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Complementary Therapy and Wellbeing Service, Christie Hospital

CoM Tags:

hospital, integrated health, complementary therapies, College of Medicine,

 
This is an integrated complementary therapy service at The Christie NHS Foundation Trust. 

The team offers interventions and support for patients free at the point of delivery.  They are also involved in service evaluations and research projects. Work is disseminated through publications, educational events, courses and conferences.  The team also provides services for carers and staff, as well as specialist wound care support and smoking cessation help.

The project was shortlisted for our Innovations Award 2011, and was a runner up in 2013.

 

Year established
1997
Number of staff
6.7 FT equivalent (30 p/t practitioners)  7 Volunteers – plus additional voluntary hours from paid practitioners.
Number of users
Over 10,000 patient treatments, 1,500 carer treatments and 1,500 staff sessions delivered in 2011 – 12
Is there a charge to users?
Free at the point of delivery.  Staff service subsidised by the Trust.
What makes your project sustainable?
The service has a business manager who monitors funding of all projects and produces business cases/funding bids/service level agreements as required.  She also monitors attendance at all courses to make sure they are viable.Challenges have in the past included accessing funding. At present we have a variety of funding streams to help sustain the service which are reviewed every three years. Our research has been the key to our success. We have maintained a portfolio of research projects and service evaluations highlighting outcomes such as reduced anxiety, improvements in quality of life and greater compliance with treatment.
User demographics
Our demographics are complex but the majority of patients have a diagnosis of living with cancer and/or having received cancer treatment. Our carers can be family or friends.
Innovation
This is an established innovation in an acute cancer care setting. Projects include:• Specialist essential oil work to assist with fungating wounds, vaginal dryness, mucousitis, skin care, nausea and insomnia
• In situ hypnotherapy and relaxation training to help patients with treatment, surgery and procedural related concerns and anxieties , e.g. needle phobia, claustrophobia linked to radiotherapy treatments and anticipatory nausea
• Hypnotherapy based ‘Fighting Spirit’, Mindfulness and Creative Imagery sessions/classes for a range of concerns and issues
• Touch/bodywork techniques to help with relaxation and improve resilience through treatment and at end of life care
• Acupuncture clinics for assistance with fatigue, hot flushes, pain, xerostomia, sleeping difficulties/ insomnia and peripheral neuropathy
• Palliative Care Specialist Complementary Therapy service/clinics
• Memory/Dementia care Clinics
• Breathlessness Project
• dedicated complementary therapy services for carers and staff
• Emotional Eating Workshops for staff ( to be rolled out to patients late 2013)
• Smoking Cessation and Alcohol Advice/Support
• Training/ consultancy locally, nationally and international
Patient-centred, whole-person, preventative approach
The complementary therapy service at The Christie was initiated to support patients and their families through the cancer journey.  It is an integral service provided by a team of highly qualified professionals.  All services are piloted and evaluated before full integration and are audited to make sure that they continue to address the needs of the users.Our approach is to combine the best of complementary therapies with the best of conventional medical care. We work closely with a range of healthcare staff here at The Christie, all of whom strive to be holistic, compassionate and informative.The Trust is active in promoting health, wellbeing, with the local population, patients, carers and staff through a number of initiatives, information and support groups – including smoking cessation and alcohol advice. We do not use the words ‘healing’ or ‘alternative’ within the setting we work in. These terms in the context of cancer treatment can sometimes be misinterpreted and confusing for patients, carers and staff.We have service users involved in our research projects as patient representatives. One of our service users is a hospital governor. As we are integrated across the Trust our team contribute to various projects e.g. Survivorship Initiative – this has a patient representative.

As a hospital we have a Clinical Governance Committee that looks at a range of issue, including the environment. The Trust recently completed a project with looking at green spaces, which included focus groups with patients, visitors and staff.

