Cancer Support and Information in Greater Manchester

1. Greater Manchester Cancer From Health and Wellbeing Events…to Health and Wellbeing Information and SupportLindsey WilbyMacmillan Project Manager – Living with and Beyond Cancer May 2019

3. Greater Manchester Cancer Achieving World-Class Cancer Outcomes, 2015: NHS England should…ensure that every person with cancer has access to the elements of the Recovery Package by 2020….this...couldinclude…access to a patient education and support event, such as a Health and Wellbeing Clinic, to prepare the person for the transition to supported self-management, including advice on healthy lifestyle and physical activity.

4. Greater Manchester Cancer What are they? • (Group) events or programmes which: • Provide the right information at the right time • Maximise health and well being: from diagnosis to recovery (or improved palliative experience) • Help to manage the short and long term effect cancer and treatments can often have on lives • Equipping for and supporting self-management

5. Greater Manchester Cancer What should they include? • Expert advice on health promotion • To minimise risk of recurrence and support healthy living particularly physical activity, nutrition and healthy weight management, smoking cessation. • Support to ensure that individuals have the confidence and skills to manage their condition themselves • For example referral onward to rehabilitation and psychological support services as appropriate and signposting to local support groups, voluntary sector organisations or buddying services. • Information about complementary therapies • How these therapies may help to facilitate wellbeing. • Advice on adjusting to life after treatment • And addressing fears of cancer recurrence.

6. Greater Manchester Cancer What should they include? • Information on signs and symptoms of recurrence and potential consequences of treatment • All events should clearly convey and reinforce the methods to activate fast-track access back into the system if there are any concerns regarding new symptoms or recurrent disease. • Signposting to financial and benefits advice • Specific issues relevant to the individual’s type of cancer • For example: communication difficulties, dysphagia, colostomy care, prosthetic care, early detection and management of lymphoedema, body image and sexual functioning. • Signposting to work support/vocational rehabilitation • Signposting to services for patients including work support and information that patients and carers can share with their employers. • Management of common symptoms For example fatigue.

7. Greater Manchester Cancer Why should we offer them? Benefits to patients • Group discussions and peer to peer support can allow patients to feel less isolated • Increased confidence in self management and participating in care leading to feeling more in control • Increased awareness of side effects, symptoms and warning signs • Reduced anxiety and improved emotional wellbeing • Knowledge of local services that are available and knowing how to access support whenever needed • More confident in ability to make positive lifestyle change • Better understanding of their ‘new normal’ • Reference: Macmillan Cancer Support (2017) Holistic Needs Assessment Care and Support Planning

8. Greater Manchester Cancer Why should we offer them? Evidence of long-lasting benefits • A 2016 study found: • 84% of patients who attended a HWB intervention reported significantly improving their diet • 57% reported using self help to reduce their stress and anxiety levels • 49% felt their close relationships had improved • The study also found that there were statistically and clinically proven improvements in wellbeing measures which lasted up to a year • Reference: Polley et al.,2016: Using a Whole Person Approach to Support People With Cancer: A Longitudinal, Mixed-Methods Service Evaluation. Integrative Cancer Therapies. 15; 4: 435-445. • …And we therefore have a GM-level target for every patient to be offered one

9. Greater Manchester Cancer How should they be delivered? • generic for all long term conditions, including cancer • generic for all cancers • divided by treatment completed and in remission vs. those living with their cancer • across several tumour types (e.g. pelvic cancers) • tumour specific • targeted at patients from one or more Trusts • single events • a series of events/workshops • online – webinars, YouTube clips, apps • a combination of several of the above options

10. Greater Manchester Cancer BUT • What is gold standard? What is “good enough”? • …A generic, Trust-wide, marketplace based event cannot offer the same depth of content as a bespoke (but regional) tumour-specific event…but the latter can’t offer access to local services, AND • We don’t have the necessary resources, either financial or human, to deliver this level of intervention, face to face, for every cancer patient in GM, AND • Even if we did, we can’t guarantee attendance (even with appointment letters; this is even more challenging in certain localities/populations)

11. Greater Manchester Cancer The Long Term Plan (2019): Personalised Care for Cancer Patients 3.64.By 2021, where appropriate every person diagnosed with cancer will have access to personalised care, including needs assessment, a care plan and health and wellbeing information and support. This will be delivered in line with the NHS Comprehensive Model for Personalised Care. This will empower people to manage their care and the impact of their cancer, and maximise the potential of digital and community-based support. Over the next three years every patient with cancer will get a full assessment of their needs, an individual care plan and information and support for their wider health and wellbeing. All patients, including those with secondary cancers, will have access to the right expertise and support, including a Clinical Nurse Specialist or other support worker.

12. Greater Manchester Cancer

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14. Personalised (Stratified) Care and Support Personalised Care and Support Planning based on Holistic Needs Assessments Ongoing support for Health and Wellbeing Diagnosis Needs Assessment Stratific’tn criteria Shared decision about follow-up • Treatment Summary • Regular scans/tests • Monitoring for side effects • Rapid re-access to clinic • Telephone Support • Support for self-management • Signposting or referral to support / advice / services • Cancer Care Review Prehabilitation Professional-led follow-up Treatment Self-managed follow-up INCLUDING REMOTE MONITORING

15. Greater Manchester Cancer Thank youlindsey.wilby@nhs.net07879 402915