Meet St Michael's Hospice, Basingstoke
The project was led by Helen Woolley and Jean Smith (Prostate Cancer UK Physiotherapists) at St Michaels’s Hospice. They were assisted by Sally Sawyer and Margaret Cullen (Prostate Cancer UK Clinical Nurse Specialists [CNS]), Caroline Mathias (Occupational Therapist) and Linda Gorven (Psychologist). This project is part of the Prostate Cancer UK Health and Social Care Professionals programme, sponsored by Royal Mail and Movember.
The big idea
Recent research has indicated that increased physical activity improves both the quality of life and longevity of men with prostate cancer. St Michael’s Hospice is a voluntary sector organisation, that provides palliative and end-of-life services to the population of North Hampshire.
St Michael’s Hospice runs a joint clinic with a Urological Oncologist and Clinical Nurse Specialist at Basingstoke and North Hampshire Hospital. This clinic refers patients, including those with prostate cancer, to a therapeutic rehabilitation programme run by the hospice. The programme has been offered for around two years and is designed to support patients with advanced life threatening illness to maximise their physical and psychological functionality. A multidisciplinary team offers a personalised programme of care that supports patients to self-manage their condition and avoidable hospital admissions.
Experience of running the therapeutic rehabilitation programme has demonstrated that prostate cancer patients would benefit from a more tailored programme of support. This is partly because men with prostate cancer tend to be younger than patients with other chronic conditions such as heart failure. They are therefore more likely to want to access additional fitness and exercise, as well as information and guidance in relation to employment. Many prostate cancer patients may live for years with the disease and are likely to also have a range of psychological and emotional needs.
Finding out what works
A holistic support programme was set up for men with prostate cancer, which included weekly holistic support sessions over a period of six weeks. Primarily the team looked to promote the importance of physical activity, provide support around healthy lifestyles and manage any side effects of treatment.
The service hosted a different speaker each week, covering several topics including symptom management, healthy living and nutrition, relationships and complementary therapies. Each session lasted a whole afternoon and comprised of; an education section on the week’s theme, some time to talk with other attendees on an informal basis and an exercise class. The physiotherapist-led exercise classes included a circuit of activities that men are also able to do at home, which is a crucial aspect of the programme. To encourage this, participants are given a book of exercises, an exercise diary and a pedometer. During this time, carers were invited to attend a support group to share experiences and seek further advice on how best to support men with prostate cancer.
Challenges of implementing change
The service faced initial challenges in referrals pathways as the clinic aimed to reach men recently treated, but initially received patients who were up to ten years post treatment. The team worked hard to improve links with consultants and GPs, to ensure there was a steady stream of patients and that patients were at the appropriate point in their journey.
Impact of change / outcomes
Physical activity was measured and tested by a six-minute walk test, which showed improved results in the majority of attendees. Patients also reported improved confidence and positivity following participation in the programme. Patients and carers found the course useful for meeting carers and other men with prostate cancer and it helped them to talk about issues such as decision-making on treatment options.
Within the group of 85 men who attended the course:
- 100% of men reported satisfaction with the care the received
- 100% of men reported that they felt equipped to self manage
- 70% of men increased their levels of physical activity
- 19% of men had a change in mean mental wellbeing score
All people that attended the course were informed of local services e.g. erectile dysfunction clinic. The team have also helped to set up a local support group the men can access.