Background In response to evidence in the Hospice UK document ‘Rehabilitative palliative care: enabling people to live fully until they die’ we designed a service to address three key areas:

• To proactively engage patients in interventions to improve their activity levels

• To reach out to patients in an environment that for many is less daunting than a hospice setting

• To remove barriers to accessing hospice services.

Aims Empower palliative care patients to maximise their physical activity in order to promote an ongoing active lifestyle and develop resilience in managing the impact of their condition.

Method Paced Rehabilitation and Enablement Programme (PREP) is a community-based service at Willen Hospice funded by a grant from St James’s Place Foundation and was developed in partnership with the local council and secondary care. PREP is an 8–12 week programme delivered within a gym setting by a clinical team consisting of physiotherapy, occupational therapy, nursing and a gym instructor. The weekly two-hour programme includes exercise and education underpinned by an individual goal orientated ethos. The programme utilises a range of outcome measures to identify goals, progression and evaluate the overall impact of the service.

Results Of the eight patients who have so far completed the programme:

• all have achieved their goals

• all have improved their physical performance (Mean ‘3 metre timed up and go’ increase of 5.8 s; Mean ‘sit to stands in 1 min’ increase of 67%)

• all are engaged in ongoing physical activity and participating in valued roles of their everyday life (country dancing, fishing and gym memberships)

• three patients want to return as volunteers to support other patients.

Conclusion We believe PREP is an ideal opportunity to empower palliative care patients to stay active for longer and to regain their sense of value and confidence and could be replicated across palliative care settings.