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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program

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Published on: April 19, 2019

Barriers to Implementation of Prehabilitation.

Tarannum Rampal¹, Shana Tribe²

¹Department of Anaesthetics, Princess Royal University Hospital, Kings College NHS Foundation Trust, London, UK.

British Journal of Hospital Medicine (London, England : 2005)

|November 24, 2025

Summary

Prehabilitation, a multimodal approach to improve surgical patient outcomes, faces barriers in the UK. Key challenges include cost-effectiveness, workforce shortages, and the absence of national policy.

Keywords:

cost-effectiveness digital health technology implementation science policy pre-operative exercise prehabilitation

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Area of Science:

Geriatric Medicine
Surgical Care
Public Health Policy

Background:

Global demographic shifts necessitate healthcare system adaptation, particularly for an aging population undergoing complex surgeries.
High-risk surgical patients, characterized by frailty, sarcopenia, cancer, comorbidities, and obesity, represent a significant challenge, accounting for a disproportionate number of surgical deaths.
Prehabilitation emerges as a critical intervention to mitigate risks associated with functional capacity and quality of life in surgical patients.

Purpose of the Study:

To explore the barriers hindering the widespread availability of prehabilitation services in the United Kingdom.
To identify key obstacles impacting the implementation and accessibility of prehabilitation programs for high-risk surgical patients.

Main Methods:

The study involved an exploration of existing literature and expert opinion regarding prehabilitation implementation.
Analysis focused on identifying and categorizing the primary challenges faced in delivering prehabilitation services within the UK healthcare context.

Main Results:

The research identified three principal barriers to prehabilitation availability in the UK: cost-effectiveness concerns, workforce shortages, and a lack of comprehensive national policy.
These factors collectively impede the systematic integration and scaling of prehabilitation programs.

Conclusions:

Addressing the identified barriers is crucial for expanding prehabilitation access and improving outcomes for high-risk surgical patients.
Policy development, resource allocation, and workforce training are essential for the successful implementation of multimodal, personalized prehabilitation strategies.