery have at least one lifestyle risk factor for surgery.

The programme is designed to run for six to eight weeks for each patient, however can be flexible depending on requirements of different timeframes to surgery. At the end of the programme each patient has a follow-up assessment examining changes in fitness, lifestyle and quality of life.

The initial 12-month pilot (January 2018-19) demonstrated some highly encouraging results. Seventy three percent of patients moved from being inactive to achieving a physical activity level recommended by the World Health Organisation (WHO) of 150 minutes of exercise per week and regular strength work.

The team also observed a substantial reduction in hazardous levels of drinking among patients in the lead up to surgery, accompanied by reductions in anxiety and depression scores and improvements in quality of life. These benefits were maintained 3 months post-surgery.

This success saw the PREP-WELL team shortlisted for the highly prestigious national British Medical Journal Awards 2020, in the category of Anaesthesia and Perioperative Medicine.

Over the next 4 years the funding will be used to build on this early success. Key programme components will include:

You’ve Got This will also use funding to introduce PREP-WELL into community-based locations across South Tees.

The investment will also help the project expand to allow for more high-risk surgeries and spread to a larger patient population including orthopaedic and cancer surgeries, which account for 8,000 surgeries a year in South Tees.

James Hartley, Programme Officer at You’ve Got This said: “The PREP-WELL project has proven that prescribing physical activity can have life-changing results for people in South Tees.

“It’s an innovative approach that aligns with our vision at You’ve Got This, which is to look differently at healthcare and break down barriers that prevent people from leading active, healthy lives. Sport England funding will help You’ve Got This grow the project beyond its original base at Middlesbrough’s Live Well Centre.

“PREP-WELL being in one place creates a barrier for people who were unable to travel,” said James.

“Thanks to the investment, we’re able to remove that barrier and will look to use local, community facilities, staff and resources so that people can access the service in familiar surroundings.

“This will help us reach more patients and improve many more lives in South Tees.”

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