54 Access to Prehabilitation in UK Neuro-Oncology: Insights from a UK-wide review of adult brain tumour services (2024-2026)

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Abstract Background Prehabilitation aims to optimise physical, psychological and functional health prior to and during cancer treatment. While an increasing focus in neuro-oncology, little is known about its availability or structure across the United Kingdom (UK). Methods As part of the Tessa Jowell Centre of Excellence programme, workforce and service data were collected from 25 UK adult neuro-oncology centres (2024–2026), covering 90+% of the UK population. Responses were extracted from application forms and thematically analysed. Data were self-reported and validated through expert review. Results 17/25 centres (68%) reported involving allied health professionals (AHPs) to prepare patients for surgical/oncological treatment. Only 7 centres (28%) reported providing components of prehabilitation to all patients; a further 10 offered restricted access to specific subgroups (e.g. awake craniotomy, high-risk patients, or tumour subtypes). Service scope varied: 7 centres offered pre-surgical input only, 3 pre-oncology only, and 7 both. Of the 17 centres providing input, 9 delivered active intervention, while the remainder offered assessment alone. Prehabilitation was delivered by AHPs from multiple disciplines, most commonly occupational therapists (12 centres), physiotherapists (10), speech and language therapists (8), neuropsychologists (7) and dietitians (4). Assessment approaches ranged from comprehensive evaluation to clinic-based screening. Barriers were common: 9 centres reported funding and workforce constraints, 2 cited limited time before treatment initiation, and 2 highlighted insufficient data to support further service development. Despite variation, two-thirds of centres (15/25) reported active plans to establish or expand prehabilitation. Conclusions Access to neuro-oncology prehabilitation across the UK is inconsistent, with marked variation in eligibility, scope and workforce. Many services remain assessment-based or limited to specific patient groups. Data collection, workforce investment and clearer definitions may be required to ensure equitable and sustainable prehabilitation access.

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