Written by Leap
Every two minutes, someone in the UK is diagnosed with cancer*. In that life changing conversation exercise is likely one of the last things on a patient’s mind. However, we know that movement and physical activity are a key part of optimising health and wellbeing during cancer treatment.
Patients who move regularly report reduced lymphoedema, lower levels of cancer-related fatigue, have shorter hospital stays and less post-operative complications and side effects from anti-cancer treatment.
So you can see why breaking down the barriers for people living with long term conditions to move is one of our key objectives at Leap. And when in June 2021 we were contacted by Kerry, Macmillan Oncology Advanced Physiotherapist for Buckinghamshire, about improving the provision and access to movement for people living with cancer we were only too pleased to work with her.
Our first step was to map existing provision, we looked for instructors with the knowledge, skills, and behaviours to deliver physical activity to people living with cancer. The mapping showed us that, to the best of our knowledge, we only had one individual across the whole county appropriately qualified to deliver to these residents.
We then formed a steering group to lead this work consisting of representatives from Buckinghamshire Healthcare Trust, Bucks Clinical Commissioning Group (CCG) and Public Health teams. By bringing these stakeholders together we identified the need for greater connectivity between the clinical and community provision and set out to establish a health instructor network.
Health instructor network established
After further conversations with Kerry and other key health system partners including Bucks Public Health, Bucks Clinical Commissioning Group, Bucks HealthCare trust Oncology, Falls and Cardiac health teams we decided to create the Health Instructors Network to help address problem around the lack of opportunities for people with long-term conditions to be active. The aim of the network is to achieve the following outcomes.
– Create a network of instructors all motivated to help people living with long-term conditions to be active: We currently have just over 20 instructors involved, and we are all connecting via a Whatsapp group to share key information, useful resources, and challenges etc.
– Better connect instructors with key health system partners to improve the pathway and opportunities for people living with long term conditions: We are delivering 2 face to face events per year and online events every 6 weeks around specific topics to connect the network more regularly and in turn improve pathways for residents.
– Provide training and support to gain qualifications for instructors to increase the number of instructors we have across Bucks with the right knowledge, skills, and behaviours to help people living with long-term conditions to be active: We currently have a bursary available to support instructors to gain Level 4 Cancer Rehab, Cardiac Rehab or Falls Prevention qualifications.
Strength in collaboration
The improvements in activity provision for people living with cancer would not have been possible without the collaborative efforts of several partners.
Bucks CCG who provided expertise around qualifications and connected the group to primary care cancer leads and social prescribing teams.
Bucks Healthcare Trust was catalyst for engagement with cancer specialist nurses and healthcare professionals involved in the Bucks and Thames Valley Cancer Alliances. Whilst developing and getting sign off for the pathway from cancer services into community activity.
Bucks Public Health funded bursaries for instructors and connected the group to colleagues working on connected prevention programmes.
The community instructors committed to part funding their own training, collaborating on a Bucks wide programme and completing consistent information processes and evaluation.
• Mapping instructors who were delivering cancer pre and rehab activities and bringing together others who wanted to be trained and part of a bigger movement.
• Establishing and coordinating the Bucks Health instructor network and cancer network working group.
• Bringing together various clinical organisations, public health and community deliverers.
• Helping to make the case for Public Health investment to upskill community instructors with cancer specific qualifications.
• Facilitated start up investment for three community sessions through the Together Fund whilst patient begin to be directed through the pathway.
• Production and coordination of marketing collateral for the Can Move programme of activities.
• Trust developed between clinical staff and community deliverers, bringing mutual respect for the role each can play in supporting the wellbeing and outcomes for people living with cancer.
• Greater understanding of Cancer specialist qualifications in movement and complimentary qualifications are helping to inform a strategy for a more sustainable workforce.
• By establishing the health instructors’ network, the instructors now have a ‘community of practice,’ feeling part of something bigger, and supported – the group share knowledge, challenges and solutions. The group is starting to shift its focus onto different long-term conditions with the aim to replicate the improvements to cancer pre and rehab opportunities.
• Working together the health instructors have agreed on a standardised evaluation process to be used across clinical and community-based sessions which will aid evaluation and learning.
• Over £7,000 provided through Together fund
• 4 instructors trained / upskilled?
• 22 instructors engaged through the health instructor network
• Over 16,000 cancer patients now have a movement pathway
Learning along the way
Whilst many community instructors are passionate about providing movement opportunities for people with cancer, the pathways need to make sessions financially sustainable for instructors and will not be supplemented by their other sessions.
Future plans / next steps
• We need a sessions or two in the Aylesbury, Buckingham or Winslow area of the county
• How do we get more people – Funding to do the exercise referral
• Need to get numbers of patients through.
• Where next…. CVD and Dementia are the next LTC on our list
It’s been a pleasure to bring together a movement of healthcare and exercise professionals with a shared passion and mission to improve the wellbeing and outcomes for people living with a cancer diagnosis. The can do collaborative attitude from all involved made the sometime complex system easier to navigate and change. I hope that now the pathway is in place healthcare professionals will be confident to empower patients to engage with regular movement and activity.
Chris Gregory – Head of Strategic Relationships
Community instructor Interested to deliver to people living with cancer?
Please get in touch to help us develop the pathway further. We’re particularly interested in talking to instructors in the Aylesbury area.
Are you a healthcare professional helping people living with cancer?
Access support to have a conversation about movement with your patients. www.movingmedicine.ac.uk