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Across cancer services in Greater Manchester, amazing work is happening every day. Frontline staff, managers, clinical leaders and people affected by cancer work together with the simple focus of making sure that every person throughout Greater Manchester is able to access a world class cancer service.
This podcast is all about sharing some of the work going on with the wider Greater Manchester Cancer workforce – that’s thousands of people across all areas of Greater Manchester, working in many different roles - and giving some of the fantastic people who do that work the opportunity to share their experiences with everyone.
In each episode, presenter Steve Bland (from the BBC podcast You, Me and the Big C) will focus on a different topic and talk to some amazing guests so if there's anyone you'd like to hear from or a topic you want to see covered, please get in touch.
For more information about GM Cancer visit www.gmcancer.org.uk.
personalised-care-episode-3-treatment-summaries
Thu, Aug 01, 2024 5:02PM • 35:20
SUMMARY KEYWORDS
patients, treatment, summary, nurse, cancer, macmillan, gp, document, care, diagnosis, explained, people, oldham, prehab, pathway, week, terms, little bit, information, affect
SPEAKERS
Steve Bland, Jacqueline Jackson, Helen Wrench, Sarah Sykes
Steve Bland 00:09
Hello and welcome back to another episode of the GM cancer Podcast. I'm Steve Bland. And this is the podcast that takes you right inside Cancer Services here in Greater Manchester. Now this is the second episode of our new series looking at different pieces of work different programs, different innovations that are happening and going on in Greater Manchester that are making a real difference to patients. In this episode, our guests give you all that you need to know about treatment summaries.
Helen Wrench 00:42
I'm Helen Wrench and the Macmillan NC lead nurse for personalized care for cancer. We're going to talk about treatment summaries.
Sarah Sykes 00:48
I'm Sarah Sykes. I'm lead Macmillan colorectal nurse. I'm based at the Oldham Care Organization, which is part of the NCA,
Jacqueline Jackson 00:55
I had Jacqueline Jackson. I'm a patient who's on the pathway. I was diagnosed three years ago. And I am cancer free at the moment. But I'm using the student summary.
Helen Wrench 01:14
So just a little a little bit of a background as to why the treatment summaries were introduced. I was appointed to role in 2016 as part of what was Manchester cancer was involved with the creation of the treatment summaries, and Sarah will remember that we did a lot of work with the colorectal teams and urology teams in creating, we created about 48, I think treatment summaries at that time which were shared for other providers to use them. And why we did that was was part of what was cancer survivorship and Macmillan, who were looking at improving the cancer patients experience and also the communication to the GPs. And what they came up with very, very, kind of like simply it was four elements, which was a holistic needs assessment, care plan, treatment summary, some health wellbeing, information support, and a cancer care review. The importance of the treatment song was to share, communicate the diagnosis of that patient the stage and give the patient what those red flags symptoms would be so that they could re access the clinical teams and get information on recurrence quite quickly. So it's really important that it's a patient document and quite valuable one for GPs to use and to undertake that cancer care with you.
Sarah Sykes 01:14
Yeah, and I think over the years, they've devolved quite a lot, because initially, the consultants were quite keen weren't there to complete it themselves. But I think we found that a lot of the information was maybe written towards the GP, and maybe not directed quite as much towards the patient. So I think after multiple discussions, we decided it should become a nursing based task. So it's a document that's completed by the nursing team. And again, initially, it's all changed, as we've learned over the years, so initially posted to a patient, and maybe explained in principle, but without a patient having ever had sight of it. And maybe correctly understanding that not just its short term, but long term use as well. So certainly, with the aid of patient feedback, we've made sure that not only is the document posted to patients, but that we actually demonstrate the document to patients at our well health and wellbeing events. And added on to that now and in line with our follow up pathway which has also changed a little bit. And we now see patients back in clinic about six to eight weeks after surgery. So they should have had a chance to receive the treatment summary, read it through. And then any questions that might arise from that there's a face to face appointment to discuss and explain in a little bit more detail.
