Patients will be individually randomised, meaning that all participating sites will need to be able to provide all interventions during the pilot phase. This ensures consistency and allows for a fair comparison across the different intervention arms. 

While all sites must be prepared to offer all interventions, some may be "centralised." For example, access to financial support, advice, or guidance might be provided remotely via phone, email, or videoconference. Similarly, a postoperative surveillance intervention could involve a centralised call system or a chatbot-type response. The specific delivery mechanisms will be further defined during the co-design phase. 

The cost of the interventions during the trial's pilot phase is classified as an "Excess Treatment Cost" (ETC) according to NHS AcoRD guidance. These costs are payable by the local NHS economy (i.e., the Integrated Care Board - ICB) if the intervention is found to be of benefit. Our study is focused on designing and testing effective interventions and supporting their potential adoption, but we are not responsible for the long-term funding or widespread implementation. 

We will consider existing data on excess treatment costs in surgical trials (mean £356.88; median £93.96; max £3322.60; min -£279.78) when developing the interventions. We will also liaise with the Local Clinical Research Networks (LCRNs) of pilot sites to establish the feasibility and affordability of delivery, ensuring that designed interventions are realistic for potential future funding.