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Evaluation of the PROSPER Online Learning Course

  • Evaluation
  • Improving Health and Social Care
  • Social Care

The PROSPER (Prevention of Shoulder Problems) programme is a physiotherapy-led exercise intervention designed to reduce shoulder problems in people recovering from breast cancer treatment. A randomised controlled trial (RCT) previously demonstrated that PROSPER is both clinically and cost-effective.

To support its wider implementation, an online training course was developed for physiotherapists and other healthcare professionals. This study evaluated:

  • Whether the online course effectively trained clinicians to deliver the PROSPER programme.
  • The extent to which clinicians implemented PROSPER with patients after completing the course.

Impact and Implementation

The findings highlight systemic barriers preventing implementation, rather than issues with the training itself. Physiotherapy is not routinely embedded in NHS cancer pathways, limiting patient access to evidence-based rehabilitation.

The study has led to new collaborations with NHS England’s Cancer Pathway Team to explore how rehabilitation services like PROSPER can be better integrated into cancer care.

The PROSPER online course remains freely available for clinicians.

Next Steps

  • Develop pathways for physiotherapy in NHS breast cancer services to improve patient access to rehabilitation.
  • Engage with stakeholders to explore potential digital solutions for increasing patient uptake.
  • Continue working with NHS England and professional groups to support wider adoption.

Completed Project

Key Findings

  • High interest in training: 58 clinicians (mostly physiotherapists) registered, exceeding the original target of 50.
  • Completion challenges: Only 31 of 58 (53%) provided feedback, with just 11 completing the course in full. Lack of time was the main barrier.
  • Limited implementation: While 60% of learners (19/31) intended to use PROSPER, only five physiotherapists reported actually implementing it at 6-month follow-up.
  • Barriers to delivery: Lack of physiotherapy integration in cancer care pathways meant patients were not referred. Time constraints prevented clinicians from introducing new programmes.
  • Positive reception: 84% of respondents (22/26) would recommend the course to colleagues.

Who we worked with

University of Exeter, Faculty of Health and Life Sciences