People who undergo major surgery often suffer a significant decline in their functional capacity that impacts every area of their lives – including work. Most people want to get back to a semblance of ‘normal’ as quickly as they can, so embark on rehabilitation programmes to get their bodies and minds back to the highest possible level of function, independence and quality of life.
While rehabilitation is a vital part of this process, it is still reactive and follows the event. On the other hand, prehabilitation, an emerging concept in surgical care, is a proactive approach. It puts people in the best possible health before surgery in order to get the best outcome. There is a lot people can do in advance, including preoperative physical exercise, optimising nutrition and addressing emotional wellbeing to ensure people are in the right place to set them up for success.
Prehabilitation represents a shift away from the impairment-driven, reactive model of care and towards a proactive approach that enables patients to become active participants in their care. This approach is proven to reduce post-operative complications and improve a patient’s overall outcome.
Why should firms care about prehabilitation?
Loss of physical function arising from major surgery can impact every area of a patient’s life, including their ability to do their job, and the quicker someone returns to health, both physically and mentally, the better it is for employees and employers alike.
Employees who follow a prehabilitation programme before undergoing major surgery will have a far better experience: the length of their hospital stay is reduced, they suffer fewer post-operative complications and they experience less post-operative deterioration in their physical health.
By providing people with the reserve or a buffer to withstand the stresses of surgery, prehabilitation can restore people to their baseline physical, social and emotional function faster, giving them a better chance at recovery and accelerate their return to work.
When approaching any life-changing situation we tend to prepare ourselves as best as possible to positively influence the outcome, and major surgery should be no different.
Benefits for the individual
- Complications are halved. Around 40 per cent of cancer patients suffer complications of some sort, but those including prehabilitation in their treatment plan see post-surgery complication rates halved. Those that do experience complications show improved tolerance and fewer severe complications.
- Hospital stays are reduced. The length of the post-operative hospital stay is significantly reduced – by three days on average. This means those having had surgery can return to their families or their homes far quicker, which will ultimately get them back on track faster.
- Recovery time is reduced. Going into surgery with an improved fitness level – which is a direct result of undertaking prehabilitation – means that not only are the individuals undergoing surgery less likely to experience complications but, given their body is in a more optimal physical state, their overall recovery time is likely to be shorter.
- Maintained and improved mental health. The anticipation of major surgery can be mentally debilitating. Many people report suffering anxiety before and after major surgeries, especially for health conditions or diseases such as cancer. Prehabilitation programmes also offer patients mental health support throughout their journey and results show that eight out of 10 people undergoing Onko prehabilitation treatment either maintained or improved anxiety, compared to those who did not undertake any prehabilitation.
Benefits for the employer
- Staff respect and loyalty. A company providing staff with strong support during a time of extreme distress and need, such as undergoing cancer surgery, will have more value placed on them and be respected as an employer.
- Reduced recruitment and training costs. Research shows that 25-30 per cent of cancer patients do not go back to work post-treatment. But if they feel physically stronger as a result of prehabilitation programmes, and experience fewer post-operative complications, it is more likely that they will return, in turn saving employers time and money recruiting and training replacement staff.
- Lower sick pay costs. On average, people go back to work around three months after cancer surgery, but if they have suffered complications this could double. Cancer prehabilitation has been proven to cut recovery time by as much as half, meaning employees will be able to return to work earlier. Supporting an employee with prehabilitation could significantly reduce the cost of statutory sick pay for employers.
Supporting staff on their treatment journey
Should employers find their employees need to undergo surgery for any reason, encouraging a work-life balance that allows them more timeout to get a head start and take up prehabilitation is hugely valuable: for both the employee and employer.
Prehabilitation is incredibly powerful for any patient but does not have the level of awareness it should. We encourage companies looking at their health insurance plans to consider the benefits of prehabilitation not only to their employees, but to their organisation as a whole.
Krishna Moorthy is a consultant surgeon and co-founder of digital cancer care programme Onko