Within the UK, 1 in 2 people will be diagnosed with cancer in their lifetime. 50% of cancer patients will survive at least 10 years, which has more than doubled since the 1970s thanks to amazing improvements in technology and medicines.

Cancer prevalence and survivorship is increasing exponentially and age is the biggest single risk factor for cancer and locally, North Cumbria has a super-ageing population. By 2020, nearly 25% of the Cumbria population will be aged over 65.

Locally, we have 2,500 new cancer diagnoses in North Cumbria every year, and 15,000 of our population are estimated to be living with cancer. With a growing number of cancer survivors and numbers of patients on long term treatment, the nature of cancer care is changing. We need to develop a robust and sustainable community cancer service infrastructure to support our cancer patients. 

Macmillan is sponsoring the launch of a Community Cancer Nursing Service in North Cumbria, to launch in June/July 2020. Over three years, Macmillan will invest in North Cumbria to launch and evaluate a Community Cancer Nursing service, to identify the most modern and appropriate care model for cancer patients and survivors.

This quasi-specialist team will build a robust and accessible infrastructure to provide care for cancer survivors. Working across the system, with patients, alongside health and care professionals, the team will deliver high quality care that is both accessible and visible to patients, and will enable teams to provide holistic care for their patients.

We have worked hand in hand with the public, patients and staff to develop the service vision. And wherever our vision goes, our mission objectives go – and this is because everybody had the same message for us, and we therefore want to keep the four key elements of our mission as central as our vision. These are both attached for review.

Throughout July and August 2019 the members of the Macmillan Community Cancer Nursing (MCCN) Service steering group attended various cancer support group meetings, specialist team meetings, education events, and regional networking events to gather ideas. Most crucially, though, the team also organised several drop in sessions and workshops for the public, patients and staff to attend.

An evaluation of these consultation process is attached. But in summary, the output from this co-production was not only the development of our vision and mission objectives, but the 200+ ideas provided the mandate for the service, and also formed the basis of the service specification, defining what the service itself would deliver.

Throughout September and October 2019 the draft service deliverables (as well as the service vision and mission objectives) were taken back to the public to sense check and make sure we had interpreted people’s ideas correctly. A few tweaks later and have our service specification finalised, and we are now working with patients and specialist teams to support the launch of the service itself.

In addition, a patient user panel has been established to ensure decisions regarding the service are co-produced. Co-production of the service is key to its longevity and success. Service users need to provide their expertise to design a service that supports and meets their expectations and needs. 

Working with our co-production group (patient user panel), the service deliverables are quite ‘clinical’ and we are all working together to transform this into an accessible format that helps to explain the impact of the service, and what it means for patients, families and carers. We will also continue to work with this group throughout the year to shape the decisions related to the service.

A big gap in our strategy, however, is that we are missing is a lay representative (or two) to sit on our steering group. We have some wonderful contacts who share their knowledge and expertise, but none have been able to commit to the monthly steering group meetings. We would love for someone to join though, so if you are reading this and think this is the job for you please get in touch! (necsu.mccn.hub@nhs.net).

In June 2020, the service will be launched, and will be monitored closely to ensure changes to care delivery are made in order to deliver an optimal and sustainable model of care. We will be focused on capturing real-time feedback to assess the service’s performance, and we will continue to work with our co-production group to deliver service improvements.

In closing, every opportunity to discuss the service with patients, families and carers, as well as health and care professionals is sought out and utilised. We want to generate as much awareness as we can, so this service, that has been designed by our population, is accessed by the people that need it.

The vast majority of cancer survivors (70%) will have one or more other long term conditions. Further to this, it is well recognised that persons from more deprived socio-economic groups are more likely to experience worse outcomes than those from less deprived groups.

According to Macmillan, it is estimated that there would be almost 20,000 fewer deaths from cancer each year if mortality rates for all socio-economic groups matched those for the least deprived.Tackling health inequalities is central to our service mission objectives – to increase access to our services.

On this basis, our workforce model has been built based on the prevalence of cancer throughout North Cumbria, whilst also considering the geographic area that requires support. Trends in cancer prevalence and health inequalities will be kept under review, to ensure that our workforce mobilises according to need.
 

ICC

Est. % of interventions

ICC Area (sq km)

Copeland (1 ICC)

19%

587.7

Keswick & Solway + Carlisle Network (2 ICCs)

28%

1041

Carlisle Rural + Carlisle Healthcare (2 ICCs)

17%

1031

Eden (1 ICC)

16%

2149

Workington + Cockermouth & Maryport (2 ICCs)

20%

371