Physical Activity Embedding Physical Activity into Cancer Care Evidence and Examples Rhian Horlock, Physical Activity Manager, Sporting Opportunities

The cancer story is changing Improvements in early detection and diagnosis More advanced treatments Move from acute to long term condition Increasing numbers of people living with and beyond cancer Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, Br J Cancer 2012; 107:

The survival rates are changing Total Prevalence - now Total Prevalence Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, Br J Cancer 2012; 107:

The survival rates are changing Macmillan Cancer Support (2011) identified median survival times based on research by the Cancer Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine research.

Not everyone is living well

Physical Activity improves health and wellbeing outcomes Macmillan Cancer Support (2011). The importance of physical activity for people living with and beyond cancer.

‘Keeping active has helped me, and my family, through a really difficult time. It’s helped me return to a more normal way of life and has given me a real sense of achievement’. Ted Poulter, 66 Pseudomyxoma peritonei

American College of Sports Medicine (2010) British Association of Sport and Exercise Sciences (2011)

UK Physical Activity Guidelines

“I want to do it so that I can go walking with friends without feeling like I am a burden”

A framework for physical activity behaviour change Stakeholder engagement Quality assurance Raise awareness Brief advice Behaviour Change Intervention Support and follow up Get and stay active

Primary care Secondary care Public health Leisure, parks and cultural services Social care Leisure and physical activity providers Community and voluntary sector Commissioners Who? How long: Stakeholder engagement Quality assurance Running throughout intervention

Cancer Physical Activity Standard Evaluation Framework Brand Marketing Programme governance Quality assurance Training needs What? Stakeholder engagement Quality assurance Running throughout intervention How long:

Who: Identify individual in appropriate setting Taking a MECC approach Raise awareness of the importance of physical activity Raise awareness of local opportunities Why? What? Senior Health Care Professionals Health and Wellbeing ACP 30 Secs Raise awareness Brief advice Behaviour Change Intervention Support and follow up Get and stay active

Who? Why? When? During holistic needs assessment, health and wellbeing event, a follow appointment at the information centre Support patient choice Assess current physical activity levels Senior Health Care Professionals Health and Wellbeing ACP MECC HOPE 5 minutes How long: Raise awareness Brief advice Behaviour Change Intervention Support and follow up Get and stay active

Who? Move More pack Exploring readiness and confidence Exploring personal goals and appropriate opportunities Arranging ongoing support Support the individual to become more active Plan for set back and support Agree follow up and support appropriate for the individual Why? What? Clinical Nurse Specialist Exercise professional How long: 30 minutes Raise awareness Brief advice Behaviour Change Intervention Support and follow up Get and stay active Why?

Raise awareness Brief advice Behaviour Change Intervention Support and follow up Get and stay active

“Everyone will have access to a short, free and friendly health walk within easy reach of where they live, to help them to become and stay more active.”

Who? What? Provide 1:1 ongoing support and follow up Help people cope with relapse and re-setting of goals This should be person-centred, as required by the individual Activity related support groups Good together Peer to peer support Mentoring Volunteers 1:1 follow up Group behaviour change support Text, , phone or online Raise awareness Brief advice Behaviour Change Intervention Minimum 12 months at regular intervals How long: Support and follow up Get and stay active

Sport England Project Get Healthy, Get into Sport funding Integrate sporting opportunities into the physical activity behaviour change approach 6 Areas - Luton, Shropshire, Berkshire, Dorset, Manchester and Sheffield Working closely with the other five sites to share learning and become areas of good practice Increasing awareness and developing referrals by linking with communities, people affected by cancer themselves, local GPs, and other Primary Care providers Access resources and embed Physical Activity pathway Part of a national evaluation framework Upskilling workforce to Level 4 Cancer rehabilitation standards Expanding the sporting offer and work with NGBs on their ‘Get Back to’ offers

Project Update NGB Taster Sessions held across the 6 sites with England Athletics - Run England/321/Athlefit, British Cycling - Breese Easy Rides, Badminton England -No Strings, ASA –SwimFit & SwimTag, Nordic Walking UK, FA - Walking Football, Foot Golf, England Basketball – Walking Basketball Dance -Back to Ballroom. Knowledge Exchange Workshops held 6 Project steering groups in place with key stakeholders. Pilot Evaluation complete. National Tender out to avert New area project launches Summer 2014

Move More Luton 200 active participants 80 friends/family members actively supporting a range of activity including, gym, swimming and group fitness classes. Every participant is entitled to 12 FREE activity sessions and an ongoing reduced rate thereafter across 5 facilities in Luton with 1:1 support and a huge range of activity types at flexible and accessible times. Introduced a wide range of ‘Sporting Opportunities’ into the programme. For example: Walking Football, Badminton, Golf / FootGolf, Nordic Walking and Athlefit Recruitment of a Macmillan Health & Wellbeing Practitioner. This job will focus on increasing referrals and raising awareness in the community and with health professionals

Referral League Table Cancer Site Total Number / Number of Referrals (Luton & Dunstable) Breast26 Bowel5 Prostrate4 Colorectal2 Lymphoma1 Leukaemia1 Kidney1 Bladder1 Cervical1 Throat1

Partnership Working in Luton Active Luton Move More Luton Luton and Dunstable Hospital –L&D Cancer Services Lead Nurse, Luton Community Oncology Nurse, L&D Urology Clinical Nurse Specialist University GP’s and Primary Care Public Health Luton CCG Macmillan Cancer Support Luton and Beds CSP Cancer Support Groups

Discussion