293 A Unimodal Prehabilitation Service: The Effect on Length of Stay and Associated Hospital Costs

Abstract Aim During 2024 we successfully piloted a Physiotherapy led prehabilitation service, aiming to increase fitness of patients awaiting hepatobiliary cancer surgery where improvements in strength were demonstrated. Our aim was to therefore explore the impact on length of stay (LOS) and associated cost. Method LOS data was gathered for elective surgical patients having either liver of pancreatic elective surgery for a cancer in 2024. This was then compared for those who had a period of prehabilitation versus those who did not. Upon completion the planning and costing team reviewed the associated costings. The criteria for referral to the prehabilitation service changed during 2024, initially patients with a poor anaerobic threshold on cardiopulmonary exercise testing (10.9 mls/kg/min or less) were eligible. After six months this was opened to any patient having surgery for a cancer. Results No prehabilitation input.SurgeryAverage LOS (days)Average cost/procedure (£)Distal pancreatectomy8.018,141Liver resection8.719,744PPPD17.631,510Total pancreatectomy2539,418Whipple22.624,745Average16.426,724 With Prehabilitation input.SurgeryAverage LOS (days)Average cost/procedure (£)Distal pancreatectomy5.215,748Liver resection8.620,341PPPD30.119,262Total pancreatectomy8.821,158Whipple19.631,456Average14.421,593 Conclusions Reviewing the data, there is an average LOS reduction of 2 days and cost reduction of £5,131, this figure takes in to account the cost of delivery. In the current NHS climate services like these will be crucial in moving forward with both cost improvements and encouraging long term health improvements.