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National Cancer Survivorship Initiative
Macmillan Health and Wellbeing Clinics
Stephen HindleMacmillan Survivorship Programme Lead
National Cancer Survivorship Initiative
What are Macmillan H&WB Clinics?
• ‘One-stop-shops’ providing information and support to help patients and carers to prepare for the transition after treatment
• Aims to increase health and well being through support with: lifestyle management, managing your cancer, potential signs and symptoms, and how to get help
• Volunteers play key roles in supporting clinics
National Cancer Survivorship Initiative
Key findings of 15 pilots 2010/11• Increased patient knowledge and confidence
• reported reduced anxiety and greater empowerment• more appropriate use of services• earlier intervention – may link to improved outcomes
• ‘One-stop shop’ enabled access to services• reassurance of knowing support there in case of future need
• Patients valued volunteers• Created relaxed atmosphere - put patients at ease• Providing information and signposting, explaining in simple
terms, offering empathy & understanding • Volunteers’ personal experience of cancer gave encouragement
to patients about their future
National Cancer Survivorship Initiative
Success Factors
• Tailored approach to target audience for recruitment, delivery and environment
• Information about HWB and what services patients can access• Successful processes for recruitment / attendance inc.
• Event integrated in pathway (93% invited to Barts clinic attended )• Booking systems which require patients to book appointment• Consultant referral;• Confirmation letters/phone calls
• Volunteer Support & Role• Targeting BME groups in partnership with community organisations
National Cancer Survivorship Initiative
How to set up a Macmillan Health and Well Being Clinic
• Review evaluation material• Engage MDT and Medical lead• Agree survivorship pathway• Agree case of need• Agree operational policy (include awareness
raising/marketing)• Decide content• Set up steering group to monitor project
• Lots of help on LearnZone!
National Cancer Survivorship Initiative
Health and wellbeing clinic component options
Awareness & EngagementCommunity & patient / Third sector MDT via attendance at NSSGs / Primary care /
HWB Integrated in cancer care pathways
Training packages for Staff /Volunteers
Pre HWB AssessmentHNA undertakenPre HWB questionnaire from patients/carers to shape event Referral Mechanisms, inc. self referral, booking, confirmation
Administrative Support (paid/voluntary)
Pre HWB
Inputs
National Cancer Survivorship Initiative
Health and wellbeing clinic component optionsProcesses– Tracker system
Intervention– HNA and care plan (supported by volunteer) –Self management tool and techniques, folder & action plan– Exercises eg Relaxation techniques
Communication Models– Presentations / CDs/ video/ photo loops– Market stalls– One to one support / Group work/open discussions– Music/song/dance/drama
Information Giving– Health and wellbeing messages and services to access– Information leaflets– Volunteer navigated support and signposting
HWB Clinic Event
National Cancer Survivorship Initiative
Health and wellbeing clinic component options
DocumentationLetter to GP, copy to patient and action in notesFollow up card with contacts, signs/symptoms of recurrenceAction plan revisited at agreed timePost clinic evaluation and targeted support eg Belfast/Leeds model
Buddy Support ProgrammePatient referred to peer support programme where exist
Timely Referral & Access to Other ServicesThird sector eg Sister to Sister group LeedsDedicated programmes eg fatigue management
Information Information pack/health and wellbeing booklets/rehab folder
HWB
Outputs
National Cancer Survivorship Initiative
Why do Health and Wellbeing Clinics work?
Health and Wellbeing Clinics help people to take control by:• Focusing on an individual’s role in maximising their own quality of life • Enabling attendees to find out more about what matters to them• Supporting an holistic approach by involving a wide range of support
services• Acting as a springboard for continuing activity
Aiming to increase self-efficacy
National Cancer Survivorship Initiative
What is self-efficacy?• ‘Confidence in the power to ‘master’ the environment influences active
participation in health enhancing behaviours’ (Lev, 1992)• Your belief in your ability to make a difference to your life
Four methods used for enhancing self efficacy:• ‘Mastery’ experiences – actual skills performance• ‘Vicarious’ experience – seeing others succeed• Verbal /social persuasion – positive feedback; suggestion; self
instructed performance• Physiological feedback – emotional arousal
National Cancer Survivorship Initiative
How can Macmillan help you? – Getting Back in the Driving Seat/Taking Charge resource
• Providing focus for person to think about what matters to them• Gives physical space where important issues can be recorded & reflected upon
National Cancer Survivorship Initiative
Contents of Taking Charge• Introduction about self management• Tips to support self management • Useful information• Prompts for consideration of issues affecting health & wellbeing• Plan for action to help move forward - focus on:
• motivation for change• action to be taken• desired result• plan for setbacks• reward for achievement• utilising available support
National Cancer Survivorship Initiative
Taking Charge – supporting people to self manage
National Cancer Survivorship Initiative
How can Macmillan help you? – Getting the Right Messages Across presentation• Underpins aim of Health and Wellbeing Clinics to enable attendees to manage day-
to-day issues as independently as possible. • Customise with local information and images & order different silhouettes at
be.macmillan.org.uk• Additional information for presenters in notes• Can be used as training resource as well as in clinics
Addresses issues of: Vocational Rehabilitation/Work support
Cancer-Related Fatigue
Diet Emotional Issues Financial Issues
Sexual Issues Physical ability Practical support
National Cancer Survivorship Initiative
How can Macmillan help you? – Learn Zone
• learnzone.macmillan.org.uk
Contains all information about Macmillan’s face-to-face L&D and e-learning offer for PABC, volunteers, health and social care professionals and Macmillan staff (need to register)
• Health and Wellbeing Clinics section:– Click on ‘Special Interest Groups’ on top left side of home page– Select ‘Health and Wellbeing Clinic’ from list of groups
• Presentations and Resources section – Setting Up A Clinic
National Cancer Survivorship Initiative
Contact us at Macmillan• setting up a Health and Wellbeing Clinic:
– Fay Scullion 07834 192222 [email protected] – Jane Rudge 07834 191245 [email protected]
• self management support training for volunteers and resources– Suma Surendranath 020 7840 4982
• Stephen Hindle 020 7091 2045 [email protected]