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Implementing the
Recovery Package
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2016
Purpose of session
1. Overview of Living with and Beyond
Cancer
2. Promote wider understanding of Recovery
Package
3. Explore stratification
Improvements in early detection and diagnosis
More advanced treatments
Move from acute to long term condition
Increasing numbers of people living with and beyond cancer
50% of people with
cancer in the UK now
survive at least 10 years
( April 2014)
Source: Macmillan Cancer Support identified median survival times based on research by
the Cancer Research UK Cancer Survival Group at the London School of Hygiene and
Tropical Medicine. Incidence and mortality data for the survival analysis are originally
sourced from the Office for National Statistics.
The survival rates are changing
Macmillan Cancer Support (2011) identified median survival times based on research by the Cancer
Research UK Cancer Survival Group at the London School of Hygiene and Tropical Medicine
research.
The survival rates are changing
Total Prevalence - now
Total Prevalence - 2030
Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, 2010-2040.
Br J Cancer 2012; 107: 1195-1202.
Not everyone is living well
Cancer Patient Experience Survey 2014
25% not informed about
side effects before
treatment
74% - Not offered a
written assessment and
care plan
41% - Not enough
support from health and
social care services after
Multi morbidity is the norm, not
the exception
Source: York Centre for Health Economics Research Paper 96
Cancer and other morbidities
Source: Macmillan’s Routes from Diagnosis programme
The English National Cancer
Survivorship Initiative
Four Priorities
1.
2.
3.
4.
Recovery Package
Redesign follow-up
Physical activity and healthy lifestyle
Consequences of Treatment
Living With and Beyond Cancer
The Five Survivorship Stages
Information and
support from point of
diagnosis
Promoting
recovery
Sustaining
recovery
Managing
consequences
of treatment
Improving Survivorship Intelligence
Supporting
people with
active and
advanced
disease
The NCSI defined four priorities:
1.
Recovery Package
2.
Redesigning follow-up
3.
Physical activity
4.
Consequences of treatment
National recognition
By 2020
• Independent Cancer Taskforce A Strategy for England
2015- 2020
• NHS Five Year Forward View
• Jeremy Hunt - Secretary of State for Health has
announced new measures to develop a tailored
recovery package for everyone surviving cancer.
• A more personalised treatment plan and better
support to live well, with and beyond the disease.
The NCSI defined four priorities:
1.
Recovery package
2.
Redesigning follow-up
3.
Physical activity
4.
Consequences of treatment
•Breast 80% patients
•Colorectal 50% patients
•Testicular 95% patients
•Project management
•Clinician engagement
•Patient support
•Remote surveillance
The ‘How To Guide’
The NCSI defined four priorities:
1.
Recovery package
2.
Redesigning follow-up
3.
Physical activity
4.
Consequences of treatment
Physical Activity improves health
and wellbeing outcomes
Macmillan Cancer Support (2011). The importance of physical activity for people living with and beyond
cancer.
Quick Question...
UK Physical Activity Guidelines by Chief
Medical Officer
Be active every day aiming to
accumulate 150 minutes moderate
intensity physical activity in bouts of 10
minutes or more.
Exercise to improve muscle strength on
at least two days of the week.
If at risk of falling, use exercises to
improve balance and co-ordination.
Avoid sedentary behaviour.
Physical Activity Levels – people living with cancer
50%
45%
40%
35%
30%
25%
20%
15%
10%
5%
0%
Active to recommended
levels
Active but not to
recommended levels
Inactive
Do you think adults change their
lifestyle behaviours after a cancer
diagnosis?
46% of smokers quit
30.1% exercise LESS
‘Exercise is safe during and after
cancer treatment’.(Expert Panel at
American College of Sports Medicine)
https://www.penncancer.org/pdf/pal/American_College_of_Sports_Medicine_Roundtable_on_23.pdf
Individual behaviour change
The teachable moment
•People are more inclined to
change their lifestyle behaviour
following a cancer diagnosis
•They do not do so without a
quality behaviour change
intervention
•People are more inclined to
change if the issue is raised by a
senior health care professional
•72% of GPs and 60% of
Oncologists only talk to a few or
none of their cancer patients about
moving more
Visit www.macmillan.org.uk/physicalactivity
The NCSI defined four priorities:
1.
Recovery package
2.
Redesigning follow-up
3.
Physical activity
4.
Consequences of treatment
‘consequences of cancer and its treatment’ means the
wide range of long-term physical and psychosocial
changes that seem to be associated with cancer and its
treatment however long ago the diagnosis and
treatment may have been given..
This is often referred to by a range of different names,
including;
• side effects
• late effects
• toxicity
• adverse effects
• long-term effects
• chronic effects
• consequences of treatment
Body image issues
Persistent hair loss
Mental health problems
Swallowing/speech
problems
Heart disease
Breathing difficulties
Nausea, vomiting
Lymphoedema and
osteoporosis
Urinary or bowel
incontinence
Sexual difficulties
CoT Resources
Visit http://be.macmillan.org.uk/be/s778-consequences-of-cancer-andits-treatment.aspx for more
CoT Resources for Professionals
CoT Resources for people affected by cancer
• Early discussions about work and finance can be vital in
preventing problems.
• It doesn’t have to be a long discussion
• You don’t have to be an expert but do need to understand the
importance of work for health and wellbeing.
• Macmillan has developed a range of online and offline
resources to support you to have conversations and direct
patients to information on work and finance and relevant
services
• 82% of people think it is
important to continue to work...
• ...but 47% have had to give up
work or change roles as a result
of their diagnosis
•Over 60% of PLWC reported no
health professional informed them
about the impact cancer might
have on their working life
Work is good for physical and mental health and
well-being
Work can help promote recovery and
rehabilitation and improve quality of life.
Is work good for your Health and Wellbeing. Waddell G, Burton AK (2006).
Working for a healthier tomorrow Dame Carol Black, (2008).
Work and Finance Resources
Visit :
www.macmillan.org.uk/workandprofessional
www.macmillan.org.uk/financialsupport
Living With & Beyond Cancer Resources
These can be ordered from :
be.macmillan.org.uk/ recoverypackage
Any Questions?