I realised that I had completely underestimated the effect having cancer would have on me - Nina Jackson

Nina Jackson, patient representative on the Macmillan Cancer Improvement Partnership (MCIP)

Nina Jackson

I was diagnosed with breast cancer at the Nightingale Centre at Wythenshawe Hospital in May 2012 when I was 45. I had the lymph nodes in my left armpit removed. I then had chemotherapy and radiotherapy at The Christie.

In April 2014 I had to have a mastectomy. I chose to have a reconstruction at the same time using fat from my abdomen. This was carried out by the plastic surgery department at Wythenshawe. I then had further chemotherapy at The Christie. 

It is now over a year since I finished my treatment and so far all is well. Getting back to work full time and doing my full range of work was an important milestone. Luckily I have a supportive team manager and an understanding team.

I have been lucky compared to some cancer patients, but I do have some lasting side effects including some permanent hair loss caused by the Docetaxel chemotherapy I received. I have mild lymphoedema in my left arm. It is well managed, but I have to take particular care of my arm to prevent problems developing. This includes massaging it nightly to encourage fluid to drain. I have also developed osteopenia due to my treatment. I take medication to hopefully prevent this from becoming osteoporosis. I have to make sure I eat plenty of calcium rich foods and do weight bearing exercise.

These side effects and my operation scars are a permanent and daily reminder that I have had cancer. When I was first diagnosed I said I was going to treat it as an isolated incident. However, as time went on I realised that I had completely underestimated the effect having cancer would have on me. Without being too dramatic, I didn’t anticipate that it would become part of me.

In the autumn of 2013 I went to a Macmillan workshop to give feedback on my cancer experience. I felt that I had had a mostly positive experience. I thought it was important to share good practice and what had worked well. Following the workshop I became involved in the Macmillan Cancer Improvement Partnership (MCIP) as a patient representative.

This is a partnership between Macmillan, the three Manchester clinical commissioning groups (CCGs), The Christie, St Ann’s Hospice, the main hospitals, Manchester City Council and people affected by cancer (patients and carers). The aim is to improve the experience of everybody affected by cancer in Manchester at every stage of their journey.

I have been involved in the ‘Primary, Palliative and End of Life Project’. This project developed a locally commissioned service which included identifying clinical and non-clinical cancer champions in each GP surgery, providing training, making sure cancer reviews happen and improving end of life care. The idea was to improve cancer services for patients and their carers at the GP level. This service has been a recognised success with 90% of GP surgeries completing the standards.

I was able to give the patients’ point of view using my experiences, ensuring patients’ needs were always taken into account.

As I had never been in the hospital system before I did not realise that my GP would be involved in my care. One area I felt strongly about was that GP surgeries should contact all patients within two weeks of their cancer diagnosis to say we know you may not be able to take it in yet, but we are here and can offer help. This became part of the locally commissioned service. I am particularly pleased about this as services can be improved but if patients aren’t aware that they exist they won’t be used and won’t be able to help the people they are designed to help.

In November 2015, MCIP and The Christie hosted a ‘Living With and Beyond Cancer’ event for the clinical and non-clinical cancer champions in Manchester Town Hall. They asked me to speak to give a patient’s view of living beyond cancer. Although it was rather daunting speaking in front of 100 people it was a good experience. I and the other patients who took part received positive feedback. Hearing true stories from real people helped give GP staff an insight into the issues faced by people affected by cancer. This increases awareness of patients’ needs.

I was able to talk about how I had found the effects of cancer don’t end when treatment ends. I still think about cancer more than I expected to. The fact that I have had treatment twice makes the worry of reoccurrence more real. I particularly worry about the cancer returning and not knowing it has. One unexpected experience was, when at one point two friends had just found out their cancer was terminal and another had just been diagnosed with secondarys, I felt bad for getting better. Some people laughed and thought I was crazy. It wasn’t until I spoke to another friend who had had similar feelings, that I was reassured and found this was not necessarily an odd reaction. 

A positive is that I have made some new friends through having cancer!

I have felt listened to and that my contribution has been valued. I feel proud that I have hopefully helped improve the cancer services and experience for other people affected by cancer in Manchester.

