SafeFit, the online exercise and wellbeing programme for cancer patients during lockdown
The country has been thrown into a very different position this year; one that no one could have possibly predicted or planned for. So many vital services that we normally take for granted, have had to adapt very quickly, to the sudden Covid-19 pandemic and the world of cancer was no exception.
The normal day-to-day cancer services that were providing patients with a lifeline of support, had to stop and so did all the trials.
Wessex Fit for Cancer (also known as Wesfit) was one such trial which had to be paused, to protect the vulnerable people that were taking part. The clinical trial was working with a small group of cancer patients at University Hospital Southampton; looking at the positive impact exercise, personalised nutrition and mental wellbeing advice, had on a cancer patient awaiting cancer surgery and/or treatment.
The irony is, these patients’ very vulnerability that the trial was working to support, suddenly was at risk of becoming even worse, with the government guidance to shield for so many cancer patients and self-isolate for thousands more. The virus sweeping the nation, was (and still is) a major health risk for anyone with existing health conditions including those who may be receiving immune-suppressing treatment – like chemotherapy, for example.
The team behind Wesfit, could not sit back and see their patients left stranded, so they set about developing a virtual version of the trial, SafeFit.
SafeFit has come about because of the lockdown and offers online sessions to cancer patients, with fully qualified instructors from CanRehab. The virtual service means that the support can be wider-reaching and the sessions are now available online for many more cancer patients to access through a simple self-referral application.
Those signing up gain free access to the support on offer and can contribute their experiences and data to research aimed at assessing these services as part of standard cancer care in the future.
Funding needed to continue;
However, the virtual service is now under threat of having to stop as well, because the vital funds needed for this programme, are running out. We are therefore, starting a public fundraising campaign, with the support of the Southampton Hospitals Charity, in order to try and keep SafeFit going.
SafeFit uses the techniques, people and resources from Professor Sandy Jack’s national WesFit trial, and initial funding came from the NHS England Wessex Cancer Alliance. It costs approximately £30,000 for SafeFit to operate over 3 months; therefore, we need to raise £60,000 if we want to keep SafeFit going for 6 months and £120,000, for a year.
“I had to call nine patients to explain we were pausing our WesFit trial, they were completely devastated.” Explains Professor Sandy Jack, consultant clinician scientist and Professor of prehabilitation medicine at University Hospital Southampton.
“I was clear there and then that we needed to put all our energies into supporting these people and others like them through the pandemic. I am determined we can raise the funds needed, to keep SafeFit going while people still need us” Adds Professor Jack.
Initially, the plan was for around 1000 patients nationwide to be supported by the Southampton team and CanRehab trainers, with plans to provide support for all; dependent on securing this further funding.
Exercise sessions are delivered by volunteer personal trainers, who have been trained and accredited in appropriate, safe exercise for cancer patients by the CanRehab charity. A small cohort of patients have trialled these before launching the service nationwide.
“Cancer services will never be the same again after coronavirus. We’ve started the sort of ‘universal intervention’ described in the NHS Long Term Plan right now. What’s more, Sandy and the team are building research into it, to provide solid data on its impact and how to implement such support long-term.” Comments Sally Rickard, Director of the NHS England Wessex Cancer Alliance, funder of the WesFit initiative.
With the news that gyms will not be able to re-open on 4 July, as many had been expecting, it is even more vital that the cancer patients currently being supported by SafeFit, do not feel abandoned again.
Professor Anna Campbell Professor Clinical Exercise Science and Director of CanRehab said: “Our work, and that of the WesFit team has shown that this type of support is hugely valued by cancer patients, is cost effective, employs non-NHS, skilled staff in the hard-hit leisure sector.”
June Davis, from Macmillan Cancer Support commented: “This pilot offer has been designed and developed rapidly through a fantastic collaboration between multiple partners to support people living with cancer.”
Anyone wishing to support the SafeFit service, can do so by visiting Southampton Hospitals Charity to donate directly to the SafeFit fund.
Pioneering ‘Prehabilitation’ research up for national award
The groundbreaking WesFit study into exercise and psychological support before cancer surgery has been shortlisted for the 2020 Health Services Journal Value Awards, which recognise outstanding dedication to making things better in the NHS.
The £2.3 million study comparing the impact of pre-surgical exercise, psychological support or both combined was initially funded by the Wessex Cancer Alliance as a Wessex-wide project, but now has multiple other regional NHS England cancer alliances seeking to join, with Plymouth Hospital the latest site to open in November 2019.
