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Penny Brohn: patient centred approach

 

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Penny Brohn Cancer Care (PBCC) is the leading UK charity specialising in helping people to live well with and beyond cancer. We address the physical, psychological, emotional and spiritual impact of cancer using the Penny Brohn Whole Person Approach. Our provision is designed to work alongside medical treatment to encourage improved health and wellbeing. All services are offered free of charge.

We actively support the National Cancer Survivorship Initiative (NCSI) vision to holistically care for the growing numbers of people living with and beyond cancer. We have developed out integrated care pathway of services to align to the NCSI vision. See below:

Overview of Penny Brohn Services

Treatment Support Clinic – for people undergoing active treatment this half-day clinic provides emotional and physical support, and lifestyle advice. The clinic encourages people to care for their own wellbeing – reducing side effects; and to make changes likely to improve their quality of life.

Health & Wellbeing Clinic – (hospital and community based) a group clinic approach that is patient-centred with a strong emphasis on informed choice, leading to an increased ability to self-manage as well as signposting to other services.

Living Well Course – for those who need further support to improve the day-to-day experience of living with cancer through realistic, workable action planning and other self-help techniques.

Follow Up Services – light touch interventions to maintain lifestyle changes and support wellbeing. These are offered as a range of support including   follow-up events, online support and information services.

Follow On Services – for those with more complex needs. For example, these include follow on single day or in-depth residential courses such as the Approach and Retreats based at our National Centre.

More detail on our Living Well courses:

  • improve the quality of their life and help manage the psychological, emotional and physical aspects of cancer better
  • have more choice and control over how they support themselves when living with or beyond cancer
  • meet with others to share learning and experience and break down the sense of isolation a cancer diagnosis often brings
  • learn about the help and support that is available
  • improve their day to day experience of living with cancer through realistic workable action planning and other self-help techniques

Living Well courses are being offered in partnership with other voluntary or public sector organisations – including currently operating courses in partnership with the NHS locally (specifically at the Bristol Haematology and Oncology Centre (BHOC) based at the Bristol Royal Infirmary).

More detail on our Treatment Support Clinic:

The Treatment Support clinic, where NHS oncology staff work alongside healthcare professionals who support a more whole person approach to health and wellbeing, offers users (clients with cancer and their supporters) an integrated service.

Users are educated and encouraged to take evidence-informed steps to:

  • understand their disease and treatment
  • understand the role of the immune system and how its activity can be influenced by self-help techniques and lifestyle choices
  • increase their resilience
  • reduce side effects
  • introduce long-term lifestyle changes to support their physical, psychological, emotional and spiritual health, now and in the future

The clinic is structured around the whole person model of health, with the elements of each weekly session designed to address each one of the physical, mental, emotional and spiritual aspects of health over the course of the morning

Group size is limited to 12. This includes supporters of people with cancer who are welcome to attend the all parts of the clinic (they may also access one-to-one acupuncture if numbers permit).

STRUCTURE OF THE TREATMENT SUPPORT CLINIC – 9.00AM-1.30PM weekly (drop-in but prior booking advised)

Opening session 9.00am-9.45am

Each session starts with an opportunity for users to get to know one another and briefly share the particular challenges they are facing with regards to cancer treatment and also to share any helpful strategies they have employed to help themselves.

Information session 9.45am-10.15am

  • 30min information session and discussion led by either a doctor, a nurse, a nutritional therapist or a visiting expert (e.g. a psychologist, an acupuncturist, a walks-for-health leader etc)
  • covers some aspect of cancer prevention, treatment or strategies to help reduce the adverse effects of cancer treatment.

Facilitated Group Physical Activity 10.20am-10.50am

  • 30 minutes of group exercise led by a physical activity facilitator with experience of working with people with cancer
  • rotating programme of different physical activities including aerobic mini-circuit work, modified Nordic walking, Qi Gong or Tai Chi, yoga
  • activities are individually tailored to users’ needs during the session
  • aim is to build confidence, restore users’ relationships with their bodies and inspire people to incorporate flexible and appropriate levels of physical activity into their daily lives, even in the middle of treatment.

Break 10.50-11.10

  • healthy snack and juice/smoothie made following PBCC Healthy Eating Guidelines

Self-help techniques then Acupuncture 11.15am-1.30pm

Or

Acupuncture then Self-help Techniques 11.15am-1.30pm

  • session of smaller group relaxation/meditation/imagery training
  • CDs are available so that users can practice at home
  • opportunity to develop skills and techniques with the help of an experienced trainer.

All users with cancer are also offered a 40 minute one-to-one session of acupuncture

  • operated on a “multi-bed” basis where the acupuncturist treats different people in different rooms at the same time
  • increased cost-efficiency
  • 10 people can receive a treatment in a 2-hour period.

Other opportunities

  • Users also have the opportunity to have a brief consultation with an integrative doctor or to book into other services offered by Penny Brohn Cancer Care
  • Treatment Support Clinic maintains a specific resource table with recipe suggestions, books, CDs, information from a range of local and national support and survivorship services
  • Users are encouraged to stay for lunch and socialize. A table is reserved for users of the Treatment Support Clinic to encourage further informal group support.

Service initially developed in response to requests from existing PBCC service users

  • Many service users make their first contact with PBCC only when their first round of cancer treatment is near completion or already finished. Before then, they are too involved in surviving day-to-day with hospital appointments and managing side effects. They are also highly sensitive to the opinions of their oncology staff during this period.
  • When they discover the range and potential benefits of the many self-care options, they often express frustration that they did not know about these earlier, and feel that they have experienced greater loss of wellbeing and more physical and psychological side effects through treatment, than was necessary. These include side effects such as weight gain, weight loss, ongoing digestive problems, loss of physical fitness, anxiety, loss of sleep, depression, loss of confidence etc.

The Treatment Support Clinic was set up in response to these documented user needs, and with the clear understanding from users, that, if they were to feel safe and confident using the Clinic, staff from the Oncology Services would need to be supportive and involved.

We collect regular and ongoing feedback from service users, both via anonymous questionnaires and verbally during the sessions where we ask for their comments about how the Clinic could be improved and which topics, speakers and types of exercise they would like included in future sessions.

Each of the Information Sessions is structured informally with most of the session devoted to Questions and Answers so that information is directed by the needs of the service users who are present in that session.

We also have a Resource Table with information signposting other useful books, courses, organisations and resources. Clients’ suggestions for services or things that they have found helpful are included on this table.

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