I will now be involved in phase three of the MCIP programme, which has been set up to improve breast and lung cancer services.

I have received treatment from my GP, district nurses, both the Nightingale Centre and plastic surgeons at Wythenshawe and The Christie. I know from my experiences and those of other patients that communication between all of these sectors is vital. They are all part of both the treatment and moving forward jigsaw. Hopefully the passage for people affected by cancer will run more smoothly.

Macmillan encourages people who use their services to give something back. This is something I have wanted to do. It has been rewarding and given me a sense of achievement. There are lots of opportunities and ways to do this – it doesn’t have to involve speaking in front of 100 people! Keeping the real needs of patients at the top of the agenda is vital. Every person’s experience is different, so the more people who become involved the more this can happen. Unless you have had cancer you really don’t know what it feels like from a patient’s point of view.

You can find out more about MCIP and how to get involved at www.macmillan.org.uk/aboutus/healthandsocialcareprofessionals/macmillansprogrammesandservices/cancerimprovementpartnership.aspx 

It’s ‘OK to Ask’ is a really important message to patients everywhere - Geraldine Peddie

Geraldine Peddie, Christie patient

I

Geraldine Peddie

was diagnosed with Non Small Cell Lung cancer in December 2007. The lead up to the diagnosis took nearly three months, and this is my story.  

In the autumn of 2007 I could feel a small hard lump just above my left collarbone. I went to my GP who asked about my general state of health, was I losing weight?  Did I have a cough? How was my appetite? As all seemed to be fine apart from the lump we arranged a three week follow up. At the end of three weeks I returned and was concerned as I felt that the lump had increased in size and I thought there was also another lump there. As there were no other symptoms he just advised me to monitor it and come back if necessary.  

Two of my close friends had experiences with lumps. On both of these occasions it had turned out to be cancer and on one occasion her GP had said she didn’t think it was anything to worry about! I asked for a second opinion and was duly referred to a haematologist.  

He took several blood tests and asked for a chest x-ray. After the x-ray, things went at a much quicker pace, with a biopsy and CT scan within three weeks. I had been a smoker but only a very light smoker and had only smoked for about 10 of my 51 years. On 27th December 2007 I was given the diagnosis.

I am so lucky to be alive. The survival prospects of this cancer are very poor. Nearly 80% of those diagnosed didn’t survive for the first year. I made a commitment to myself that I would never regret doing anything and I would definitely never regret not doing anything. I was also fortunate to be symptom free for over six years. In this time I travelled extensively and I really had a great time even though I was “living with cancer.” In 2009 I met my husband and we got married in 2011.

Over my eight years of almost continuous treatment with eight different lines of treatment I feel I have had the best attention that anyone could want for. I became a patient of The Christie in March 2015 when I was enrolled in a clinical trial.

The trial drug was very much targeted to my cancer. Although it is lung cancer there are several types of lung cancer and within each type there may be different properties. I was fortunate enough to have a protein referred to as EGFR (Epidermal Growth Factor Receptor). I had been treated with two previous ‘targeted’ therapies for those who are EGFR positive to great effect. The trial drug was the third generation of this type of drug, especially developed for those who have acquired a resistance to previous drugs.

This has been quite literally a life saver. I had almost exhausted all approved conventional treatments and my cancer was progressing unchecked. From day one of the trial I felt relief and benefit. Dr Krebbs and his team are so attentive and caring. They are always only at the end of the phone for any questions I have and I have felt in very safe hands for the last year.  
Although experimental, the treatment has been very successful with a huge reduction in the size of the tumours initially. There is now only one ‘stable’ tumour left and I am feeling very well.  

There is a big likelihood of the cancer becoming resistant to this treatment, but I am hoping that day is a long way off yet. When that day arrives I would be very interested in what other trials I might be suitable for at the time.  

If anyone reading this has cancer or knows someone who has been diagnosed with it, I would urge them to always ask about clinical trials. The theme for International Clinical Trials Day on 20th May is that it’s ‘OK to Ask’ and I think this is a really important message to patients everywhere. Going on a clinical trial can give you access to the latest treatments and also helps doctors and researchers to develop more effective treatments for future generations.