Jacqueline Jackson 03:49
That's very different than the experience I had actually because I got diagnosed during COVID. So when I was I mean to be honest with you, I it was all a bit of a shock to me. And actually the diagnosis because I had no symptoms at all of bowel cancer. So when I was diagnosed through the FIT test at home, so I was completely in shock. During COVID, once diagnosed and I did go for the colonoscopy and I was very fortunate had Macmillan nurse there when they got the diagnosis because they knew straight away that it was cancer. Having said that, I was very much on my own in hospital. So when it was it was talked about but obviously by the nurses but I didn't really have that sort of peer support or I felt very much on my own as if I was the only one. Having said that I got quite a lot of support on the phone from Julie, who was the colorectal nurse at the time and Then she gave me her phone number. And that phone number was by the phone. And I have to say, I probably mithered the life out of her! Really, all the time, and then receive this through the post, because obviously that wasn't. And I was when I got it, I was really pleased, because obviously it's all set out. The actual diagnosis. I know, it's it seems, I think the shock of the diagnosis, you forget what you've actually had done. And it's so individualised because we say, well, you know, you've had bowel cancer. Oh, I didn't know a relatives had bowel cancer, but she'd had them lower. It was in the lower bowel. So totally different operation. So I think this for me, it's because it's spelt it out extended right hemicolectomy. That's it? I think I said it right? That's it sort of gave me that erm, memory really sort of knew what it was called that had when people asked, I could actually say, Oh, yes, it's that and all the dates were on there. And like you said, the staging. And and so I was fortunate enough, that the Macmillan Nurse on the phone explained a lot to me. And so about the coming in and seeing the oncologist. So I did have those, that conversation, but it's a very different experience. But during COVID, I think everybody's experiences were very different.
Helen Wrench 06:33
Did you use it Jackie, as a prompt, in terms of if you was due a CEA blood test, or a CT?
Jacqueline Jackson 06:39
I did, and I still do. I'll be honest with you, because it's written down. You know, you know, exactly, you know, because I'll be honest, but I've got dyslexia. So it's quite good that I've actually got a written documents that I can refer to, because I do think also the shock of everything, and the fact it's a medical hospital, setting, it all sorts of put the blank on, for quite a lot of people, I don't think I'm the only one, I think a lot of people feel to go into hospital either speak to a doctor on the phone or a nurse, and your mind just goes blank. So it's just schools having, I mean, this came through the post, and you can tell how dog eared it is, that it's well used. But I also was invited them to the health and wellbeing events a year later. And I found that really good because also we could talk about that as well at that events.
Helen Wrench 07:37
I think you do a treatment summary session?
Sarah Sykes 07:39
Treatment summary session - I mean, it's I describe this to a lot of patients, it is a little bit like your passport follow up. And we do encourage that people keep it you know, with a lot lot of people keep records in a folder, but to keep it at hand. Because as I've alluded to a little bit, our follow up system has changed. But during COVID a lot changed quite quickly. And sort of from face to face to telephone. And that's progressed from there, but a bit you just picked up on it, there's a lot of words in the treatment, summary, and a lot of picture based information will have been given at the time of diagnosis. So you will have had an extended right hemicolectomy explained to you that there is no kind of accompanying picture that on the treatments are rare. So maybe something for improvement going forward is we could take a little bit of our pre op information and include it on the treatment summary, so it's not just words about what surgery is, but what you know what parts of your bowel has been removed. Because if this is an information leaflet, not just our treatments summary are for patients, but for GPS, it's probably quite relevant to them to view as well, in regards to some symptoms you might have that you speak to your GP about as well.
Jacqueline Jackson 08:47
Well, it's interesting, because I actually did ask a Julie, I believe some mentioned about me appendix. And they said yes that's part of the the so I didn't know that. As a layperson, I didn't realise that that would also be took out. So that's the thing like that, you know, it's just oo, my appendix has been taken out as well!
Sarah Sykes 09:15
Because we I mean, we've tried to de-medicalize it as much as possible, but some words just can't be changed, because they are what they are. And that's probably where pictures would come in handy as well a little bit for the words that can't be substituted to be made a little bit more user friendly.
