Delivering quality cancer care in rural and coastal settings: Experiences of a large-scale integrated cancer transformation programme
Background:
Rural and coastal areas constitute 85% of the UK landmass and house ~10 million people. Evidence suggests that those living with cancer (LWC), residing in rural and coastal areas are disadvantaged compared to those in urban areas (e.g. increased distance from treatment centres, poor transport infrastructure, limited specialist workforce, social/economic deprivation). The UK County of Lincolnshire, with a mix of rural, coastal, and urban areas, but low population density due to its rural nature and size, has~37,000 people LWC. Evidence shows that people LWC offered holistic support before, during, and after diagnosis, have improved outcomes, compared to those not in receipt of support. We discuss experiences of a large-scale, system-wide, integrated cancer transformation programme (the LWC programme) to meet the needs of all communities, regardless of where they live.
Methods:
The LWC Programme is driven by patients’ experiences (n=603) via community consultations (2017-2023) that explored the challenges of living with cancer. We have measured progress and impact in acute, primary and community care, synthesising quantitative and qualitative data on the ‘LWC Dashboard’. Stratified models for psychosocial, financial support and physical activity, using existing assets have been developed. We identified 6 ‘places’ where people access support (hospital, pharmacy, primary care, community health services, work, home) and developed ‘place-based’ projects to improve access to information, advice, and support.
Results:
By June 2024, 50% of patients were offered a Holistic Needs Assessment (HNA) within 31 days of diagnosis (70% for tumour pathways with a Cancer Care Co-ordinator), 43% for those undergoing chemotherapy during treatment. Consistent referral to psychological support services has been adopted by all acute Cancer Nurse Specialists and Cancer Care Co-ordinators. 61 of 82 GP Practices have accessed offers of Cancer Care Review training. 2000+ mapped community assets go live on our website in Autumn 2024. More than 80% of patients who have accessed psychosocial support report less distress after 12 weeks. The Macmillan Outreach Project (commenced December 2023) will ensure that people can access information and support closer to home.
Conclusions:
The LWC Programme founded on patient experience has resulted in tailored support to meet the needs of rural, coastal and urban residents. There is a need to step outside historical boundaries of what a ‘health’ service is to realise transformation. The widespread establishment of Integrated Care Systems (ICSs) in England (July 2022) has expediated the adoption of this programme which will be replicated to support other long-term conditions.
History
School affiliated with
- Lincoln Institute for Rural and CoastalHealth (Research Outputs)
- Lincoln Medical School (Research Outputs)
- School of Health and Care Sciences (Research Outputs)
- College of Health and Science (Research Outputs)
Publication Title
Journal of Cancer PolicyPublisher
ElsevierExternal DOI
eISSN
2213-5383Date Accepted
2024-12-18Date of First Publication
2024-12-18Date of Final Publication
2024-12-18Open Access Status
- Not Open Access
Will your conference paper be published in proceedings?
- N/A