For further information please visit www.nihr.ac.uk/get-involved/international-clinical-trials-day.htm 

I was very pleased to be asked to be a ‘face’ of The Christie and to raise awareness of ways to prevent healthcare associated infections - Wayne Gilbart

Wayne Gilbart, Lead infection control nurse

Wayne Gilbart

As an infection prevention and control nurse I was very pleased to be asked to write a blog about the important work infection control does.

I want to raise awareness of ways to prevent the transmission of healthcare-associated infections. These are infections that patients get when they are in hospital. Hand hygiene is considered the single most important way of preventing the spread of these infections. 

I work as part of a team at The Christie to look into cases of hospital infections, but also to prevent them happening. Infection prevention means ensuring that good hand hygiene takes place and working with staff to ensure they apply standard infection control precautions (including good hand hygiene and appropriate wearing of personal protective equipment when dealing with body fluids) to all patients and specific precautions to patients who have a known infection. 

When we talk about hand hygiene we mean washing your hands with soap and water or decontaminating them with alcohol-based hand rub. In most circumstances alcohol based hand rub is a great way of cleaning your hands and only takes about 15 seconds. We do ask staff to clean their hands with soap and water for infections like Clostridium difficile.

These infections can have a profound effect on a patient and can lead to additional treatments and a longer stay in hospital. Healthcare-associated infections cost the NHS over a billion pounds a year and cause profound distress to patients.

I am very proud to be a member of staff at The Christie where the issue of good hand hygiene is taken very seriously. Our infection control link workers carry out observational hand hygiene audits on a monthly basis and if there are any issues in a clinical area we will work with the team to ensure good hand hygiene standards are being maintained. 

We also promote good hand hygiene technique through the use of the Sure Wash system. My colleague Gary Thirkell describes this as ‘Wii Fit’ for your hands - it’s basically a way of teaching good hand hygiene technique. This is important because research has shown that people don’t always clean their hands as well as they should, missing out some bits. Since we’ve been using it we have had very positive feedback from staff, patients and relatives who have used the machine.

On 5th May, The Christie took part in World Hand Hygiene Day, a World Health organisation (WHO) initiative. This year we got staff to sign a pledge about hand hygiene with the tag line ‘We believe in clean care #safehands’. This helped to demonstrate to our staff, patients and relatives that we remain strong in our commitment to clean hands. Roger Spencer, our CEO, was the first person to sign the poster. 

The ‘Clean your hands’ poster is designed to be seen by everyone and I believe that everyone has a role to play in infection prevention and in promoting good hand hygiene. I regularly visit the wards and departments in the hospital to engage with staff about infection prevention and the posters have ensured that my face and the message of my team is being seen by members of staff that I have not met yet. 

I believe that the infection prevention team has a responsibility to hospital staff to be accessible to them for help and advice and to be excellent communicators, so this poster is a great way of promoting our service. I am very proud of my team - Gary Thirkell, Joanne Chambers and Kim Jackson who all do a great job in infection prevention at The Christie. 

As well as staff, it is important that patients and relatives clean their hands and for relatives to stay away if they are feeling unwell (for instance with flu-like symptoms) and I believe that this poster is a great way of engaging our patients and relatives in a conversation about hand hygiene and its importance. Patients and relatives have an important role in reminding staff about clean hands. I have talked to numerous patients and always emphasised the role they can play in hand hygiene.

I believe that we at The Christie have a responsibility to our patients, relatives and staff to ensure the highest standards of infection prevention (including hand hygiene) and patient safety. With the support of our director, Jackie Bird, this poster is just one of the ways the team is seeking to engage in the infection prevention agenda and to remind everybody to ‘Clean your hands’.

The Maggie’s centre is a one stop shop of support run by professionals offering practical and emotional support - Louise Hassall

Louise Hassall, Christie patient and Maggie’s volunteer

Louise Hassall

In 2010, at the age of 37, I was diagnosed with cervical cancer. Nothing can prepare you for what is about to happen to you, your family and your friends both physically and psychologically.

