The Royal College of Anaesthetists (RCoA) and the Centre for Perioperative Care (CPOC) welcome the publication of the National Cancer Plan for England.  

The plan sets out a 10-year ambition to improve cancer outcomes through earlier diagnosis, faster treatment and improved support for people living with and beyond cancer.

For the first time, the plan formally embeds prehabilitation and rehabilitation as core components of cancer care in England, recognising the crucial role this plays in preparing patients for treatment and supporting recovery.  

Evidence shows that preparing for surgery can reduce postoperative complications by up to 50% and the importance of preparation cannot be undervalued.

In 2025 Macmillan, in partnership with CPOC, the NIHR Southampton Biomedical Research Centre, the NIHR Cancer Nutrition Collaborative and the World Cancer Research Fund, published Prehabilitation for People with Cancer: Clinical Implementation Guidelines. These updated 2025 guidelines build on the original guidance published in 2019 and provide detailed, evidence-based recommendations for designing and delivering prehabilitation services for people living with cancer.

The plan’s wider ambitions to increase the proportion of people who are cancer free or living well five years after diagnosis and to meet all cancer waiting time standards by 2029, cannot be realised without helping patients get ready for treatment. Preoperative risk assessment, and early preparation by adjusting lifestyle behaviours can make sure cancer treatment starts on time, reducing avoidable delays and enabling more predictable surgical pathways.  

The government will also introduce new national quality standards for prehabilitation and rehabilitation from 2027. These standards are intended to ensure consistency and equity of support across the country. The RCoA and CPOC welcome this development and can contribute clinical expertise and established best practice from national perioperative guidelines to help shape these standards as they are developed.

President of the Royal College of Anaesthetists Dr Claire Shannon said: “The College welcomes the commitment of the National Cancer Plan which reflects our established perioperative principles; that early assessment, shared decision making and targeted optimisation are essential to improving outcomes and ensuring patients start treatment without avoidable delay.  

“This bold and clear commitment from the government is vital to improving outcomes and delivering equitable benefits for patients across the NHS.”

Co-Deputy Directors of the Centre for Perioperative Care Dr Jo Simpson and Professor Javed Sultan, added: “CPOC welcomes the National Cancer Plan, particularly the patient-centred focus it provides. The recommendation for improved preparation for surgery, including access for all to prehabilitation via a digital tool, is important as we know that this will reduce inequalities and results in improved surgical outcomes.  

“We look forward to working with the Department of Health and Social Care and our partners to deliver improved perioperative pathways for people with cancer.

For more information on preparing for surgery, view the RCoA’s Fitter, Better, Sooner resource and CPOC’s Top 7 Perioperative Optimisation resources.