A new service, one of the first of its kind in the UK to provide Early Palliative Intervention Care (EPIC), has been launched at South Tees Hospitals NHS Foundation Trust thanks to funding from Macmillan Cancer Support.
Part of the wider specialist palliative care team, it has involved the creation of two specialist roles at the Friarage Hospital offering services across Hambleton and Richmondshire.
It will initially be focused on those with upper GI (gastrointestinal), colorectal and skin cancers but is expected to open to other tumour groups as the service develops.
The community service aims to bridge the gap between diagnosis and end of life care for patients who have been diagnosed with incurable cancer.
For those able to access the service their voice will be listened to and individual circumstances considered.
Early palliative care team
Responsible for the delivery of the new service is Natalie Whitwham who is the Macmillan early palliative intervention nurse and Kimberley Almond a Macmillan cancer care co-ordinator. Together they comprise the early palliative care team and people will be referred if they are diagnosed with incurable cancer.
Natalie has a background as a district nurse before moving into bowel cancer screening, symptom management and advanced care planning.
She said: “Following a diagnosis of cancer, especially one that is incurable and life limiting people need time to come to terms with it. Their family need support too, and the social and financial situation needs to be addressed with the right help from the right people.
“It’s a lot to take on, people can become overwhelmed with it all and entirely disappear from the care pathway as a result. Only to re-emerge later when they are much further along, having suffered with physical discomfort and pain, loneliness, fear of the unknown; often confronting a much worse situation with less time.
“We anticipate over the next two years the service will expand beyond the three initial tumour groups. Guided by where the referrals come from, we will focus on areas needed most such as different tumour groups.
"We will also look at how to engage those who are historically seen as hard to reach groups such as people with learning disabilities, adolescents moving into adulthood or people with mental health problems.
“In addition, the three initial tumour groups do not have to be the primary diagnosis, they could be secondary. In the same way as the Sir Robert Ogden Centre was devised in collaboration with a broad spectrum of community representatives. A group comprised of people including district nurses, people affected by cancer both directly and via close family, financial welfare experts and residents hopefully ensured that what we have is a service that people really need.
“We’ve had people like Stella King, someone who lost her husband to bowel cancer and experienced palliative services first-hand and who now works as a volunteer for our palliative care team here.
“We are also looking at working closely with the wider healthcare network of services to ensure patients are not missed or overlooked. Making sure we keep track of outpatients when they leave hospital and that we avoid unnecessary hospitalisations.
“Listening and planning are key. Meeting patient expectations is vital. Some patients are quite rural and will have distinct needs. So, we need to set expectations from the beginning, show people what they can do when healthcare staff are not around and provide support and advice to the immediate family.”
Stella and Geoffrey
Originally from Bakewell in Derbyshire, Stella King, 73, now lives in Catterick in Richmondshire where she works as a volunteer in the palliative care team at the Friarage, Hospital. She lost her husband who she was with for over 40 years to bowel cancer in September 2013; he was 75.
She said: “We moved up to Catterick from Derby when Geoffrey’s care was transferred to the James Cook Hospital and we were under the care of the specialist palliative care team at the Friarage. As a result of the compassionate and professional care we received I wanted to give back; so soon after we lost Geoffrey, I offered to help the team as I used to work in a hospital.
“I’m convinced following my experience with this trust that a specialist palliative service is vital. Before Geoffrey was referred here our experience was not as good, never seeing the same doctor twice, a lack of continuity and of a joined-up approach.
“Once Geoffrey was referred to the Friarage team we both felt more supported. As his care and treatment began to revolve around South Tees Trust we made the decision to move closer from Derby to Richmondshire.
“In between appointments we received check in phone calls and visits to our home from the Macmillan palliative team. We knew we could talk to them about problems that came up and advice around Geoffrey’s treatment or how we were coping and plan.
“We had access to occupational therapists, dieticians and when Geoffrey was admitted to hospital, he received regular visits from the palliative team. I was encouraged to pick up the phone if I had any queries and, in that situation, there is always something; it means an awful lot to have trusted advice and support.”
Pioneering new service
Kieran Conaty partnership manager for Durham, Darlington and Teesside for Macmillan Cancer Support said: “We’re excited about this pioneering new service at the Friarage to help people affected by incurable cancer.
“Donations are more important than ever as we continue to work with our NHS partners to develop services that deliver personalised care for patients and their families. Personalised care means people have choice and control over the way their care is planned and delivered, it is based on what matters to them.
“South Tees NHS FT is also participating in our workforce development programme, providing a clear pathway for existing nurses to develop into cancer care specialists, nurturing and retaining the talent within the NHS.”
Anyone in need of cancer support can call the Macmillan Support Line on 0808 808 00 00, which is open seven days a week, 8am to 8pm, or visit Macmillan’s Online Community.