Sometimes all I want is to sit in a calm and friendly environment with people that understand and maybe not even talk about cancer, but to know others around me feel some or the same emotions that I do.

I also want to know that my loved ones have the opportunity to seek refuge in a place that is comfortable, safe and with people who will understand. Often these services are available but can be scattered around and are not always easily accessible at a time when they are required. 

When I found out that a new centre called Maggie’s would be opening I was intrigued as to how this would complement the already great services that The Christie offer. I wanted to know how this would impact me and other patients and how my loved ones may benefit too.

I was therefore excited to be given the opportunity back in the winter to learn more about Maggie’s, meet the centre manager Sinead Collins and see the new building that was just last week opened by Her Royal Highness the Duchess of Cornwall.

On a bitterly cold and rainy Manchester day I met with Sinead, the centre manager, donned work boots, gloves, a high visibility vest, glasses and a hard hat and was taken to see the building in progress. Sinead explained each room and how the finished building would look.

Despite the weather and the unfinished rooms I could already feel the calm and peace that this building holds with much of this down to the thoughtful layout and space. The long area through the centre of the building, and the ability to see an exit or the outside no matter where you are, put me at ease and added to the feeling of being relaxed and calm.

With warming fires and a big kitchen table to encourage a meeting place for those dropping in, it will certainly make for a welcoming experience from the moment you walk through the door.  

The centre is a one stop shop of support run by professionals offering practical and emotional support without the need for an appointment, which is important as you can’t always predict when and what support you need, and in my experience if you aren’t able to get the help immediately you often don’t go back.

I felt like it was a haven away from the hospital despite being a stone’s throw away and a great space to go by yourself or with those who you are with, to just sit with a cup of tea.

I couldn’t help but compare my needs throughout the last six years and the services that will be on offer at the Maggie’s Centre.

In the past my husband and I have come out of appointments often having heard bad news and we’ve had nowhere other than a public waiting area, corridor or the car to digest the information - and that can add to your distress. The opportunity to now have somewhere to go that is on the grounds of the hospital will be a huge help and make a big difference.

During the hours of waiting between appointments and chemotherapy where a patient wanders around the hospital or the local area, I and others will be available at the Maggie’s centre to discuss nutrition or to take a class on managing stress, creative writing or an exercise class such as yoga, tai chi or walking. Being able to take your time drinking tea or just sitting serenely without the time constraints you can feel in a café or other public place will add to an improved sense of calmness, and for those who love gardening or find it therapeutic, there is a garden to enjoy and the opportunity to help tend it.

Importantly, the service is available to anyone affected with cancer at any stage, and this includes family and friends who will be made to feel welcome and their emotional needs met too. During many of my operations and procedures my husband pounded the streets of Didsbury, but now he will now have the option to go to Maggie’s where he can chat to others in a warm and welcoming environment and benefit from the services on offer. Knowing that this is available to him already makes me feel better. I believe that the cancer journey can be harder on those supporting you, so Maggie’s will be peace of mind to me and an additional support network to Steve.

The Christie is an excellent hospital, with fantastic staff that do a brilliant job at offering support and services, but the addition of the Maggie’s Centre will add value to my experience and wellbeing as a patient and to all patients, so I am looking forward to using the centre and offering my time to help as a volunteer.

The Christie named as the world’s most technologically advanced cancer centre outside of North America - Professor Chris Harrison

Professor Chris Harrison, Executive Medical Director

Professor Chris Harrison

There is a lot of building work going on at The Christie at the moment and we are also investing a lot of money in new technology. 

Anyone who is familiar with our main site in Withington will know that the landscape has changed considerably in the last 10 years and the work we have done is now paying dividends.

I was delighted to find out recently that The Christie has been named as the world’s most technologically advanced cancer centre outside of North America according to the web site Top Masters in Healthcare. It has painstakingly researched 100 top cancer centres across the world and ranked them according to the level of cutting edge technology available for treatment and diagnosis. You can read more about this here.

Our technology not only helps us provide great medical care but also helps maintain the first rate experience of care reported by our patients.  

