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This mixed methods cross-sectional survey of healthcare professionals (n=138) identified facilitators and barriers, highlighting multidisciplinary cohesion, dedicated champions, resources and NHS trust engagement, accessibility, inequality avoidance, community support, and clear individualised educational support and 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\n[https://doi.org/10.1007/s00520-026-1](https://doi.org/10.1007/s00520-026-1)1097-9  \nExploring facilitators and barriers to the implementation of prehabilitation for individuals with pancreatic cancer: a survey of healthcare professionals  \nElizabeth Wrench1 · Elizabeth McGladrigan1 · Robert M. Lauder1 · Declan Dunne5 · Cliff Shelton1,6 · Joel Lambert3,4 · Laura L. Machin1 · Daren A. Subar3,4 · Theodoros M. Bampouras1,2 · Christopher J. Gaffney1  \nReceived: 28 November 2025 / Accepted: 7 August 2026 © The Author(s) 2026  \nAbstract  \nPeople with pancreatic cancer experience poor survival, low quality of life and limited treatment options compared to those with other cancers; interventions that can improve outcomes and quality of life are urgently required. Pancreatic Cancer UK recently released ‘optimal care guidelines’ for pancreatic cancer, which recommends that all patients, no matter the treatment route, should be offered prehabilitation (typically exercise, nutrition and psychosocial intervention) at the point of diagnosis. We investigated the facilitators and barriers to implementing prehabilitation for individuals with pancreatic cancer, from the perspective of healthcare professionals. A mixed methods cross-sectional survey on the facilitators and barriers to implementing prehabilitation and engaging individuals with pancreatic cancer in prehabilitation was designed and circulated to healthcare professionals (n = 138). Responses were analysed using a thematic approach. Key factors highlighted by healthcare professionals that could support the implementation of a prehabilitation intervention included multidisciplinary team cohesion and collaboration and dedicated prehabilitation champions, resources and National Health Service trust engagement, accessibility and avoiding exacerbating health inequalities, community support, and clinical guidelines. Key factors that could overcome barriers to the participation of individuals with pancreatic cancer included educational support, clear aims and information, understanding of the disease-related burden and individualised programmes. Considering each of these factors in the design and delivery of services could inform future research and the implementation of prehabilitation for individuals with pancreatic cancer.  \nKeywords Pancreatic cancer · Prehabilitation · Optimal care pathway  \n* Elizabeth Wrench  \n[L.Wrench@lancaster.ac.uk](L.Wrench@lancaster.ac.uk)  \n1 Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK  \n2 School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK  \n3 Blackburn Research Innovation Development Group in General Surgery (BRIDGES), Blackburn BB2 3HH, UK  \n4 Department of General Surgery, East Lancashire Hospitals NHS Trust, Blackburn BB2 3HH, UK  \n5 Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8YE, UK  \n6 Department of Anaesthesia, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester M23 9LT, UK  \nIntroduction  \nPancreatic cancer is the fourth most frequent cause of cancer-related death, with a 5-year survival rate less than 10%  \n[1]. The only treatment option that offers the potential for a cure is surgery in combination with chemotherapy, yet less than one in ten pancreatic cancer patients in the UK receive surgery [2, 3] . Pancreatic resection is associated with significant morbidity and mortality, and research suggests surgery significantly impacts the quality of life for patients in the postoperative period [4] . Treatments for pancreatic cancer have shown limited progression compared to other cancers, and therefore, interventions which improve both quality of life and outcomes are urgently required [1] .  \nPrehabilitation is predominantly investigated and utilised in the pre-operative period for individuals with cancer. It consists of exercise, nutritional and/or psychological  \ni","cbCaiiyPaZnFWonU","https://ap.wps.com/l/cbCaiiyPaZnFWonU","pdf",1953174,14,"English","# Introduction\n## Burden and treatment challenges in pancreatic cancer\n## Role and scope of prehabilitation\n## Optimal care pathway and rationale for diagnosis-time delivery\n## NHS implementation challenges and health inequality considerations","[{\"question\":\"What does the study aim to investigate about pancreatic cancer prehabilitation?\",\"answer\":\"The study investigates facilitators and barriers to implementing prehabilitation for individuals with pancreatic cancer from the perspective of healthcare professionals.\"},{\"question\":\"What is prehabilitation and what components does it typically include?\",\"answer\":\"Prehabilitation is typically exercise, nutrition and psychosocial intervention, often delivered as a multimodal approach and can be offered before multiple oncological treatments.\"},{\"question\":\"Which factors were highlighted as supporting the implementation of prehabilitation?\",\"answer\":\"Healthcare professionals highlighted multidisciplinary team cohesion and collaboration, dedicated prehabilitation champions, resources and NHS trust engagement, accessibility, avoiding worsening health inequalities, community support, and alignment with clinical guidelines.\"}]","Exploring facilitators and barriers to the implementation of prehabilitation for individuals with pancreatic cancer - a survey of healthcare professionals | PDF",1790105179,35]