Jacqueline Jackson 09:30
And I did use the NHS website, I will say Macmillan website and the Cancer Research UK websites to get more information and from a pictoral point of view.
Helen Wrench 09:41
So in terms of the content, Jackie, that has been agreed with user involvement, and also clinical teams, that going forward, let's say was loaded into putting pictorial there makes it a bit clearer. Yeah. Are you involved with the community groups to help refresh?
Jacqueline 09:57
I am Yes, yeah.
Helen Wrench 09:59
Because what we have realize also is that there's a number of treatments that we aren't delivering. And we do not have the template. So we need, again to create new templates in readiness to support patients there.
Sarah Sykes 10:12
So even though this is a template, it's personalised for every patient
10:15
Well everybody's an individual, aren't they? And I think that's the better than that. And I felt this was mine. I also felt as a patient, it gives you that control over the situation. Because you're able to say to the GP, you're able to say to where the practice nurse, I've got other sorts of illnesses as well. I've got sjogren's syndrome, spinal stenosis, diabetes, type two. So I'm actually in touch with quite a lot of other consultants and other practice nurses. So when this has been so useful to take with me, because they can't sometimes see this copy on on the systems, so I'll be honest, I've I've taken this to both Fairfield to Rochdale to and Salford Royal with me. And of course they've got it there. And quite often they've actually photocopied it. While to put on my files.An
Helen Wrench 11:16
And that, Jackie too that cancer care review, we know the importance of the document is to be shared from secondary care to primary care. Did you use that to have a cancer care with you?
Jacqueline Jackson 11:26
How I did with my GP I actually have to take though this, they actually phoned me and said that everybody would be entitled to a cancer care review from your GP surgery. Let me see, that must have been the August. Yes, the August after the operation in the April. And but that actually didn't happen. I actually had to go ring the GP and say, look, I'm supposed to have this.
Helen Wrench 11:57
Was that. COVID Do you think?
Jacqueline Jackson 11:59
It could have been, to be fair, it could have been? Yeah, that's But having said that, even now, it's me. That's telling the GP? Always.
Helen Wrench 12:10
GPs are general practitioners. And that's why exactly emphasize yourself, because they are very specific to the particular tumor pathway. And the special condition the particular surgrery have had, yeah, so that enables the GP, so actually advocate, you know, back in, back in, you've got that power to go back in? Oh, yes. That's important to be heard.
Jacqueline 12:31
And it's useful, like, for instance, for medication, and, you know, different medications, and that that do affect the bowel. Now, I'm able to discuss that with them using this document. So that, again, it just helps, you know, cuz I use -, quite often a co-codamol as well, if I'm struggling. So it's because I still have sort of a few problems. So we're, it's, it gives us certain, it's, it's like a tool really to sort of say, yes, this is what I had, go back to that and, and
Sarah Sykes 13:08
it's reflective, that you're on a five year follow up pathway as well. So re access to our service is quite easy. It doesn't require GP referrals or rapid access referrals. It's you know, if, if we've spoke to you a month before and symptoms change, then then, you know, Part of this documentation, and it says it is always contact us reminders if we've not done tests, and as you expected them, if symptoms change, and you know, can't we there's no hints and tips in the document, then services always open and doesn't require referral from primary care for that entire period.
Jacqueline Jackson 13:41
I think having the phone number and the contacts names, just gives the patient that comfort and that you just notice that the rest of them, you know, someone's going to be there. You know, there's a answerphone if they're not, you know, to me, then they then get back to you, which is absolutely great. And it's, it does help the patient's he or she has that confidence that if there was something that was a bit unsure about I could always ring, and I have to say when I've had the tests as well. I've been so impressed just lately. I think you've got someone as well, that does check in.
Sarah Sykes 14:18
Yeah. Ah,
Jacqueline Jackson 14:20
it's absolutely wonderful because she's able to sort of say, Oh, yes, you know, you're up to this, you're up to that, and also ringing me up and actually saying what, what the results were, instead of having to wait like sort of probably 2, 3, 4 weeks, which I do know in the rest of the country, they are doing
Helen Wrench 14:39
so you're getting a letter now. So to reassure you say for example, people are checking you're OK.