Unsurprisingly the centres ranked top are the major US centres such as Memorial Sloan Kettering in New York and MD Anderson in Texas. However, the technology at The Christie including our cutting edge radiotherapy, chemotherapy centres and mobile delivery, advanced imaging techniques, brachytherapy, robotic surgery, developing integrated procedures unit, the developing proton beam centre and our integrated clinical trials unit put us 9th in the world and top ranked outside North America.  

This confirms previous findings that The Christie has all eight of the technologies identified by The US top hospital programme as being the hallmarks of a world leading cancer centre. These include our advanced radiotherapy capability, PET scanning and the ability to undertake robotic surgery. 

Of course availability of cutting edge technology is only one aspect of providing world class cancer care but surely it has to be one of the ingredients needed to provide world class care. The gold standard of a world class service must be the outcomes of care for the people we serve in communities across England and the quality of experience of that care. 


No technology can completely overcome the difficulties of treating cancer once it has spread and so we need to continue to find ways to allow cancer to be diagnosed early - this is what the new cancer vanguard in Manchester is working on. That said, it is comforting to know that right here in Manchester we have some of the best facilities in the world to diagnose and treat cancer.  

I want to extend my heartfelt thanks to The Christie for saving my leg - John Burns

John Burns, Christie patient

John Burns

In the spring of 2015 I noticed a reddish spot on my lower left leg and went to get it checked out. It turned out that a tumour had developed over the previous 12 months, but due to me having Gross Lymphoedema in both legs, the tumor itself was not apparent until approximately six months prior to my referral to Manchester Royal Infirmary for various tests.

Following MRI scans, ECGs, blood tests, x-rays and other tests, my wife and I were told that the tumor was cancerous and that the only two alternatives were amputation of my leg or to try and remove the tumor by surgery. It was stressed that due to the cancer being extremely close to the shin bone it was considered doubtful of a good outcome. In spite of this I was referred to Mr Kosutic at The Christie.

When I met with Mr Kosutic, his first opinion was that amputation seemed the best option, but he and a colleague decided to check with a further scan. They confirmed that the cancer was only a few millimetres away from the shinbone.

Although a little doubtful, Mr Kosutic said he would operate and hopefully save my leg - a very brave decision – but somehow I had every faith in him, and six months later it is so far so good.

Prior to the operation it was explained to me that it would be a rather large wound, and so it turned out to be (19cm long by 14.5cm wide).

After the operation I needed special dressings that were put on in layers, with a 28mm thick sponge in between covering the wound. The outer layer had an outlet attached to a vacuum pump which compressed the dressing and sponge to the wound, and at the same time removed all the blood and lymph fluid, depositing it into a canister which was regularly changed. This marvellous machine allows healing to take place more rapidly.

The dressings were changed every five days for four weeks. This took a great deal of care and an unbelievable amount of patience, skill and good nature on the part of the nursing staff - angels every one of them! After I was discharged, I was transferred to the Bolton District nursing care.

In October 2015 I was re-admitted overnight for a skin graft operation. It went unbelievably well and I stopped using the vacuum pump after 10 weeks. I don't think the wound would have healed so quickly without the pump.

I want to extend my heartfelt thanks to Mr Kosutic for his wonderful skill, the skill of his team both in and out of theatre, and also to all of the nurses and staff on Ward 10 and the Surgical Ward who looked after me during my time at The Christie. Thank you all.

Half of all people born since 1960, the year I was born, will at some stage in their lives be diagnosed with cancer - Professor Chris Harrison

Professor Chris Harrison, Executive Medical Director at The Christie

Professor Chris Harrison

The Christie’s Executive Medical Director, Professor Chris Harrison has been appointed NHS England’s new National Clinical Director for Cancer, from 1st April 2016. In this new role, Professor Harrison will work with NHS England’s National Cancer Director, Cally Palmer, to implement the national five year cancer strategy, ‘Achieving World Class Cancer Outcomes: A Strategy for England 2015-2020’. 

Here, he blogs about his new role and how he will use his experience of improving cancer care at The Christie.

I am delighted to be joining the national cancer team to work with Cally Palmer, the National Cancer Director, and other team members in implementing the national strategy, “Achieving World Class Cancer Outcomes”.

