There are 2 and a half million people living with a cancer diagnosis in the UK today and
that number is set to grow.
So we know that sometime between now and 2030 that number will hit 4 million.
That’s a massive massive challenge for the National Health Service and for organisations
like Macmillan and we really need to make sure that we are geared up to be able to support
the patients in the way that they need support when that happens.
Patient (1) I had 18 months of treatment, and when you get to the end of that 18 months
treatment everybody around you thinks oh you’re better.
But in actual fact that’s just the start of it really.’
The National Cancer Survivorship Initiative was a partnership between Macmillan, the department
of Health and NHS England and it ran from 2008 to 2013 and the aim of the National Cancer
Survivorship Initiative was really to look at what happens to patients when they go through
treatment and live beyond what we call survivorship and out of this was born the Recovery Package.
The Recovery Package has four components.
The first one is Assessment and Care Planning.
Dr Kate Jenkins (KJ) Holistic Needs Assessment is a way of assessing a patient at various
different points during their cancer journey.
Not just to look at the physical issues they might be facing but also to see what elements
of emotional distress may be playing a part.
So it’s basically looking at the whole person, not just their cancer.
Patient (2) It’s not always just cancer problems, it’s things that affect your work,
or your family life, or your relationships with your friends.
Dr Richard Simcock: We’re finding that it’s making consultations really very focused and
effective, because we can very quickly drill down onto the areas that are of greatest concern
to our patients.
KJ: The clinician who’s carried out the assessment with the patient will come up with
a care plan, which is basically a list of actions to see if we can address some of the
issues that have come up in the assessment.
The second part of the Recovery Package is a Treatment Summary and this is just making
sure that there is communication between the hospital, the GP and the patient.
So that everybody is aware of what has happened during treatment.
Naomi Day: For other healthcare professionals who may not be in direct contact with that
patient, it gives them the opportunity to have an understanding and an awareness from
a medical perspective as to what that patient has been through.
Roy Dear: What it does do is encourages the consultant to say “well the treatment’s
finished, I would advise that you do this and this.
There are risks that the disease might come back, and this is what you should do about
it.
These are the signs you should look for, also these are the contact numbers you may need”.
So they get my contact number for a start, so it’s a really good thing to do.
Dr Lucy Thompson: It’s very easy for people to feel quite dropped at the end of their
treatment.
Sometimes that’s the time when they come back to us as their GP to talk about things,
and if we’ve got a Treatment Summary then it means we can have a much more useful review
with the patient at that time.
The third part of the Recovery Package is the Cancer Care Review and this is a conversation
between the GP and the patient so we can make sure that the patient fully understands everything
that has been going on and have discussed the needs that they might have, so that if
they have needs going forward something can be done and they can be picked up on.
LT: Having a structured template for the Cancer Care Review prompts us to think about questions
that GPs don’t always think about.
When we first see our patients we tend to be very medical, but in fact for people affected
by cancer they often have very different needs and priorities that they want to talk about.
Having a template that prompts us to ask about simple things about their understanding of
their condition, and their treatment to date - finance and benefits.
Checking whether they’ve been involved with other health professionals and referred to
an OT or a Physio or other people who may be helpful to them is really beneficial.
The fourth part of the Recovery package is a Health and Wellbeing Event which locally
maybe known as an education event or a Health and Wellbeing Clinic.
This is a group event that happens at the end of treatment where people can get essential
information and support from clinical specialists, local providers and other subject experts.
It is also where the patient can start to learn how to take control of their lives and
do things around talking about exercise and healthy lifestyle issues which will really
help them going forwards.
Dr: Richard Simcock: We have a marketplace of various cancer charities, providers and
health information services, to provide in a very informal atmosphere information for
patients about the services they provide about living well and living healthily.
But done in an environment that is non clinical, unthreatening, informal, and for patients
to be surrounded by peer groups.
ND: The Living Well and Health and Wellbeing Clinics that we run give patients the opportunity
to highlight problems with a Clinical Nurse Specialist at that time.
And we can also again then signpost them out from that day to other services if needs be,
i.e. the dietician clinic, the exercise clinics.
Pam Harris: I went along to the living with cancer group sessions and they were amazingly
helpful, different speaker every week.
Could be the practical aspects of living with cancer, perhaps some physiotherapy to help
people relax.
A chance to meet other people in the same boat, different forms of cancer but all wanting
to get on with life.
So it was immensely helpful.
Our role at Macmillan, now that the Recovery Package is truly developed is to make sure
that it gets rolled out as far and wide as possible throughout the United Kingdom.
I said at the beginning that there are 2.5 million people living with cancer.
I want every one of those people to have had access to the Recovery Package.
That is the only way that we can make sure that services going forward are truly person
centred.