Publish date: 30 January 2023
Giving our communities the power to tackle cancer themselves
By Moray Hayman, Cheshire and Merseyside Cancer Alliance Project Manager
Giving people across Cheshire and Merseyside faster access to diagnostic tests and investing in screening services to find cancer earlier is paramount in catching the disease when it is easier to treat successfully.
However, equally important in tackling cancer in our population is to reduce the risk of people developing it the first place, and for people to be able to spot the signs of cancer themselves so they can take action and seek medical help.
The NHS Long Term Plan (LTP) has a strong focus on supporting patients to adopt improved healthy behaviours, which helps people live longer and have healthier lives and also reduces the demand for treatment and care.
To further this vision, Cheshire and Merseyside Cancer Alliance (CMCA) set up its Early Diagnosis Community Engagement programme to improve earlier diagnosis of cancer and therefore save lives and improve quality of life for people affected by cancer.
The programme focusses on tackling inequalities in cancer outcomes across Cheshire and Merseyside and empowers people to take control of their health and wellbeing. It supports communities to reduce people’s risk of dying from cancer, by improving their understanding and awareness of signs and symptoms of cancer and encouraging appropriate health-seeking behaviour.
The main goal of the project is to contribute to the LTP early diagnosis of cancer ambition that by 2028 the proportion of cancers diagnosed at stage one and two will rise to three-quarters of cancer patients.
To do this, CMCA wanted to target this support at the heart of local communities through an innovative project that utilises the expertise and reach of grassroots organisations. Organisations which know their local population intimately and can spread our awareness messages directly, with authority and through local people whom the community trust.
We identified a number of potential outcomes of the programme.
Community Outcomes – as a direct result of the initiative more people will:
- Connect to their communities and feel more educated around signs and symptoms of cancer
- Manage their own wellbeing and feel in control to make decisions on their health after being given a clearer understanding of healthier life choices
- Feel able to be involved in shaping service delivery and service outcomes within their own communities
- Access a wide range of opportunities to support their community engagement
- Be supported to attend screening where appropriate for their age
- Have increased social skills with the engagement of their own community
- Be appropriately supported to understand early signs and symptoms and know how and when to check for them.
System Outcomes – by working with the voluntary sector and health and social care partners, the initiative will:
- Reduce the number of people entering hospital diagnosis via accident and emergency
- Increase the numbers of people accessing support including information, advice and signposting
- Increase access to early intervention services with people being diagnosed earlier
- See more people supported to achieve emotional wellbeing
- Reduce stigma and discrimination relating to cancer diagnosis
- Support co-working and collaboration between primary care services, health and social care to meet the totality of individual and family needs
- Increase levels and models of mutual/peer support
- Improve outcomes for families and carers through signposting/referral
- Reduce late stage 3 and 4 cancer diagnoses.
We allocated a budget of £300,000 to fund grassroots organisations in three pilot areas of our sub-region. Halton, Knowsley and Warrington were chosen for the initiative and to reach these small organisations we recruited help from voluntary, community, and social enterprise (VCSE) bodies locally to promote the project and assign funding to appropriate groups after a vetting process. These were Warrington Voluntary Action, One Knowsley and Halton and St Helens Voluntary and Community Action.
The programme launched on 6th June 2022, and from the outset it has been vital to ensure information delivered by this project is of high quality, and to deliver support in line with national and local guidance and protocols across the three targeted areas.
The VCSE organisations have been key in helping the grassroots organisations to bid for the funds and to shape their own particular proposal. We required these bodies to:
- Provide information for staff working on fund, agreeing contracts and establishing fund criteria advertised to ensure meaningful reach into the appropriate communities
- Create of bespoke online application and monitoring forms, sifting applications, and providing feedback to ineligible applicants
- Advertise grants via a dedicated page created on appropriate websites, and specific social media activity including circulation of funding and application information to organisations
- Deal with telephone and email enquiries, offering support and signposting for applicants
- Direct contact to community groups with capacity to deliver projects and providing additional development support, where appropriate, to bring ideas and applications forward
- Check applicant governance, policies (such as safeguarding) and accounts to ensure eligibility, including grant history of applicant and banking arrangements. Recording and making any recommendations
- Manage the process of grant-making
- Provide assessments for panel members, hosting panel meetings, providing advice, and recording decisions and feedback to senior management and trustees
- Record all decisions and providing feedback to both approved and declined applications, with ratification if appropriate
- Set up payments, banking and accounting systems, verifying grant recipient banking details
- Issue and process evaluation forms and due diligence of grant expenditure
- Collate data and case studies to show outcomes and stories of projects supported
- Produce a report detailing all grants made, geographic and social outcome breakdown, and highlighting key case studies
- Meet the monthly reporting requirements of CMCA
- Collect robust evidence so evaluation forms part of this process
The initiative is currently funding around 30 grassroots projects across these three boroughs to spread cancer information and give support to people touched by cancer.