We have a lot more to do if we are to achieve the objective of bringing about radical improvement in the outcomes that the NHS delivers for people affected by cancer. But it can be done and by setting out a vision for what cancer patients should expect from the health service, the strategy sets out how.

All of us working in health care have responsibility for people who have, or may have cancer. Half of all people born since 1960, the year I was born, will at some stage in their lives be diagnosed with cancer.

I was first introduced to cancer care as a medical student on the wards of hospitals in Manchester witnessing some of the huge variations in care and attitudes prevalent at that time. As a young hospital doctor I was thrown, unprepared, into discussing the possibility of cancer with patients and their relatives. Later I saw more of the wider impact on families and some of the difficulties of diagnosis as I sat with and learned from experienced and compassionate GPs in Lancashire. Cancer affected my own family and close friends with an impact going far beyond the medical aspects of treatment.

These early experiences shaped much of my later career by convincing me that we could prevent many cancers by organised efforts to support people and communities. And that we should be organising and leading cancer services more professionally so that specialist care, including palliative and supportive care, was available to all.

Much has changed since then but the twin aims of prevention and improving services remain at the core of the national programme, and is an important reason why I am so pleased to be involved.

In the 1990s, as a Director of Public Health in Lancashire, I had the privilege of overseeing plans for the new cancer centre in Preston with the associated development of the system of cancer care across the county. Later, as Regional Cancer Director in the North West, I led a peer review visiting programme to every hospital in the region, seeing for myself the opportunities to standardise and improve hospital care, and also through our primary care programme the importance of excellent primary care.

For 11 years I’ve been a trust medical director in both a specialised cancer centre – The Christie in Manchester – and then a large group of teaching hospitals – Imperial College Healthcare in West London. Both areas have moved towards ways of working between cancer services which allow whole pathways to be thought of and managed coherently rather than in isolation. I have seen at first hand the challenges and opportunities for cancer care both in highly specialised centres and also acute hospitals, but if we are to make the step change in cancer outcomes called for in the national strategy all parts of the health system must work together within the national framework.

The number of people with cancer will continue to increase and if our efforts at prevention and treatment are successful there will be more people alive with and surviving cancer in older age groups each year. This is one reason why improving the experience of cancer care is vital and given the same level of importance as improvements in survival and treatment.

At the same time the NHS faces unprecedented financial pressures and we must find new ways of organising and doing things. This means challenging existing approaches to develop effective mechanisms for commissioning and funding, and finding creative ways to work with voluntary, charitable and commercial organisations.

It also means challenging some ways of organising services, for example, finding faster more convenient ways of patients and GPs being able to access tests, using the whole range of professional skills available in the NHS, and using the lessons from the national cancer vanguard pilots.

National action alone cannot achieve these objectives but it can set the framework for local decisions and developments. I see my role as providing a focus for clinical advice into national policy and, as importantly providing support, encouragement and guidance to those seeking to improve outcomes for cancer patients and their families across the country.

Enhanced Supportive Care makes excellent cancer care possible - Dr Richard Berman

Dr Richard Berman - Christie consultant 

Dr Richard Berman

Cancer is changing. With better treatments, more and more people are surviving, or living longer than ever before. And as a palliative care consultant at The Christie, this means that my role has changed too.

I still work hard to ensure excellent care for patients at the end of their lives; but increasingly, I help patients much earlier, during their cancer treatment, by providing specialist care to manage their pain and symptoms. This means that we actually help patients to get through their cancer treatments, in a positive way.

And in fact, evidence from around the world shows that earlier involvement of supportive and palliative care in cancer care results in better outcomes for patients, including the potential to extend their survival.

This represents a real opportunity for palliative care. But if we want to be part of cancer care earlier, does the term ‘palliative care’ still fit?

I think it doesn’t matter where patients are in their cancer journey, people always need hope. They need to feel that the health professionals looking after them are working with them in a positive way, and doing their best to keep them feeling as well as possible, for as long as possible.

So we needed a very positive vision; a new approach to delivering palliative care. How about the term ‘Supportive Care’?

