Public Confidence In Cancer Services Is Crucial To Future Outcomes
Across West Yorkshire and Harrogate, the Cancer Alliance and our six hospital Trusts– Airedale, Bradford, Calderdale/Huddersfield, Harrogate, Leeds and Mid Yorkshire – are continuing to collaborate on ways of working that have enabled the ongoing delivery of cancer surgery, treatment and diagnostic tests – prioritised by clinical need - during the COVID-19 outbreak and into the current restoration and recovery phase.
To date in West Yorkshire and Harrogate, we have managed to maintain around 60 per cent of cancer surgical activity during the COVID-19 outbreak, across all six hospital Trusts. As the demand for treatment of COVID patients begins to decrease, with fewer patients requiring hospital treatment being admitted and capacity being released for non COVID-related work, every organisation is planning how to do more.
In West Yorkshire and Harrogate, the model of a single cancer ‘hub’ – the model used in London and Manchester - was never the best option for us. Our hospital Trusts – working as a Cancer Alliance - have committed to supporting system-wide resilience and recovery, while recognising that the offer of treatment at their usual hospital, closer to home, is better for patients and their families.
Leeds Teaching Hospitals will continue to offer the majority of surgery for rare and intermediate cancers. Mid Yorkshire – through Pontefract – and Bradford will provide surgery for common cancers and their existing specialist work, while Calderdale, Airedale and Harrogate will continue to manage their own common cancer surgery.
Either stand-alone COVID protected sites – like the dedicated care centre at Pontefract Hospital, announced this week - or isolated COVID protected zones within hospital estates (both in the NHS and independent sector) are being created and used to undertake more surgical treatment in a safe way.
Pontefract Hospital – part of Mid Yorkshire Hospitals Trust – is a great example, providing cancer services for 550,000 citizens of Wakefield district and North Kirklees. To keep the risk of staff or patients being exposed to COVID-19 to an absolute minimum, all other inpatient other services will be moved off the hospital site temporarily and the hospital will be zoned to enable separate access to the cancer centre.
The Urgent Treatment Centre (UTC) and GP Out of Hours’ Service which is based at Pontefract will remain open with patients and staff using the separate entrance to the UTC.
As in all our hospitals where cancer surgery is to be carried out, there are agreed Alliance-wide safety guidelines for pre-operative self isolation, pre-operative testing for COVID-19 and separation of patients from potential contact with anyone who has not been screened.
Excellent modern facilities, including consulting rooms and theatres, and the physical layout of the site, mean that Pontefract is ideally placed to manage the risk of infection and drive forward the recovery of cancer services in Mid Yorkshire. The real life experiences of patients who receive a positive experience of care there will help us to change the perception that the NHS is totally devoted to coronavirus patients at the expense of all other treatment.
Receiving a cancer diagnosis, awaiting or undergoing cancer treatment is an intensely worrying time for every patient, but even more so against the backdrop of concern and uncertainty generated by the current COVID-19 situation.
Across the country, evidence is showing us that many people are opting not to engage with cancer services at this time, are reluctant to visit hospital when invited to attend and instead are choosing to defer their diagnostics or treatment – either because they are worried about what they perceive to be an additional burden on an already overstretched NHS, or they are afraid of contracting the virus during the course of their treatment.
Primary care, too, has seen a drastic reduction in the numbers of people coming forward with concerning signs and symptoms that might be cancer. For many people, contacting their GP to talk about a lump they have found, a change in bowel habits, unexplained weight loss or any other possible cancer symptom is a step they find difficult to take at any time. Add the fear of contracting coronavirus into the mix, and the likelihood of them seeking early help- thereby increasing their chances of a positive outcome - is dramatically reduced.
Securing public confidence in the availability and safety of cancer care is therefore essential to ensure we reverse these concerning downward trends. The earlier the diagnosis, the more likely cancer is to be treated. The longer a patient defers the treatment they need, the greater the potential deterioration in their condition.
Helpful campaigns #StillHereToHelp and #HelpUsHelpYou have been designed at regional and national level to promote the message that the NHS is still open for business and well able to deal with non-COVID related conditions such as chest pain, heart attacks, strokes and suspected cancer. I’m one of a number of clinicians who have recorded personal messages to support the campaign objectives.
We’re also grateful to patients like Lynne, a retired teacher from Ossett, for sharing with us their first hand experiences of accessing care at this time.You can read Lynne’s story – Don’t Sit On Your Symptoms, Act Now - here.
But these important high level messages can only go so far, and as a Cancer Alliance we have begun to gather insight about what patients need in order to feel reassured before they make that important decision to access services at this time.
Around 40 members of our Cancer Alliance community/patient panel are being asked their views What information would help them make the choice? Which sources of information would they be most likely to Trust? Would they only be willing to be treated at their local hospital or would they attend elsewhere in West Yorkshire and Harrogate if it meant they could receive their treatment more quickly? Would they expect their clinical team to remain unchanged irrespective of their treating hospital?
We are also working with our colleagues in the Yorkshire Cancer Community and patient support groups across West Yorkshire and Harrogate to widen this patient engagement and ensure that any changes in attitudes over time are reflected in our operational approach and our communications activity.
We consider that our approach for recovery and restoration in West Yorkshire and Harrogate offers the safest, most effective way to maintain and increase cancer treatment at this present time and in the months ahead. However, this is a fast moving situation and our plans will kept under constant review to ensure we can respond to prevailing pressures at any given time, and based on feedback from our colleagues in local hospitals and our patients.
One message will, of course, remain unchanged - the safety and wellbeing of our patients remains our overriding concern at all times.
