physical activity embedding physical activity into cancer care evidence and examples rhian horlock,...

Physical ActivityEmbedding Physical Activity into Cancer CareEvidence and Examples

Rhian Horlock, Physical Activity Manager, Sporting Opportunities

The cancer story is changing

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

Maddams J, Utley M, Moller H. Projections of cancer prevalence in the United Kingdom, 2010-2040. Br J Cancer 2012; 107: 1195-1202.

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.

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.

Not everyone is living well

Physical Activity improves health and wellbeing outcomes

Macmillan Cancer Support (2011). The importance of physical activity for people living with and beyond cancer.

‘Keeping active has helped me, and my family, through

a really difficult time. It’s helped me return to a more normal way of life and has given me a real sense of

achievement’.

Ted Poulter, 66 Pseudomyxoma peritonei

American College of Sports Medicine (2010)British Association of Sport and Exercise Sciences (2011)

UK Physical Activity Guidelines

“I want to do it so that I can go walking with friends without feeling

like I am a burden”

A framework for physical activity behaviour change

Stakeholder engagement

Quality assurance

Raise awareness

Brief advice

Behaviour Change

Intervention

Support and follow up

Get and stay active

Primary careSecondary carePublic healthLeisure, parks and cultural services

Social careLeisure and physical activity providersCommunity and voluntary sectorCommissioners

Who?

How long:

Stakeholder engagement

Quality assurance

Running throughout intervention

Cancer Physical Activity Standard Evaluation Framework BrandMarketing

Programme governanceQuality assuranceTraining needs

What?

Stakeholder engagement

Quality assurance

Running throughout intervention

How long:

How long:

Who:

Identify individual in appropriate settingTaking a MECC approach

Raise awareness of the importance of physical activityRaise awareness of local opportunities

Why?

What?

• Senior Health Care Professionals• Health and Wellbeing• ACP

30 Secs

Raise awareness Brief

advice

Behaviour Change

Intervention

Support and follow up

Get and stay active

Who?

Why?

When?

During holistic needs assessment, health and wellbeing event, a follow appointment at the information centre

Support patient choiceAssess current physical activity levels

• Senior Health Care Professionals• Health and Wellbeing• ACP• MECC• HOPE

5 minutes

How long:

Raise awareness

Brief advice

Behaviour Change

Intervention

Support and follow up

Get and stay active

Who?

Move More packExploring readiness and confidenceExploring personal goals and appropriate opportunitiesArranging ongoing support

Support the individual to become more activePlan for set back and supportAgree follow up and support appropriate for the individual

Why?

What?•Clinical Nurse Specialist•Exercise professional

How long:

30 minutes

Raise awareness

Brief advice

Behaviour Change

Intervention

Support and follow up

Get and stay active

Why?

Raise awareness

Brief advice

Behaviour Change

Intervention

Support and follow up

Get and stay active

“Everyone will have access to a short, free and friendly health walk within easy reach of where they live, to help them to become and stay

more active.”

Who?

What?

Provide 1:1 ongoing support and follow up

Help people cope with relapse and re-setting of goals

This should be person-centred, as required by the individual

•Activity related support groups•Good together•Peer to peer support•Mentoring

•Volunteers•1:1 follow up•Group behaviour change support•Text, email, phone or online

Raise awareness

Brief advice

Behaviour Change

Intervention

Minimum 12 months at regular intervals

How long:

Support and follow up

Get and stay active

Get and stay active

Sport England Project

• Get Healthy, Get into Sport funding

• Integrate sporting opportunities into the physical activity behaviour change approach

• 6 Areas - Luton, Shropshire, Berkshire, Dorset, Manchester and Sheffield

•Working closely with the other five sites to share learning and become areas of good practice

•Increasing awareness and developing referrals by linking with communities,

people affected by cancer themselves, local GPs, and other Primary Care

providers

•Access resources and embed Physical Activity pathway

• Part of a national evaluation framework

• Upskilling workforce to Level 4 Cancer rehabilitation standards

• Expanding the sporting offer and work with NGBs on their ‘Get Back to’ offers

Project Update

NGB Taster Sessions held across the 6 sites with

England Athletics - Run England/321/Athlefit,

British Cycling - Breese Easy Rides,

Badminton England -No Strings,

ASA –SwimFit & SwimTag,

Nordic Walking UK,

FA - Walking Football,

Foot Golf,

England Basketball – Walking Basketball

Dance -Back to Ballroom.

Knowledge Exchange Workshops held

6 Project steering groups in place with key stakeholders.

Pilot Evaluation complete. National Tender out to avert

New area project launches Summer 2014

Move More Luton

200 active participants 80 friends/family members actively supporting a range of activity including, gym, swimming and group fitness classes.

Every participant is entitled to 12 FREE activity sessions and an ongoing reduced rate thereafter across 5 facilities in Luton with 1:1 support and a huge range of activity types at flexible and accessible times.

Introduced a wide range of ‘Sporting Opportunities’ into the programme. For example: Walking Football, Badminton, Golf / FootGolf, Nordic Walking and Athlefit

Recruitment of a Macmillan Health & Wellbeing Practitioner. This job will focus on increasing referrals and raising awareness in the community and with health professionals

Referral League Table

Cancer Site Total Number / Number of Referrals (Luton &

Dunstable)

Breast 26

Bowel 5

Prostrate 4

Colorectal 2

Lymphoma 1

Leukaemia 1

Kidney 1

Bladder 1

Cervical 1

Throat 1

Partnership Working in Luton

Active Luton

Move More Luton

Luton and Dunstable Hospital –L&D Cancer Services Lead Nurse, Luton Community Oncology Nurse, L&D Urology Clinical Nurse Specialist

UniversityGP’s and Primary Care

Public HealthLuton CCG

Macmillan Cancer Support

Luton and Beds CSPCancer Support Groups

Discussion