1. 2016 Implementing the Recovery Package

2. 1. Overview of Living with and Beyond Cancer 2.Promote wider understanding of Recovery Package 3.Explore stratification Purpose of session

4. Improvements in early detection and diagnosis Move from acute to long term condition More advanced treatments Increasing numbers of people living with and beyond cancer

5. 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. 50% of people with cancer in the UK now survive at least 10 years ( April 2014)

6. 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.

7. 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.

8. Not everyone is living well

9. 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

10. Multi morbidity is the norm, not the exception Source: York Centre for Health Economics Research Paper 96York Centre for Health Economics Research Paper 96

11. Cancer and other morbidities Source: Macmillan’s Routes from Diagnosis programme

12. The English National Cancer Survivorship Initiative Four Priorities 1.Recovery Package 2.Redesign follow-up 3.Physical activity and healthy lifestyle 4.Consequences of Treatment

13. Living With and Beyond Cancer

14. The Five Survivorship Stages Information and support from point of diagnosis Promoting recovery Sustaining recovery Managing consequences of treatment Supporting people with active and advanced disease Improving Survivorship Intelligence

15. 1.Recovery Package 2.Redesigning follow-up 3.Physical activity 4.Consequences of treatment The NCSI defined four priorities:

18. National recognition

19. 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.

20. 1.Recovery package 2.Redesigning follow-up 3.Physical activity 4.Consequences of treatment The NCSI defined four priorities:

21. Breast 80% patients Colorectal 50% patients Testicular 95% patients Project management Clinician engagement Patient support Remote surveillance

22. The ‘How To Guide’

24. 1.Recovery package 2.Redesigning follow-up 3.Physical activity 4.Consequences of treatment The NCSI defined four priorities:

25. Physical Activity improves health and wellbeing outcomes Macmillan Cancer Support (2011). The importance of physical activity for people living with and beyond cancer.

26. Quick Question...

27. 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. UK Physical Activity Guidelines by Chief Medical Officer

29. 46% of smokers quit 30.1% exercise LESS Do you think adults change their lifestyle behaviours after a cancer diagnosis?

30. https://www.penncancer.org/pdf/pal/American_College_of_Sports_Medicine_Roundtable_on_23.pdf ‘Exercise is safe during and after cancer treatment’.(Expert Panel at American College of Sports Medicine)

31. 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

32. Visit www.macmillan.org.uk/physicalactivitywww.macmillan.org.uk/physicalactivity

33. 1.Recovery package 2.Redesigning follow-up 3.Physical activity 4.Consequences of treatment The NCSI defined four priorities:

35. ‘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

36. Persistent hair loss Heart disease Nausea, vomiting Urinary or bowel incontinence Lymphoedema and osteoporosis Breathing difficulties Swallowing/speech problems Mental health problems Body image issues Sexual difficulties

37. CoT Resources Visit http://be.macmillan.org.uk/be/s- 778-consequences-of-cancer-and- its-treatment.aspx for morehttp://be.macmillan.org.uk/be/s- 778-consequences-of-cancer-and- its-treatment.aspx

38. CoT Resources for Professionals

39. CoT Resources for people affected by cancer

40. 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

41. 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

42. Is work good for your Health and WellbeingIs work good for your Health and Wellbeing. Waddell G, Burton AK (2006). Working for a healthier tomorrowWorking for a healthier tomorrow Dame Carol Black, (2008). Work is good for physical and mental health and well-being Work can help promote recovery and rehabilitation and improve quality of life.

43. Work and Finance Resources Visit : www.macmillan.org.uk/workandprofessional www.macmillan.org.uk/financialsupport

45. Living With & Beyond Cancer Resources These can be ordered from : be.macmillan.org.uk/ recoverypackage

47. Any Questions?