Jacqueline Jackson 14:44
Also a phone calls as well, I got a phone call last time which was lovely, you know, again, and when I'm wrong about this see ca tests they actually said about going for my CT scan. And again, oh, we know we can sort you out here. Um, that conversation is quite good as well.
Helen Wrench 15:03
So going back to that, you know, initially we were saying the recovery package, as was he's now personalised care core interventions enables personalised stratified follow up, which Sarah's team...
Sarah Sykes 15:16
Yeah, that's what you're talking about. So that's our follow up pathway. So that's the addition of our coordinator, and just a little bit of a reordering of how we request investigations, but still, as reflected in your treatment summary and in the five year follow up pathway.
Helen Wrench 15:32
More important when you then you're not seeing the clinical team, unless there's any abnormality.
Jacqueline Jackson 15:37
Absolutely. Because, I mean, there's no need to as well, I mean, that's the the other thing, you know, it's, you don't feel as if you're asking for things that are not necessary. You know, and I think if that's explained to people, you know, on. No, we don't need to do that you're, you know, you're, you're clear at the moments. And also, and this is the plan, you know, it's reassuring, I think, for patients.
Helen Wrench 16:05
And it is for patients, I'm just going to ask yourself, Sarah, in terms of, if you have any contact from GPs will also receive this and use the document themselves.
Sarah Sykes 16:17
Personally, no, and I don't think there's been much within the team where people have said, Oh, I've spoke to a GP or anything like that. So I don't think we get a lot of GP follow up from it.
Helen Wrench 16:30
So maybe that's something we can also look to do in terms of improving communications within primary care to support the value of these. And more important, as we said about the treatment summaries are for everybody. But for those particular people that are on a personalised,stratified follow up pathway.
Sarah Sykes 16:46
So as well as the outline of the treatment, follow up, did you find all the bits of the summary helpful, like the hints and tips for activities?
Jacqueline Jackson 16:52
Absolutely. I mean, I've, when I've attended the day, there was subjects about tiredness. And I just remember that, you know, sort of, it's not a quick fix for everybody and never probably is different. Again, I've got another autoimmune condition, which it does affect, and the chemotherapy did affect that. So it's slightly different. But I think with the encouragement of that, like, for instance, exercise therapist, the dietitian, it enables the patients a source of looking at solutions, rather than what you can't do. Yeah. And I think that's all and also different people, different resources. I found the Macmillan Centre, absolutely brilliance with everything that's there. So I have made quite good use of that. I will say, we've got a Bury Cancer Care centre. So I'm, I'm only just realizing what they do. And I think they're just establishing themselves really, because the living in the South sides of prestwich, which were quite far from the Bury centre. So we're that's another new thing that yeah, support. But having said that, I mean, I just feel that I'm just well supported. And I'm doing very well, you know...
Helen Wrench 18:20
Have you picked up in terms of increasing your physical activity?
Jacqueline Jackson 18:23
Oh, yeah. Yeah.
Helen Wrench 18:25
Maybe had that come from some of the treatment summary consultation?
Jacqueline Jackson 18:28
Absolutely, retract. Yeah, yes. I mean, that's the exercise therapists. I mean, I filled in the holistic needs assessments, which seems dangerous because I'm an ex social worker, so that's felt very strange filling an asset and assessment for myself, but I'm so glad I did. Because that's then gave me access to, like I say, the exercise therapist. And from that, she encouraged me to join other things and find things that actually wanted to do and enjoyed doing. And from then on, I mean, I do attend the gym, like four times a week, and I feel, you know, so. And if you ask me, what, seven years ago, certainly would have said, no way that's not me. So for me, having cancer has provided some help some positive. Yeah, very much. So. Yeah, yeah. And also getting involved in other things that I never thought I'd involved with.
Sarah Sykes 19:34
So there's a section as well isn't there about alerting symptoms that might require re referral? Yes. Have you ever found that you've experienced anything that's took you back to recheck that section?
