Personalised HEALTH & WELLBEING SUPPORT IN CHFT Helen Jones Macmillan Information Centre Manager 27.9.19

AIMS TODAY 1. Implementing Personalised Support in CHFT New Health & Wellbeing Programme Macmillan Information & Support Service 2. Time for Questions

Personalised care and support 3rd of 5 major changes: People will get more control over their own health, and more personalised care when they need it. 1.37 Support and help train staff to have personalised care conversations 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. NHS will increasingly be: more joined-up and coordinated in its care; more proactive in the services it provides; more differentiated in its support offer to individuals. It sets out five major, practical, changes to the NHS service model to bring this about over the next five years: •1. We will boost ‘out-of-hospital’ care, and finally dissolve the historic divide between primary and community health services. •2. The NHS will redesign and reduce pressure on emergency hospital services. •3. People will get more control over their own health, and more personalised care when they need it. •4. Digitally-enabled primary and outpatient care will go mainstream across the NHS. •5. Local NHS organisations will increasingly focus on population health and local partnerships with local authority-funded services, through new Integrated Care Systems (ICSs) everywhere.

Lwbc – the Recovery package Better patient experience & outcomes because overall support is tailored to patients Supported self management package – improves Quality of Life National Cancer Survivorship Initiative - Guidance – offer of RP by 2020 Includes a Health & Wellbeing Offer 2009 – Macmillan Report – Hidden at Home - 1 in 5 patients have unmet needs.

MACMILLAN’S ‘RIGHT BY YOU’ NEW STRATEGY Everyone with cancer will: Know that they can turn to Macmillan and how we can help from the moment they are diagnosed Have a conversation about all their needs and concerns, and get the support that’s right for them. Have their vital needs met by high quality services. Everyone with treatable but not curable cancer will be supported to live life as fully as they can.  We’ll inspire more people to give to Macmillan so we can continue to be there for people when they need us most. We’ll improve the key activities which support Macmillan to do its work as efficiently and effectively as possible.

Personalised health & wellbeing programme Previous offer of HWB in CHFT: - HWB events for people at the end of treatment (curative focus) – run 3-4 times per year. - Focus on managing the emotional effects of cancer, physical activity, Macmillan Information Service, informal time with clinical teams - Some teams offering site specific HWB events/support e.g. gynae/breast/ colorectal/head & neck – inconsistent offer

Co-design with patients June 2019 – discussed personalisation, health & wellbeing and prehabilitation plans – opportunity for patients to have their say & make recommendations 11 patients and 2 carers/partners attended – all with different diagnoses and stages of the pathway

Co-design with patients Key Points from Patients/Carers: More peer & emotional support needed, including opportunity to connect with other patients. HWBE useful at End of Treatment but patients want information earlier. Not enough support for incurable cancer patients – left alone to cope; not sure where to turn. Prehabilitation – earlier info & support wanted on – diet/exercise/emotional wellbeing. Patients found out about Macmillan Information service too late – missed out on benefits/Blue Badges/ exercise programmes etc Information overload on diagnosis – conversations are better than leaflets Befriending/buddying scheme would reduce isolation

So what did we do? A new information and support session for anyone recently diagnosed with cancer Message of Supported Self Management from diagnosis Prehabilitation/health and wellbeing information - diet, physical activity, emotional support and different services which can help to support patients e.g. Macmillan Information Service. Introduction to HNAs/Care Plans –potential to add PAM and personalisation questions to these sessions? Monthly from 7th October 2019. Offered to all newly diagnosed patients in CHFT. Family members encouraged to attend.

THINKING AHEAD PROGRAMME Health & Wellbeing Course for patients and families affected by incurable cancer- devised by Harrogate Hospital 2018 Launching in November 2019 in partnership with Kirkwood and Overgate Hospices – plan to run 4 per year initially Sessions on advanced care planning; support services; diet; finances; managing uncertainty. Adding mindfulness session; physical activity; estates planning and faith and spirituality. 2020 – Monthly Thinking Ahead information session and support group for people living with incurable cancer. 2009 – Macmillan Report – Hidden at Home - 1 in 5 patients have unmet needs.

HWB Support at eOT Continue with quarterly HWBEs for curative patients at the end of treatment Same generic sessions including social prescribing session Addition of site specific sessions on managing side effects of treatment and signs and symptoms of recurrence 2020 – plans to introduce Macmillan’s HOPE Course (Help Overcoming Problems Effectively) – supported self management course designed in partnership with Coventry university (Staff/patients trained). Also over time, HOPE Course for Carers 2009 – Macmillan Report – Hidden at Home - 1 in 5 patients have unmet needs.

Other personalised support First Steps –direct patients to the Macmillan Information Service for holistic assessment/ personalised conversations and onward referrals – what is important to a patient not only for a patient. Development of an app/digital platform to provide information when needed and for SSM Generic Cancer Support Groups – Macmillan Coffee Time and Macmillan Singing Group - started in July 2019. Plan to develop other support groups in partnership with patient focus group. Plans to introduce a Macmillan walking group (volunteer led) and working with the University of Huddersfield – cancer exercise classes. Introduction of a befriending and buddying scheme – currently recruiting patients and volunteers 2009 – Macmillan Report – Hidden at Home - 1 in 5 patients have unmet needs.

summary Exciting time to be improving our personalisation offer and delivering national strategy for cancer patients in CHFT. Introduction of a new HWB Programme/ Patient Education – pre and post treatment, as well as for palliative patients. Co-designed with patients/carers. Key role to develop and extend the Macmillan Information Service for all patients diagnosed with cancer and LWBC. Supporting the Trust with the delivery of the components of the Recovery Package/Personalisation Agenda.