‘Supportive care’ is the management and prevention of the adverse effects of cancer or cancer treatments. At The Christie we developed this into ‘Enhanced Supportive Care (ESC)’, an initiative that promotes the earlier integration of supportive care within cancer care.

There are 6 principles:

• Much earlier involvement of supportive care services in cancer care
• Teams that support cancer patients should work more closely together
• We should adopt a much more positive approach to supportive care
• Cutting edge and evidence-based practice in supportive and palliative care
• Technology to improve our communication and way of working
• Best practice in care of patients undergoing chemotherapy

And we’ve taken some bold (but simple) steps to make this work.

The Christie has renamed our palliative care team to the ‘supportive care team’ to help break down the barriers to achieving earlier involvement of palliative care expertise.

We have worked much more closely with our oncology teams, in their clinics, and on the wards.

We have focussed much more on minimising the side effects of supportive care treatments and provide up-to-date pain and symptom management – not only to improve and maintain quality of life, but also to help patients through their chemotherapy treatments.

And we not only support patients with advanced cancer, but also those who are living with cancer as a long term illness and cancer survivors.

The work we have done around integration with oncology and early intervention has increased patient and carer satisfaction, reduced hospital admissions and most importantly, given patients hope.

ESC has been recognised nationally by NHS England, and received a national QiC (Quality in Care) patient care pathway award in February 2016.

Now, I’m delighted to be able to play a role – as NHS England’s National Clinical Lead – in encouraging and supporting more cancer centres to adopt this kind of approach. As part of this, we have recently produced guidance for providers and professionals which will help them think about how they identify and meet the changing needs of cancer patients as they go through their treatment journey.

Enhanced Supportive Care is a new initiative aimed at addressing more fully the needs of cancer patients – in particular, preventing and managing the adverse physical and psychological effects of cancer and its treatment.

Cancer can take a huge toll on those who are living with it, whatever their prognosis. But as this programme is phased in over the coming months and years, I am confident that we will be doing the best we can to reduce that toll for thousands of patients.

Dr Richard Berman FRCP is a Consultant in Supportive & Palliative Care at The Christie. He is also NHS England’s National Clinical Lead for Enhanced Supportive Care.

For more details of the supportive care services offered at The Christie, please visit www.christie.nhs.uk/services/r-to-z/the-supportive-care-team/

A tiny bit of pain is nothing compared to what cancer patients are going through - Bex Smalley

Bex Smalley, Christie fundraiser and former patient

Bex Smalley

People often ask me why I do so many charity events, especially the more daring ones. As well as the fact I am a secret adrenaline junkie, I tell them that I will always do these events for as long as I can, because without The Christie hospital I wouldn't be here today. 

When I was 17 I was diagnosed with Hodgkin's lymphoma. By the time they found it they said it had been growing for a few years as the main tumour was so large. The tumour had also collapsed my lung and there were three other tumours too. 

I received treatment at The Christie, which consisted of strong chemotherapy followed by radiotherapy. Chemotherapy was hard. And as a teenager I missed out on a lot of things over the space of that year. And although the treatment was difficult it worked and saved my life. 

Since then I have done fundraising events almost every year (skipping a year or two when I had my miracle baby after being told I would never be able to have children due to the strength of the treatment I received).

The events I have done have varied from parties, walks and runs to skydives and at the end of last week, The Christie’s first ever firewalk! 

One of my friends at work told me about the event and I had seen it in The Christie newsletter too, but I wasn't sure about doing it until I was asked to join by my friend Julie. Julie’s husband is currently receiving treatment at The Christie. 

After signing up, I expected that in my fundraising kit I would read about how it is all an illusion and we wouldn't really we walking on hot coals! But that wasn't the case. So in the weeks leading up to the event I was getting more and more nervous. 

When the day came I plucked up the courage to turn up and we received an hour’s training. The trainer was a world record holder for walking on hot coals! He told us all that although it seems impossible to be able to put our bare skin on something so hot, it is in fact very possible and wouldn't cause any lasting effects. 

After the training session we were taken outside and put into groups. 

