Older People Living with Cancer

Peer advocates supporting older people affected by cancer

Commissioning for Recovery – Working in partnership across Wessex

Jen Rimmer and Kathleen Gillett from Dorset Macmillan Advocacy recently attended the “Commissioning for Recovery – Working in partnership across Wessex” conference organised by Macmillan Cancer Support.  Members of Dorset Macmillan Advocacy’s Cancer in Older People Development Group (the former Champions Board) Paula Bond and Tracy Street of Macmillan Cancer Support and Abigail Orchard, Lead Cancer Nurse at Dorset County Hospital were there in the role of facilitators and speaker respectively.  Macmillan GP advisors in Dorset, Simon Pennell and Lavina Sakhrani-Clarke attended as did representatives of Dorset Clinical Commissioning Group.

The event brought together commissioners, providers, and service users to discuss and understand how the Recovery Package can make an impact on supporting people living with and beyond cancer and how this fits in with commissioning plans.  From our point of view we tried to understand where advocacy support would fit within the package.

The Recovery Package comprises a number of key interventions developed and tested by the National Cancer Survivorship Inititative (NCSI).  These interventions could make an immediate difference to people affected by cancer, by helping them to prepare for the future and return to a lifestyle as near to normal as possible.

In brief each part of the Recovery Package is designed to work together to inform the overall care pathway:

  • Holistic Needs Assessment (HNA) resulting in a written Care Plan
  • Treatment Summary from the hospital team to inform the GP and the patient
  • Cancer Care Review by the patient’s GP practice
  • Health and Wellbeing education event to enable rehabilitation and self management

See the explanatory video by Macmillan Cancer Support.

The keynote speaker Juliet Bouverie, Director of Services and Influencing at Macmillan Cancer Support described why and how the Recovery Package had come to be developed.  Regarding the HNA Juliet explained that the top concerns for a patient’s care plan may not be those anticipated by clinicians and were most likely to be related to worry, anxiety and fatigue.  I saw immediately the role for peer volunteer advocates enabling their advocacy partners to share feelings and helping to find things out or signpost to sources of practical support when the person with cancer lacks the energy to do so.

Participants’ questions and observations included Kate Jenkins, Clinical Psychologist at Salisbury District Hospital, who felt that patients should be supported to self-manage from the start, that recovery should begin at diagnosis and that it is important not to disempower patients in the first place.  Another participant referred to this process as ‘prehabilitation’.

Recovery package diagram

Recovery package diagram

Simon Pennell chaired a question and answer session with three people affected by cancer.  Paula Bull described her experience of the Bournemouth After Cancer Survivorship Programme (BACSUP) and the enormous difference it made to her physical and mental wellbeing.  She stated that she wanted commissioners to make emotional and practical support part of care and not an ‘add-on’ or a ‘patchy’ service provided solely by charities.

During the afternoon discussions Simon Pennell said that he thought that the Treatment Summary document would empower people affected by cancer to be more proactive in respect of the support they required from their GP.  We agreed that peer volunteer advocates could have a role in assisting their advocacy partners to ‘unpick’ their treatment summary and prepare their questions and ideas ahead of their GP appointment.

Kathleen Gillett, Dorset Macmillan Advocacy

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