“This is fantastic news for the team, the communities and the patients involved in the trial here in Wessex and elsewhere across the UK.” Comments study lead, Prof. Sandy Jack
Prof. Jack’s team and the Wessex Cancer Alliance work in partnership with cancer charities, leisure facilities and local councils across Wessex, transforming pre-surgical care and bringing it closer to patients’ homes – helping see it selected ahead of hundreds of other projects to make the shortlist.
“Together we’re establishing the evidence for a whole new approach to cancer surgery services – focussing on getting people into the best possible shape before their operation to improve recovery, outcomes and help them stay healthy for the rest of their lives.” Adds Sally Rickard, Director of the Wessex Cancer Alliance
WesFit builds on Prof Jack’s pioneering studies showing that structured, high intensity exercise in the six weeks between chemotherapy and surgery returned patients’ physical fitness to pre-chemotherapy levels before they entered the operating theatre.
“That’s important because we know that in major surgery physical fitness has a big impact on how fast you recover, your chances of complications and your long term outcomes.” Explains Prof. Mike Grocott, head of the Southampton Critical Care Research group.
“Not only have we shown this improvement in pre-surgery fitness, evidence of reduced complications and massively improved quality of life, we’ve also published data showing that this kind of exercise results in the tumour itself shrinking ahead of surgery.” Adds Prof. Grocott .
The team will be there at the HSJ Value Awards 2020 awards ceremony on 21 May, and will be hoping to take the title for all those involved.
Engaging with stakeholders on the future of cancer services
On 20 September the Alliance held its Wessex Cancer Plan event, providing an opportunity to look at the progress and achievements in local cancer care to date and plan for the next five years.
With more than 100 stakeholders in the room – from those who work in primary care and public health, through to secondary care; cancer charities and patient representative groups; as well as patients with lived experience of cancer – a wealth of expertise and insight was shared that will help shape future improvements and transformation in cancer care locally.
Watch the video from the day to find out more about the conversations that were had.
Communities Against Cancer launches across Hampshire, Isle of Wight and Dorset this July
Community groups across Hampshire, the Isle of Wight and Dorset will start work this month to help people reduce their risk of cancer, be aware of the signs and symptoms of cancer, and seek help at an earlier stage.
The groups are part of Communities Against Cancer – a new project funded by Wessex Cancer Alliance and run by Action Hampshire – which aims to increase the number of cancers diagnosed at an early stage and reduce health inequalities.
Charities and not-for-profit organisations were invited to bid for small or large grants to support local activities and community leaders will receive “cancer champions” training so they can have conversations about cancer with people in their local communities. Using community leaders in this way will help the NHS reach those people who prefer to talk to someone they know and trust within their own community.
Grants have been awarded to 16 community and not-for-profit groups so far. They include:
- Dorset Race Equality Council, which will run public awareness events to reach people in Gypsy, Roma and Traveller communities and people from black and minority ethnic groups;
- Southampton Mencap, which will use the funds for the cancer champions to run educational workshops for paid and unpaid carers of people with learning disabilities, which in turn will support them to have conversations about cancer and cancer screening with the people they care for;
- Mustard Seeds Ministry which will use the funding to support a variety of community events in Portsmouth to reach socially-isolated older people from lower-income households;
- One Community in Eastleigh, which will hold regular drop-ins at community hubs, deliver talks on the signs and symptoms and how to prevent cancer, and build a network of Communities Against Cancer volunteers.
- People First Dorset, which will run educational sessions for people with learning disabilities on what cancer is and who is at risk; how to spot it; what to do if you have symptoms and how to stay healthy.
Claire Vincent, Communities Against Cancer Project Co-ordinator at Action Hampshire said: “This is a fantastic way to reach people in the heart of their communities. By using local individuals, groups and organisations who already have links with the people we’re trying to reach, they are able to get these vital cancer messages across in creative and engaging ways.”
Matt Hayes, Medical Director at Wessex Cancer Alliance said: “One of the most important actions the NHS can take to improve cancer survival is to diagnose cancer earlier. The NHS Long Term Plan sets a new ambition that, by 2028, the proportion of cancers diagnosed at stages 1 and 2 will rise from around half now to three-quarters of cancer patients. The earlier cancer is detected the more likely it is to be curable, so this really is important.
The Long Term Plan also makes a commitment to tackle persistent health inequalities. We know that on average, people in disadvantaged areas have multiple long-term conditions 10 – 15 years earlier than those in better off neighbourhoods and over half of the equality gap is from deaths including deaths from cancers.