Jacqueline 19:44
I have and then but, again, I've been able to discuss that with the GP, and my other sorts of providers, really because I'm, for instance, on metformin, and that plays havoc. So now I'm actually on the sort of the diets program where I'm hoping to get off metformin completely so Yeah, I've I must admit I've and but actually, I just find that I can ring that number if I need to. And I'm put in touch with different people. So
Sarah Sykes 20:38
do you think there's anything you would have expected to see in here? That's not included?
Jacqueline Jackson 20:43
I think like you say, perhaps, I mean, they have changed the summaries now. So this does look like a doctor's referral, a document for the doctor.
Helen Wrench 20:58
Did it? Does he actually direct to the GP, though?
Jacqueline Jackson 21:04
Yes.....................................
Helen Wrench 21:07
We realised that was, you know, we needed to direct that change to the patient. Yes. It was more important that the patient knew about this. Absolutely.
Sarah Sykes 21:13
Yeah. And even though the contact numbers quite highlighted on yours, again, on our slightly newer version, it's even more highlighted, because it's in its own separate field, as well as included in the text. So, I mean, that's a lot of our take home message about the treatments summaries, are around contact numbers. Yeah. So if we can make areas like that very clear to patients, I think that's that's what we're hoping to achieve.
21:14
It's their individual. I think that's the best, it's the fact is an individual thing, depending on their diagnosis. I mean, I'm aware there's different types. Yeah. So and I think if that was on there, because we know, it will be useful for perhaps for them, I mean, that's, you know, I can imagine that's got this, you know, you know, when you've got a certain type of cancer, it's just good to go back on them. And it says, you know, it's affected two lymph nodes, I mean, I, I did have that to staging explained to me as well, I have to say, by the Macmillan nurse, so I knew what T3, N1 and M0 was. So, you know, if there was a lot of there may sound some basic things to you, but as a patient, you need to understand,
Helen Wrench 22:31
and then again, Sarah alluded to the consultants, so have a 10 minute clinic appointment. We're not always maybe explaining things to the depth that patients understood. Yeah. So that's why we change that as a nurse like mod. Yes. designate your time of 30 minutes to sit down and make sure that people understood
Jacqueline Jackson 22:49
And I think if that's explained as well, because I think if the traditional method that people are aware of the that they have a consultation with a surgeon don't they have to? And I don't think, you know, to me, perhaps I should have had that, you know,
Helen Wrench 23:07
that query was there that he maybe should have consultant rather than the nurse?
23:11
Yeah. You know, so it's that. I think when you have, you know, in hospital, and that, let's explain to you, you know, that that's not always necessary. They've done their job. And then it's the nurse that's follow it up. And if there was any problems, obviously.
23:29
You've revamped your leaflets , I think to reflect that, haven't you? That it's nurse led? Yeah. That's right.
Sarah Sykes 23:36
But still very much a team approach. So we've not cut the consultants out completely, they're still accessible! No, definitely not. But no, it's good to hear. It's good to hear that you've kept it and used it because that that would have been, I guess our wish for them, wouldn't it Helen, that it is a document that can be carried forward with you to guide you through the follow up and answer some degree of question and concern.
Helen Wrench 24:01
I guess there's one thing in terms of what may have not been addressed and we will be doing is access in terms of the different languages as well, because, as you say, you'd have the translator there to interpret that, but the document doesn't translate does that we've got Google have a way to do some of that, butI don't know, again, whether patients do do do that. translation to the different languages.
24:24
Yeah, yeah. That would be useful. From an access point of view, as far as people with dyslexia are concerned. It it's just having a paper copy. If you're looking at go into sort of email and things like that, just having a paper copy is so useful, rather than everything by email now. It's that physical copy a lot of people like that. Yeah, they do. Yeah, perhaps older people. I don't know. Yeah. Yeah, it's that choice.
Sarah Sykes 24:57
it's still definitely a paper copy for us. And often reissued so we often get phone calls, or I did have a treatment somewhere. And then I'll be in a maybe it will have been filed without quite understanding the value, or long lasting use of it. So quite often after health and wellbeing events, we find that we re-issue a lot of treatments.
