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Well-connected
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The service is non-clinical, and
the three team members are all
Macmillan professionals with a
variety of voluntary sector experience,
including counselling, HIV charity
work, and cognitive behavioural
training (CBT), for example.
Patients aged over 18 with any
cancer type in Tower Hamlets,
City and Hackney, Newham
and Waltham Forest can access
the service by referral through
community nurse, GP practices,
hospitals and self-referral. The aim
is to make it easier for healthcare
professionals to refer patients to the
right service for them.
CHANGE FOR THE BETTER
Laura Westwick, Macmillan social
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long-term condition and those
living with cancer can face
considerable practical, emotional
and social issues.
Pe
op
le
ar
e
‘More people are being
diagnosed with cancer in the UK
but more people are also surviving,’
she says. ‘To improve the quality and
effectiveness of care and support of
those living with and beyond cancer
the follow-up pathway for many
tumour types is moving towards a
stratified model of care. This puts
more emphasis on self-care and
management and moves away from
routine follow-up appointments.’
‘We support patients with
a wide range of issues or
personal goals.’
ou
nd
One example of how
collaborative working is benefiting
patients ‘on the ground’ is an
innovative new service that is
helping cancer patients connect
to local services in east London.
The Bromley by Bow Centre
and Macmillan Cancer Support
have partnered to create a social
prescribing service. The service helps
people improve their wellbeing on
a one-to-one basis and provides
support from trained professionals
to explore patients’ needs, set
personal goals and access work and
welfare advice, art classes, walking,
gardening, and meditation groups.
prescribing manager at the centre, says
that the cancer picture is changing.
C
T
oo often in health care we are
guilty of working alone and
not utilising colleagues and
services around us, even though
they may have expertise and
experience that might help us do
our jobs better.
Lt
d
Getting patients to access the care they need is not always easy.
Jason Beckford-Ball spoke to Laura Westwick about one project in east
London that is connecting cancer patients with local services...
Patients who use the service
come from a wide background, with
recent cases including an elderly
woman with bowel cancer who
had developed low confidence as a
result of her stoma and the effects
of cancer treatment. She wanted
to socialise but didn’t know how
to start. She met the team and was
referred to an appropriate physical
activity programme and now takes
regular exercise classes.
Another patient needed to get
back to work after cancer treatment,
while others undergoing treatment
have wanted to build their confidence
in talking about their diagnosis —
the team can connect them with
psychology workshops, for example,
which help them learn to discuss
treatment and side-effects. Similarly,
the team can provide Macmillan
literature on subjects such as poor
sleep and loss of appetite.
Healthcare services are
increasingly seeing cancer as a
Westwick says high levels of
deprivation in east London further
compound these issues, particularly
for those who feel isolated and new
to the country, and who do not
speak English as a first language.
‘The time spent in hospital
and in appointments with health
professionals represent only a small
amount of patients’ time,’ she says.
‘It is vitally important that people
are connected to resources and
support in their community that can
keep them well.’
POWER TO THE PEOPLE
Westwick says that data on the first
four months of the service have
shown a high proportion of people
in their 50s accessing the service,
with a general age range of 50–80.
A large percentage are black and
minority ethnic, which reflects the
population of east London, with large
proportions of Afro-Caribbean and
Bangladeshi people, in particular.
‘We support patients with a wide
range of issues or personal goals,’
Westwick says.‘The support is led by
the patient but the focus of our support
to date has been largely around
physical activity — action planning
and identifying local community-based
exercise programmes, breaking down
social isolation, welfare and finance
issues, and emotional wellbeing.’
She adds that a large part of the
team’s role is in stress management
and confidence building.
‘’
Lt
d
The more
patients we
see, the more
the service
develops...
Pe
op
le
PROBLEM-SOLVING
Westwick says that setting up the
service was not without problems.
ar
e
within the excellent care and support
provided by healthcare professionals,
such as community nurses.’
In short, the aim is to work
together to achieve better quality of
life for patients. But has the service
been a success?
W
ou
nd
Building relationships and
knowledge of community-based
services across four heavily
populated and diverse east London
boroughs is a particular challenge,
especially given the changing
nature of services.
The team from the Bromley by Bow Centre. From left to right, Bav Chandegra,
Laura Westwick and Anny Ash.
C
‘Navigating the world of primary,
secondary health care alongside
staying closely linked with voluntary
and community-based services can
be a challenge,’ she says, ‘but is also
an incredibly valuable perspective
and insight to have. Particularly
given a patient’s journey and
interaction with these varied sectors.’
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‘We know that for patients with
the lowest levels of self-efficacy
“local” is important, so the scale
of mapping and understanding is
considerable,’ she says. ‘We have
made huge headway in this area and
the networks and services we can call
on for patients continue to grow.’
The overall aim of the service
is to improve the quality of life
of people living with and beyond
cancer, with a focus on personcentred care. This means ensuring
that patients can focus on their
wellbeing and that they know what
local activities and community
resources are available to them.
‘We also have to support the
integration of healthcare and
voluntary sectors,’ Westwick says.
‘We are trying to embed the service
‘After our scoping work we are
delighted to have a service up and
running and to be supporting local
people,’ Westwick says. ‘Seeing
patients build their confidence, tackle
issues, take control of their health
and wellbeing is really satisfying.
It has also been gratifying to
see professionals from different
backgrounds working together.
‘We have a really dynamic group
of healthcare professionals to support
the development and delivery of the
project,’ Westwick says. ‘This includes
clinical psychologists, clinical nurse
specialists such as cancer nurses, GPs,
and ward nurses.’
Westwick adds that these
relationships with other
professionals have been invaluable.
‘The more patients we see,’ she
says, ‘the more the service develops
as we build our knowledge of the
diverse local services and support
people need to move forward.’
Finally, is there anything that the
team could have done differently?
‘That is a good question,’ Westwick
says, smiling. ‘There is always
tweaking and improvement work
we need to do, as well as further
knowledge, learning and relationships
to build. But would we have done it
differently? No, so far it looks like we
have got the service about right.’
Whatever the future holds
for people with cancer living in
east London, having a dedicated
service funded by Macmillan
that seeks to improve the link
between healthcare services such as
community nurses and patients, can
only be a good thing. JCN
Find out more...
To learn more about the centre,
its partnership with Macmillan,
as well as the wellbeing service,
visit: www.bbbc.org.uk.
Here you can also find useful
resources for you and your
colleagues, such as:
 GP/practice nurse referral form
 Community organisation/non
health professional
referral form
 Hospital referral form.
JCN 2016, Vol 30, No 1
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