1. Greater Manchester Cancer
From Health and Wellbeing Events…to Health and Wellbeing Information and Support Lindsey Wilby Macmillan Project Manager – Living with and Beyond Cancer
May 2019

3. Achieving World-Class Cancer Outcomes, 2015:
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...could include…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. What are they? (Group) events or programmes which:
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. What should they include?
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. What should they include?
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. Why should we offer them? Benefits to patients
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. Why should we offer them? Evidence of long-lasting benefits
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:
…And we therefore have a GM-level target for every patient to be offered one

9. How should they be delivered?
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. BUT What is gold standard? What is “good enough”?
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. The Long Term Plan (2019): Personalised Care for Cancer Patients
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

13. Greater Manchester Cancer

14. Personalised (Stratified) Care and Support
Personalised Care and Support Planning
based on Holistic Needs Assessments
Ongoing support for Health and Wellbeing
Diagnosis
Prehabilitation
Treatment
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
Self-managed follow-up
INCLUDING REMOTE MONITORING
Professional-led follow-up

15. Thank you lindsey.wilby@nhs.net 07879 402915
Greater Manchester Cancer
Thank you