Evidence-informed practice/audit and evaluation
The Clinical Leads for the service have completed and published PhD projects on aromatherapy with haematology patients (Stringer et al, 2008) and comparing therapeutic outcomes of reflexology vs. relaxation training (Mackereth et al, 2009a.b)The team have recently been involved in:
• An RCT evaluating acubands for chemotherapy related nausea
• An RCT investigating acupuncture and fatigue for women with breast cancer
• Pilot evaluation work using acupuncture as a management tool for peripheral neuropathy
• In-house evaluations of the use of essential oils for aspects of clinical care are in the process of being worked up into formal clinical trials
• Service evaluation of a hypnotherapy project to support patients through head and neck radiotherapy who are experiencing distress (Mackereth et al, 2011)
• Focus group activity to explore involving complementary therapists with smoking cessation in a cancer care session
• Interviews with patients and carers who have been supported by the team with procedural/treatment related concerns and anxietyAn extensive publications list arising from the service is available on request.
Multi-disciplinary collaboration, communication and professional practice
A number of our research projects involve multi-disciplinary staff, universities colleagues and service users. Our team is committed to
sharing their work through publication and presentations (see recent references). We also run a series of well attended study days and conferences to not only share our work but to promote networking amongst participants and presenters form other centresOur service is part of a hospital provision and adheres to hospital policy to ensure accessibility and prevent discrimination for all its services. We completed a study looking at working with patients of opposite sex – this was a qualitative piece that was published last year. We have also recently completed a review of our services over 10 years in terms of access by gender and diagnosis, with a trend for increasing access by males. During one week last year we did a review of demographics for our service users (paper in development). Relevant papers below:
Mackereth P Parekh J Donald G (2012) Providing therapies to the opposite sex: views of complementary therapists working in clinical and private practice settings. Complementary Therapies in Clinical Practice. 18:154-158.Mackereth P (2012) Working in cancer care – ethical, legal and professional issues. In Essence 10(4): 9-12

Andrews G Mackereth P (2012) Age, sex, disease et al – are complementary therapies reaching the parts? Complementary Therapies in Cancer Care. 18: 2-3.

Mackereth P Hackman E Knowles R Mehrez A (submitted) Address the Distress: Supporting Oncology Patients during Treatments and Procedures

Mackereth P Bardy J Finnegan-John J Farrell C Molassiotis A (accepted) Legitimising Fatigue After Breast Cancer Treatment: The ‘Coping with Fatigue’ Booklet British journal of Nursing

Mehrez A Turner J Knowles R Hackman E Mackereth P (accepted ) Complementary therapies for carers witnessing medical procedures. Cancer Nursing Practice

Stringer J Donald G Knowles R Warn P (accepted) The Symptom Management of Fungating Malignant Wounds Using a Novel Essential Oil Cream. Wounds UK

McLaren N Mackereth P Hackman E Holland F Working out of the ‘toolbox’: an exploratory study with complementary therapists in acute cancer care (accepted) Complementary Therapies in Clinical Practice.

Mackereth P (2014) Focus on smoking cessation: Calm the craving in cancer care. Practice Management. Sept Issue, 12-13.

Maycock P Mackereth P Mehrez A Tomlinson L Stringer J (2014) Self-soothing in a tube. International Therapist. 109: 21-23
Roberts D Wilson C Todd C Long Af Mackereth P Stringer J Carter A Parkin S Caress a-L (2013) Complementary therapies in cancer: Patients’ views on their purposes and value pre and post receipt of complementary therapy—A multi-centre case study. European Journal of Integrative Medicine. 5: 443-449.

Mackereth P Chaudhry S (2013) On reflection. International Therapist. October Edition 106: 20-22

Molassiotis A Bardy J Finnegan-John J Mackereth P Ryder WD Filshie J Ream E Richardson A (2013 published on-line) A randomized controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. Annals of Oncology.

Nightingale L Stringer J (2013) Carers complementary therapy project on a haematology and transplant unit (published on-line) Complementary Therapies in Clinical Practice . 19, 3, 119-127.

Hackman E Mak T Mackereth P Tomlinson L Mehrez A (2013) Reducing “Bert’s” distress: a CALM model of dementia care in oncology . British Journal of Nursing. 22(4) S20-24.

Quotes from service users
Patients “Receiving a massage is like taking a break from the cancer, I can relax back, be in a different world and experience a state of bliss.”Very relaxing. Can forget about everything. Went into a day dream”Super idea. Brilliant What people need. Shows people are giving you extra care.

“Feels great now. Managed to switch off. Saves you sitting there, thinking.

“Pain relieved

“Hypnotherapy helped me get my dignity back [panic episode during previous procedure]

Carers (post chair massage)

“I could forget where I am and what’s going on around me. It’s my time!

“It was just great, I found myself not thinking

“Felt like going to bed and having a sleep, feeling calmer

“Got rid of the headache I had, made me feel more relaxed… gave me the best night sleep for a very long time

Staff

“The sessions eased my neck pain and enabled me to stay at work

“Happier in my work, time out for me, feeling valued and therefore keen to stay at the Trust

“I have been clinically depressed for 5 years …acupuncture has made me feel normal again Have been able to maintain and cope with the demands of my role without having to take more time off.

Contact details
Drs Peter Mackereth and Jacqui Stringerc/o The Rehabilitation Unit
The Christie NHS Foundation Trust
Wilmslow Road
Manchester
M20 4BX
t: 0161 446 8236/3524
w:  www.christie.nhs.uk
e:  Peter.mackereth@christie.nhs.uk  Jacqui.stringer@christie.nhs.uk