This is when I saw the hot embers and my fear kicked in again. But our trainer was the first one to walk across to show us that it can be done with ease. 

When it was my turn I stood staring at the glowing coals and my brain was telling me I was foolhardy to be considering this. But the crowd was cheering me on and I set off. 

It felt like I thought it would, like I was walking across extremely hot coals, some small embers were sneaking in between my toes and burning my skin, but the walk wasn't long and by the time I was off I was wiping my feet and dipping them into buckets of ice water. 

The team then asked me if I wanted another go and of course I said yes. 

After two walks across the ‘fire’ I was surprised to see that there were no blisters or raw skin and that my feet weren't sore at all. 

I would definitely recommend others try this event as it helps to conquer fear and also it isn't an average fundraising event either, which I think is the reason why I managed to raise over £1500! Thanks to all my friends and colleagues who sponsored me.
  
So I will keep on doing these events, no matter how outlandish they seem at first, because it is all worth it to help such an important hospital and support the hard work that they do every day to save more and more lives. 

A tiny bit of pain is nothing compared to what the patients are going through and all the money goes towards a better future for people living with cancer.

If you want to know more about our charity fundraising activities please go to www.christies.org/get-involved/ 

As the senior sister on Ward 1, the results of the Friends and Family Test are extremely important to me and my team - Emma Turner

Emma Turner, senior sister on Ward 1

Emma Turner, senior sister on Ward 1

As the senior sister on Ward 1, it’s really important to me and my team of dedicated nurses that we deliver the very best possible standards of care for our patients. Patient care is always our top priority at The Christie, no matter which part of the hospital you are in. 

Getting feedback from our patients is one of the most important ways we can find out how we are doing and learn what we need to do to drive improvements to our service. 

One of the best ways we have to gather feedback is through a survey called the Friends and Family Test (FFT), an anonymous survey which we ask all of our patients to complete when they are discharged.

The Friends and Family Test asks patients two questions; how likely they are to recommend our ward and what were the best/worst aspects of the service. The results of the FFT highlight the aspects of our care which make a difference to our patients and how we can make it even better. The percentage of patients who are ‘extremely likely’ to recommend our care is also fed back monthly as the ‘Friends and family score’.

As the senior sister on Ward 1, the results of the FFT are extremely important to me and my colleagues.

The feedback allows us to focus on what really matters to our patients, driving us to provide world class care that is centred on the patient experience.  By giving our patients a voice in the development of our service we have found that even small changes have improved their time with us.

Just one example of patient led change is our staff board. On the suggestion of a patient, we developed a board next to the nurses’ station which displays pictures of the nursing team on shift that day, their names, role and who they are looking after. The picture of the patient’s nurse that shift is also placed on the board next to their bed.

This has been warmly received by both the patients, relatives and by staff as it ensures a designated staff member can be recognised at all times. Personally, I feel that involving patients and listening to their feedback not only improves the ward but reminds them that their individual journey is at the heart of our care.

As well as allowing patients a chance to steer the development of the ward, the FFT also allows them to give the ward positive feedback. For me, informing staff of the praise we receive is one of the best parts of my job. It reminds staff that the work and dedication they put in really makes a difference, and that good care changes lives.

After some incredible feedback I just had to make a poster displaying some of the comments on the ward because everyone deserves to be reminded that, and I quote, we provide the same service as a “5 star hotel.” This type of feedback gives us all the drive to give that little bit extra every time, as well as reassuring new patients about the quality of our care.

Finally the FFT score provides us with the ultimate review of the care we provide – whether they would recommend the ward to their friends and family - or not. I am proud to say that since the official opening of Ward 1 we have never dropped below 96%. And have had the best score in of any wards at The Christie since October 2015.

This score reflects that the care we provide is gold standard and patient centric, reassures new patients that they are safe in our hands and encourages our staff to always go the extra mile.

So if you are a Christie patient, please take a few minutes to fill out the Friends and Family Test. Your feedback really does make a difference and helps us to improve care for all patients.

You can read more about the Friends and Family Test and see some of the feedback from our patients by visiting www.christie.nhs.uk/about-us/our-standards/patient-surveys/the-friends-and-family-test/