Active Together cancer rehabilitation programme boosts survival rates
8 December 2024
A groundbreaking community-based cancer rehabilitation programme delivered in partnership with Sheffield Teaching Hospitals NHS Foundation Trust has demonstrated significant improvements in survival rates, alongside substantial cost savings to the NHS, according to a new report.
The Active Together programme, which integrates exercise, nutritional advice and psychological support into cancer care, showed an overall 10% improvement in survival rates across the three types of cancer included. The one-year survival rate of 95%, compared to 85% for patients who did not participate in the programme, was observed across patients with colorectal, lung, and upper gastrointestinal cancers. This innovative approach could save the NHS more than £100 million over five years if implemented nationally and more if expanded to include people with other cancers.
Moving beyond traditional treatment models and exemplifying the shift from hospital-based to community-focused care, the programme has significantly improved survival rates for hundreds of patients, with the potential to benefit many thousands more across the country.
Key findings from the report include:
Improved one-year survival rates of 95% for people who took part, compared to 85% for those who did not
- A net saving to the NHS of £366.36 per surgery, driven by reduced hospital stays and critical care time
- 97% of patients reported improvements in their health and wellbeing, feeling more empowered and in control of their health
- 93% of healthcare professionals considering the service well or very well integrated into existing cancer care pathways
The Active Together programme aligns with national prevention strategies by empowering patients to actively participate in their cancer journey. Cancer patients were provided with comprehensive prehabilitation and rehabilitation support before, during, and after treatment, bringing vital cancer care services closer to where people live. It was developed by Sheffield Hallam University's Advanced Wellbeing Research Centre (AWRC) and is funded by Yorkshire Cancer Research. Professor Diana Greenfield, Consultant Nurse in Late Effects and Professor Gary Mills, Consultant in Anaesthesia and Intensive Care Medicine of Sheffield Teaching Hospitals are co-chair and co-chair of the programme and oversee its strategic delivery.
Annual savings would equate to £19 million based on 52,000 lung, colorectal or upper gastrointestinal cancer patients receiving surgery nationally each year, meaning the service could potentially save the NHS £100+ million over the next five years. Savings could be even greater if the programme was rolled out to people with other types of cancer.
The combination of improved survival rates and financial benefits delivered by the Active Together programme offers the potential for enhanced cancer care delivery across the UK, with its focus on prevention and community-based treatment aligning with key NHS priorities. By moving care closer to where people live while maintaining excellent patient outcomes, this approach exemplifies how to deliver an NHS fit for the future.
Transformative potential
Professor Gary Mills, Consultant in Anaesthesia and Intensive Care Medicine at Sheffield Teaching Hospitals and Chair of the Active Together Clinical Advisory Group, said:
“Active Together has been transformative for many cancer patients in South Yorkshire. Patients undergoing cancer treatment need a reserve of fitness to cope with the severe stresses of the treatment and the loss of strength and fitness this produces. Active Together improves fitness and strength prior to cancer treatment and then assists recovery, often to pre-treatment levels in the recovery period. In addition, we've seen a small number of individuals for whom surgery was initially unviable become eligible for potentially life-saving procedures after participating in the programme. The service has seamlessly integrated into our cancer pathways and potentially contributed to reductions in hospital stays, time in critical care and more efficient use of our healthcare resources."
Professor Robert Copeland, Director of the Advanced Wellbeing Research Centre at Sheffield Hallam University, said:
“These results demonstrate the transformative potential of integrating physical activity, nutrition and psychological support into the cancer care pathway. Improved patient outcomes and increased quality of life are exactly what we want to see for cancer patients. Add to this the significant cost savings to the NHS and we have the makings of a blueprint to roll out nationwide. We feel The Active Together Programme perfectly exemplifies the UK Health and Social Care Secretary's drive to move NHS treatment from hospital to community, and we would embrace the opportunity to work alongside the Government to cascade the programme across the country. Our model of collaborative research and innovation, working in partnership with the NHS, charities, and industry, is proving to be a powerful approach to improving outcomes for people with a cancer diagnosis in South Yorkshire and beyond.”
Importantly, the programme helped free up critical NHS resources by reducing the time patients needed to spend in recovery, post-surgery, with upper gastrointestinal patients who participated in Active Together spending half a day less in critical care than those who didn't take part in the programme.
Dr Stuart Griffiths, Director of Research and Services at Yorkshire Cancer Research, added:
“The results of the Active Together programme in Sheffield demonstrate how innovative approaches to cancer care can transform lives across our region. By helping people with cancer prepare for and recover from their cancer treatment, Active Together enables people to tolerate greater doses of treatment, access treatments previously unavailable to them and recuperate better after operations.
“This is particularly significant for Yorkshire, where cancer outcomes are poorer than in England as a whole. The programme's success in improving survival rates and reducing hospital stays shows how together we can make real progress in improving cancer outcomes for people in Yorkshire while delivering cost-effective care that benefits the NHS. That’s why Yorkshire Cancer Research has committed to expanding the programme across Yorkshire, with the programme now well-established in Harrogate and having recently been rolled out in areas in South and West Yorkshire. With plans for further expansion across the region well underway, the charity’s long-term aim is for everyone in Yorkshire to have access to this pioneering treatment, no matter who they are or where they live.”
Following its success in Sheffield, the Active Together model shows strong potential for wider implementation across the UK, offering a blueprint for community-based cancer support that could transform cancer care nationally.
Karen’s story
Karen Nile, 50, from Sheffield, was diagnosed with bowel cancer in March 2023.
She said within days of her diagnosis she was referred to the scheme to prepare for major surgery, which included having two stomas fitted.
She said: "They prescribed specific walking speeds and provided nutritional guidance to ensure I was as strong as possible before surgery.
"Afterwards, they provided specialised exercise booklets designed specifically for people with stomas - seeing the exercises demonstrated by people who had stomas themselves made them so much more relevant to my situation and, most importantly, achievable."
