Background: Palliative rehabilitation involves multi-professional processes and interventions aimed at optimising patients symptom self-management, independence, and social participation throughout advanced illness . Rehabilitation services were highly disrupted during the Covid-19 pandemic . Aim: To understand rehabilitation provision in palliative care services during the Covid-19 pandemic, identifying and reflecting on adaptative and innovative practice to inform ongoing provision .
Design: Cross-sectional national online survey . Setting/participants: Rehabilitation leads for specialist palliative care services across hospice, hospital, or community settings, conducted from 30/07/20 to 21/09/2020 . Findings : 61 completed responses (England, n=55; Scotland, n=4; Wales, n=1; and Northern Ireland, n=1) most frequently from services based in hospices (56/61 , 92 %) providing adult rehabilitation . Most services (55/61 , 90 %) reported rehabilitation provision becoming remote during Covid-19 and half reported reduced caseloads . Rehabilitation teams frequently had staff members on sick-leave with suspected/confirmed Covid-19 (27/61 , 44 %), redeployed to other services/organisations (25/61 , 41 %) or furloughed (15/61 , 26 %). Free text responses were constructed into four themes: (i) fluctuating shared spaces; (ii) remote and digitised rehabilitation offer; (iii) capacity to provide and participate in rehabilitation; (iv) Covid-19 as a springboard for positive change . These represent how rehabilitation services contracted, reconfigured, and were redirected to more remote modes of delivery, and how this affected the capacity of clinicians and patients to participate in rehabilitation . Conclusion: This study demonstrates how changes in provision of rehabilitation during the pandemic could act as a springboard for positive changes . Hybrid models of rehabilitation have the potential to expand the equity of access and reach of rehabilitation within specialist palliative care.