The projects include one helping primary school children connect with their families to deliver cancer awareness messages; another giving cancer survivors, patients and their carers the opportunity to express their feelings through art; and another bringing children and their parents together for a fun exercise and sport programme which also passes on healthy lifestyle messaging.
Well-Being Warriors: Brook Acre Primary School, Warrington
Brook Acre Primary School, in Warrington, has been given funding for a project to encourage relatives and carers of the students to come into school to discuss healthy lifestyle information with the children and staff as part of its Well-Being Warriors initiative.
Families have been invited to Brook Acre to interact with the children and staff, including at Loved One To Lunch sessions, charity days, annual ‘Experience Days’, which involve them being invited to take part in a range of physical activities and healthy eating sessions, and reading sessions. There they are encouraged to talk about cancer awareness, including the importance of screening and having health concerns checked out.
Brook Acre’s School Council, which includes children from each school year, also has chosen Cancer Research UK to raise money for and the school recently held a coffee morning in aid of the Macmillan support organisation.
School Business Manager Lesley Burrows said: “Staff talk with the children about healthy lifestyles, such as the need to keep safe in the sun, eating five a day, the importance of exercise – and as part of that learning we do talk about cancer.
“The children come to us with a knowledge of cancer and it is surprising what they already understand as a number of them may be familiar with it through relatives being treated for it. They also see health promotion adverts. It is amazing what they do know.”
Some of the money given to the school has been used to improve an outdoor area where the school has ‘friendship benches’ where children can discuss things that are concerning them or interested in with parents or relatives.
Lesley, who volunteers for Cancer Research UK, said: “The project we are doing now with cancer and our Well-Being Warriors encourages a discussion between the children and parents or carers and they can go home and talk about these issues. We also include information about health, including cancer, in Friday letters home to parents.
“The project has been a huge success and it has raised awareness of cancer with everyone involved.”
Bryan Dargie, Social Action Lead at Warrington Voluntary Action, said: “Local community groups have the magic touch and are brilliantly placed to have real, honest and plain conversations with people.
“This project has empowered a range of groups to talk about something that affects everyone in some way. It’s given community groups another string to their bow in supporting people to live well.”
Multi-Sport Sessions: Apollo Sports Club, Knowsley
Apollo Sports Club in Knowsley organises physical health and well-being sessions – designed to get both children and their parents fitter through fun sports – and to offer health and nutrition advice.
Apollo Sports founder Joe Stocks was moved to launch the project as his brother Tommy died of leukaemia aged just 26. Tommy loved sport and was a talented footballer, playing for Liverpool until he was 18. He was treated at The Clatterbridge Cancer Centre but passed away in 2014.
Joe said: “Raising awareness of cancer is very close to my heart and if I can prevent just one person from facing what happened to my brother that is my job done.
“We all know that being physically fitter is better for you and in our sports sessions we also include information about nutrition and knowing of the signs of cancer. But these sessions are all about fun – they are for children and their parents, playing sport together.
“We have some parents who attend who haven’t done sport for 20 years. We all know if you change that mind-set and start to exercise it is much easier to get into a better way of life, eating better and being more aware of your health.”
On offer at the Halewood Leisure Centre sessions are dodgeball, table tennis, football, basketball, badminton and other activities. There are professional sports coaches who can help to shape the three-hour sessions, which are free of charge, and about 50 people attend.
Joe added: “People can drop in and out at any time and there are lots of chairs around if people need a rest. There is no pressure to perform, it is nice and relaxed and unstructured. People are there just to have fun and it is really popular. It is great to see the same families coming back.”
Paula Kearns, Sector Resilience and Capacity Building Manager at One Knowsley, said: “The aim is to reduce obesity, which is major cause of cancer. The sessions will also help in cancer prevention by spotting early signs and also signposting our cohort to people and medical professionals who can help.”
We believe the Early Diagnosis Community Engagement programme is the only one of its kind currently operating in the UK and we will be completing a full assessment of it at the end of the project.
We are hoping that there are direct cost benefits to the wider NHS as well as health and social benefits to the people taking part. These cost savings would be through better utilisation of primary care and secondary care time with the quality of referrals being processed, less time spent in clinic attending appointments with low risk patients allowing more time to focus on higher risk or complex patients and additional pathways, as well as a reduction of costs to the system by increasing earlier diagnosis versus late diagnosis and subsequent treatment costs.
But we are also hoping that the programme will enhance health assets which can contribute to positive health and wellbeing in a community, ranging from skills, knowledge and commitment of individual community members; friendships and the strengthening of community groups and voluntary associations, the spreading of resources within the local population and benefiting physical, environmental and economic resources that bring about better wellbeing.
For more information on the VSCE organisations, see:
https://www.haltonsthelensvca.org.uk/