Virtual clinics to deliver universal interventions to maintain and improve physical and psychological well-being in people with cancer who are following social distancing guidance: A COVID-19 targeted trial

“I still can't believe how lucky I am to have found out about SafeFit, I have been matched to a fantastic trainer who I 'Zoom' with 3 times a week. She is so supportive and encouraging. There is no pressure but we are gradually working on my fitness and eating habits. This has led to a huge improvement in my sleep, my confidence and my overall wellbeing. I can't stop telling everyone I know how brilliant SafeFit is”


“Her son (who has mental health problems) has seen the difference in his mum's mood and started training himself. They talk about how much better they feel. She is sticking to her program of exercises and happily passed over her food diary as she was aware that her mood affected her eating. In three weeks she is finally back on eating three balanced meals a day (her starting average kcal intake was under 1000kcal and consisting of cornflakes and chocolate). She is practising breathing techniques and has started listening to calming things on Audible, and is finding her sleep is improving already. It’s almost bonkers to see how far she has already come and the changes it has made not just to her, but her family too. She has been really trusting in our service, and amazed with the changes even in such a short time.”

A recent statement by Professor Chris Whitty, Chief Medical Officer, NHS England, emphasised the significant benefits of exercise for all people. He said -: “this may be challenging for people self-isolating and even more so for those highly vulnerable people that are having to shield against the virus within their own home”.

SafeFit has been designed, in response to the COVID-19 crisis, to support people living with cancer to maintain and improve their physical and mental health and well-being, whilst following government guidelines.

The service is for people living with cancer aged 18 years and over who will access the service via a dedicated page on the Macmillan website. The service will be delivered by CanRehab specialist exercise instructors, who will undertake a robust screening and holistic needs assessment.

People will be supported remotely in their own homes with advice about exercise, nutrition and emotional support - the ‘universal interventions’ described in the Principles and Guidance for Prehabilitation in the support and management of people with cancer, the NHS England Personalised Care model and aligns to the development and inclusion of prehabilitation in national cancer strategies in Northern Ireland, Scotland and Wales.

An integral part of this service will be a COVID-19 interventional evaluation trial led by the University Hospitals Southampton NHS Trust WesFit research team. This will provide the evidence required by commissioners and include both primary and secondary outcomes.

The service interventions will be delivered by one of more of the following methods:

  • individual telephone consultations
  • one to one video exercise sessions
  • group exercise sessions

People living with cancer are likely to need different numbers of interventions and this will be accommodated as part of this developing service offer.

The instructors will have information required to enable them to signpost people to both Macmillan and other local information and service offers based on their identified needs including ‘Move More’ services in Northern Ireland and Scotland.

The service has been set up initially for a six -month period during which there will be close monitoring of the demand, capacity and funding options for the service going forward.

The ambition is that SafeFit will become a business as usual service, providing on-going support for people affected by cancer, especially during the extremely challenging recovery period of this pandemic. This model is highly translatable and transferable to all people with chronic diseases, particularly those recovering from critical illness.