1. Presentation title and subject Urology CNS Team October 2015 Kidney Pre-hab pilot at NBT

2. Background  Preventative rehabilitation delivered before and during cancer treatment has the potential to reduce the future clinical and non clinical needs of a person with cancer  This could in turn reduce the cost to the health and social care system associated with later stage and more serious interventions Achieving World Class Outcomes – A Strategy for England 2015- 2020

3. Patient advised about Prehab clinic/ POAC by CNS and/or medical team WLC books patient into theatre slot, Prehab clinic & POAC Patient attends Prehab clinic (alt Tues mornings NGS Macmillan Wellbeing Centre) Baseline measures of Sit to Stand 60, FACT-G & nutritional screening NB: POAC appointment will be ideally on same day in the afternoon Patient has surgery as per ERP (approx 4-6 weeks after Prehab clinic) Patient contacted by CNS (6-8/52 post-op) Repeat measures of STS60 & FACT-G Holistic Needs Assessment and Care Plan Kidney Prehab Pathway

4. Results to date  32 patients have attended Prehab clinic between April and Oct 2015  Approx 3-6 patients have attended each session  Completed data for 9 patients  Trend towards increased physical function (sit to stand 60) and improved QOL (FACT-G)  Physical and emotional wellbeing sections of FACT-G show largest improvements

5. Successes  Positive engagement from CNS, ERP teams and Cancer Support Workers  Support from kidney MDT, Cancer Services and AHP’s  Use of NGS Macmillan Wellbeing Centre space/ environment  Positive patient feedback – ‘I recovered much quicker from this operation’ (Previous partial nephrectomy patient)

6. Issues  Engagement with WLC’s has been challenging – resulting in patients not routinely booked into the pre-hab clinic  Still not capturing all patients – further work required with WLC’s  Initially unable to align Prehab clinic with POAC but now improving

7. Future  Review of data in November  Poster to be placed in outpatients to prompt patients to ask about Prehab clinic  Follow up appointment at 6-8 weeks post-op with Macmillan Cancer Support Worker to undertake post-op assessment and offer holistic needs assessment  Plan roll-out to all urology patients in Jan 2016 and run weekly clinic