Jacqueline Jackson 25:20
I found that actually, when I went into it, it's that the other people said, oh, no, I've not had one of those.
Helen Wrench 25:26
I'm just thinking, have you ever heard then so in terms of patients use them for insurance purposes? You know, because it's evidence of actually what that staging is? Have they ever used it for insurance purposes?
Sarah Sykes 25:37
I think they have, but then ultimately, it comes back towards because it might require a medical signature. But yeah, I think patients have used them for multiple reasons. Yes,
25:46
yes. That's claim benefits. I know people have. I've done that as well. And again, because
Sarah Sykes 25:51
there is I mean, I think it alludes to doesn't it the benefit advisors, so even though it might have been mentioned earlier in your pathway, and maybe declined for some people initially, it's a little bit of a aide memoir that those kinds of services are all about, and they're for everybody at any point. Yeah,
Helen Wrench 26:09
yeah. And the health and well being because, of course, that wasn't always available was it? So you've added that on as part of our conversation?
Sarah Sykes 26:17
Yeah. So your health and well being was slightly delayed? It was because we weren't doing face to face events during COVID. So you might have like, quite a lot of telephone contact, but I think we were one of the first tumor groups to get back to doing health and well being. So we did do like a little bit of a reverse. And people that hadn't had the benefit of that face to face meeting, we're kind of invited in slightly later than what we would have been expected. But, you know, hopefully worthwhile, even if it was just to go through treatment summaries again.
26:46
Oh it was, yes, the whole event was and just to meet other people that have been in the same situation. I think that's the bit that peer support is very important. I feel, at times, you know, for, for some people I know some people can't attend it if, you know, depending on their situation, individual situations, but I found it really useful. And it's just the see your face to face in a positive environment, perhaps as well.
Sarah Sykes 27:13
I think the biggest change was for us was moving from a medical model, to a nursing model - I mean, for the patient information section, like summary of your consultation, you'd often see things like refer to clinic letter. So patients would have this with all the hits are yours with the hints and tips in and then a clinical letter that was very medically jargon based that the GP copied and pasted into a letter. I can see Julie's signature. Yeah, so I know that will be a very good one. Yeah.
Helen Wrench 27:47
So that would have been the maybe the number one version that we had. Yeah. Which didn't capture the late effects of that. That's quite cool. realising, you know, with the 60 odd thought of actually in process at the moment, yeah, they're going to be refreshed to add that.
Sarah Sykes 28:05
I mean, even within our own service, like you've said, we've recognized that we don't have enough for what we offer locally at Oldham. So and you know, not just as that along with surgery, we have treatment summaries for patients that are treated unfortunately with palliative intent. But even within that, we still realise we don't have enough because it means something changes, doesn't it? So I think we I think initially did we plan for maybe four, and we have about eight or nine, but know that we need more as well,
28:36
just in the colorectal area. And there are 16 within urology and 16 within hematology, so yeah. That's a lot!
Jacqueline Jackson 28:44
That's interesting. I think your bit about the surgery school. Wow.
Sarah Sykes 28:51
Maybe I don't know if maybe. So I was just thinking that surgery school is vry much pre isn't it, I wonder if more about prehab even at that point, you could still maybe,
Helen Wrench 29:04
add that in.
29:05
so important that because I'll be honest with you, it helps. That prehab that had with the I can't remember what it's called the one with the that's like local machine.
Sarah Sykes 29:19
Incentive spirometer. Yes.
29:22
that was so useful, because having sjogren's, it affects your lungs and the actual
Sarah Sykes 29:31
anaethetic
29:31
yeah, that side of it. I was absolutely fine. And yet other people I know because they hadn't done that really struggled with breathing and that, so that really worked for me.
Sarah Sykes 29:44
It's just a little thing, isn't it? That's made such a... Did you use it post-op in the hospital? And did you take it home with you?
Jacqueline Jackson 29:51
I did yes.
Sarah Sykes 29:53
Excellent. So some people think that it finishes like, oh, I can leave that. So we give them a pre op that people We use them, I asked you to bring it back. But if you don't, it's fine. We have more. But I think people think that when they leave, that maybe it stops. But I mean, you had a stay of about two weeks, and people have a stay of about two days. Yeah. So you know, if we stop at the hospital door, that's, you know, 10 days less than the benefits you would have felt for it. So maybe we could include some of that and remember to use the sprirometer.
