Rehabilitation must be embedded throughout the cancer pathway - from prevention to palliative care - physiotherapists have warned.
The call was made by the CSP and the Association of Chartered Physiotherapists in Oncology and Palliative Care (ACPOPC) in their response to a government consultation on the forthcoming National Cancer Plan.
They argue that high-quality rehabilitation and supported self-management should be available to everyone with cancer, whenever and wherever they need it. These services, they say, are essential to improving survival, reducing complications, supporting recovery and cutting inequalities in access and outcomes.
The submission highlights the role that physiotherapy can play in tackling cancer risk factors like obesity and physical inactivity, especially among people with long-term health conditions who are at higher risk. It calls for early access to rehabilitation and lifestyle support, including therapeutic exercise, nutrition and wellbeing advice, delivered through integrated community services.
People need help to manage their health from the point of diagnosis, the submission argues. NHS community rehabilitation services are critical, not only in delivering prevention but also in reducing pressure on overstretched parts of the health and care system, it adds.
On early diagnosis, CSP and ACPOPC stress the importance of physiotherapists’ role in spotting red flag symptoms. First contact physiotherapists working in MSK services need the skills and pathways to support timely referral and diagnosis. The response also urges more targeted, community-based approaches to awareness campaigns, so that people from different backgrounds can access help earlier.
Rehabilitation must also be fully integrated into treatment pathways, the organisations argue, noting strong evidence that prehabilitation improves outcomes, reduces treatment complications and speeds recovery. Yet access remains inconsistent and dependent on geography, cancer type or service funding.
The response calls for investment in capacity and workforce across all settings, and greater use of data to identify gaps and inconsistencies. It highlights the benefits of physiotherapy-led interventions for managing chronic pain, enabling return to work, and supporting people with multiple conditions, especially those living with cancer over the longer term.
Access to palliative rehabilitation also needs to be expanded. The CSP and ACPOPC point out that many people live for years with incurable cancer, and physiotherapy can help improve function, comfort and quality of life even as health deteriorates. They warn that services remain underfunded and unequal, and urge better planning across the NHS and voluntary sector workforce.
The response also emphasises the need to improve data and research in rehabilitation, supporting innovation and national adoption of effective models. It highlights services like Prehab4Cancer and Active Together as examples of integrated, community-based approaches that empower patients and deliver proven health and economic benefits.
To reduce inequality, the CSP and ACPOPC call for better data on who is accessing rehab, co-production with marginalised communities, and a workforce that reflects the diversity of the population.
Top priorities for the new cancer plan, they say, must include prevention, improved patient experience, and tackling inequalities - supported by strategic commissioning, integrated leadership and workforce development.
CSP policy lead Rachel Newton said: ‘We need to end the postcode lottery of access to high quality prehab and rehab at all stages of cancer care. These services are proven to improve outcomes for patients and should be universally available.
Rehab expertise in neighbourhood services is essential to tackle cancer risk factors among people with other conditions and to provide early support for people with cancer from the point of diagnosis.
‘We welcome the opportunity to work with our CRA partners and most importantly members to highlight the key role physios and support workers play in delivering prehab, rehab and palliative care.’
Importance of rehabilitation
ACPOPC chair Natasha Richardson added: 'This collaborative submission was a key moment to shine a light on the importance of rehabilitation across the cancer pathway and how much it can impact on improving patient's lives as well as the overall workings of the system.
'It has been a fantastic opportunity to engage with members and really bring the views of those working at the forefront to the recommendations alongside the emerging evidence.'
CSP response to cancer plan call for evidence
002224 CRA Cancer plan response.pdf