That’s why we have commissioned Action Hampshire to help us deliver a new community outreach programme to reach those communities we know are often less likely to have regular contact with healthcare professionals.”
Small grants of up to £500 are still available. Find out more by visiting Action Hampshire.
NHS to rollout lung cancer health checks in Southampton
Lung cancer health checks are being rolled out in Southampton in a drive to save lives by catching the condition early.
Southampton is the only area in the south of England chosen for this new scheme as part of Wessex Cancer Alliance, and is only one of ten in England.
Around £70 million will fund 10 Cancer Alliance projects nationwide to check those most at risk, inviting them for an MOT for their lungs and an on the spot chest scan that can include mobile clinics.
The targeted screening will help improve survival rates by going first to the some of the areas with the highest death rates from lung cancer.
A recent study showed CT screening reduced lung cancer mortality by 26% in men and between 39% and 61% in women*.
The roll out has the potential to reach around 600,000 people in England over four years, detecting approximately 3,400 cancers and saving hundreds of lives across the country.
The NHS Long Term Plan set out an ambition that 55,000 more people will survive their cancer – to achieve this the plan also included an ambition to increase the number of cancers diagnosed at stages one and two (early stages of cancer) from half to three-quarters of cancer patients.
Dr Sarah Young, local GP and a board member of NHS Southampton City Clinical Commissioning Group, said: “We are really excited to be one the first national sites to roll-out the lung health check. This is a real opportunity to improve the lung health of our population, which will identify serious illness at an earlier stage than at present.
“We look forward to working with our local partners to deliver a targeted scheme which could benefit many thousands of patients.”
Wessex Cancer Alliance Clinical Lead, Mr Matt Hayes said: “Early detection is the best chance of surviving any cancer. Lung cancer is no exception – just 5% of people live 10 years after diagnosis if it is detected at a very late stage in the disease. These lung health checks will help us identify those most at risk of developing lung cancer at a stage where we can offer patients their best chance of life-saving treatment, and will mean a better chance of longer survival for a cancer which remains one of our biggest challenges.”
Cally Palmer, national cancer director at NHS England, said: “Catching more cancers early is a cornerstone of the NHS Long Term Plan to save a further 55,000 lives a year and targeted lung health checks is one of the first projects to roll out following publication.
“These new projects will save lives – early diagnosis for cancer is crucial as it is easier to treat, not only saving lives, but it will also mean thousands of patients will avoid life changing treatments.”
The projects will last initially for four years and NHS England will then evaluate the results to use as a basis for further roll out.
*Source: NELSON lung cancer trial.
Wessex Cancer Alliance recognised at HSJ awards
A project between Wessex Cancer Alliance and Baxter Healthcare to review cancer services secured finalist status at the HSJ Partnership Awards ceremony on 20 March 2019.
The collaborative team was among 11 others up for Best Pharmaceutical Partnership with the NHS, for their work to review out of hospital systemic anti-cancer therapy services, across Hampshire, the Isle of Wight and Dorset.
Systemic anti-cancer therapy services is the name given to the treatment of cancer with medicines, such as chemotherapy.
“Nationally there is a drive to deliver more cancer therapies closer to patients’ homes to improve both their outcomes and experience of care. We wanted to explore the existing systemic anti-cancer therapy services delivered in the community in Wessex and find examples of good practice, so we could both make recommendations to commissioners and develop an approach to ensure these services are more widely available to patients,” explained John Williams, Wessex Cancer Alliance’s Quality Support Lead for Treatment and Care.
To achieve this, the Wessex Cancer Alliance partnered with Baxter Healthcare Limited to review current out of hospital services across the eight NHS provider organisations in Wessex, and involved Wessex Voices and Wessex Cancer Trust to gather input from patients.
The project involved mapping the current care pathway for people receiving different systemic anti-cancer therapy services in each of the hospital trusts; identifying opportunities to redesign the care pathway so it includes more care closer to home; identifying training and development needs for clinicians so they can confidently provide systemic anti-cancer therapy care in out of hospital setting; and identifying opportunities for patients undergoing chemotherapy to receive associated support care at home.
It provided insight into demands, pressures, opportunities for improvement and examples of innovation and good practice that are already being implemented or are in development.
As a result, Wessex Cancer Alliance has made a series of recommendations relating to the transformation of chemotherapy services for out of hospital care. These have been shared locally, regionally and nationally to inform commissioners, networks and providers on current provision of out of hospital services.
It has also helped facilitate talks between neighbouring trusts on their out of hospital services, and with the charity sector on partnering to provide mobile cancer care units and cars to enable some services.