30:23
it's really useful. And also it gets you moving, and your body moving. Because
30:29
it enhances your recovery. It does. Yeah, absolutely. So yeah, we have
Sarah Sykes 30:35
an enhanced recovery section.
30:37
That would be, I feel very useful for lots of people that because, you know, the last thing you want is people just sat there thinking, Oh, I'm going to have this operation. It gives you a focus somehow. I will say, Julie explained that you've got to get fit for the operation. I only had a couple of weeks to do it. So I did. You know, and fortunately, I did, because like I say, with getting having C Diff as well. I was in a, you know, very restricted, and I got home I was you know, the wounds didn't heal very well at all. So had some district nurses coming out. Again, brilliant. Yeah, I got a brilliant service.
Helen Wrench 31:20
So I just thought about something else to add on here. Physical activity. Yes. So in terms of we know the importance and the benefits of preventing cancer recurrence, but also the wider. We now charged with asking patients, how much activity do they undertake per week. And it's 150 minutes to moderate to high. So therefore, we should be having a conversation.
Sarah Sykes 31:40
Yeah. So we've got exercise and physical activity that we just talked about three times a week with a prehab. I don't know if this is on your original one. But we now list referrals and advice given on services available? No, but I certainly know when I complete these I tend to just leave in the services that we've referred you to. But then we decline in some, you know, if we listed services that were available, rather than telling you what we've referred you to. Yeah. So services that were available with maybe a Macmillan Information Centre contact number.
32:13
Yeah. can just leave them on? Yeah. Because the holistic needs assessment will pick up those are particularly that you want to be referred to.
Sarah Sykes 32:21
So we can see what we've done and what we need to do, and do it that way. But yeah, yeah. I just wonder if we're telling you what's referred to as God and we can highlight that. Yeah. But if we tell what's also open, because especially sexual dysfunction might not necessarily affect you because of the type or the area of bowel that was removed. But for the lower rectal patients, it might be an issue. Yes. And it might be a late onset, as we've discussed it a month and there's no issues, it doesn't mean there's not an issue in the future in the future. Yeah. Yeah.
Jacqueline Jackson 32:57
Also, as well, I think if you make sure that you do cover different areas with it being in Prestwich, I felt very much removed from Oldham. So I think if it's some sort of references made to the directory, like, the Bury Cancer Centre.. I will say the social prescribers now, a very supportive in Bury, at the practice. So there, yeah, perhaps there's no one out there. Yeah. Yeah. Julie, that's our local one is very interested in.
Sarah Sykes 33:31
And again, that's maybe information we focus on more at time of diagnosis. And we could reflect back on it at time of treatment summary couldn't we. Yeah, that's, I mean, we cover such a wide area, particularly, you know, everybody comes to Oldham for surgery, and we forget a little bit but you're then gonna go and live out in say Prestwich, or north of Oldham. I mean, we literally, it's to every border really, isn't it? I mean, it's really reassuring to hear your, you know, quite positive, wonderful feedback because it, you know, gives us some reassurance that what we're doing is, you know, benefiting patients and their self management and their recovery. And it's not just us completing a task that needs to be done. I think you know, the best kind of feedback we can get is patient feedback like your won.
34:18
I mean, and it hasn't always been positive and I was in hospital...
Sarah Sykes 34:23
we want to know the good and the bad yeah.
34:26
My morphine machine broke and I was actually prescribed any oral medication which now that seems they do now they do a cover a cover. Yeah, thank goodness. But I was told by the pain management that that's now happening, so I mean, just Yeah, that wasn't a good experience! But again - COVID times, it was hard for everybody.
Steve Bland 34:56
If you enjoyed the episode, we've done loads and loads of other The topics in this podcast and you can find them all wherever you get your podcast from. If you want to find out more information about the Alliance, you can find the GM Cancer Alliance on social media. And we're back next week with another episode.