Wessex Cancer Alliance were successful in a funding application to HEE SE Cancer and Diagnostics programme to:
- highlight the prevalence of lymphoedema across Wessex and the importance of accessing treatment for patients with lymphoedema
- identify and map current cancer related lymphoedema services and support networks across Wessex.
- identify where there are gaps in the provision of NHS commissioned cancer related lymphoedema services.
- establish and recommend training requirements for the generalist and specialist cancer workforce across care sectors in Wessex to better support people with lymphoedema within current services and
- raise awareness within the ICBs of the need to commission Wessex wide lymphoedema services.
The project ran for three months, ending March 31st 2023.
Bethan Gane, Senior Physiotherapist, Poole Intermediate Care Service at Dorset Healthcare University NHS FT led the project and was supported by Kathy Cooke, WCA Workforce Programme Manager and Autumn Jerrard, WCA Project Support Officer.
Key Activities
In order to achieve the aims the following methodology was undertaken:
- Desk based research exercise and literature review.
- Stakeholder mapping including all NHS supported specialist lymphoedema services that are free for patients at the point of contact in Wessex, cancer nurse leads across Wessex.
- Semi structured interviews were completed via Teams online or face to face, with a list of formal questions but also allowing for open conversation. Interviews were held with:
- NHS supported specialist lymphoedema services.
- a range of clinicians across Wessex from services representatives from fourteen Cancer Nurse Specialist (CNS) teams across each of the acute trusts from different cancer sites where there is an increased risk of lymphoedema developing.
- a patient representative group.
- Themes from the interviews were collated and presented in a report.
Project Recommendations
As a result of this scoping project, nine recommendations have been made, with each one indicating the organisation(s) to which they are intended.
Recommendation 1 – WCA, ICSs, NHS Trusts
Raise the awareness of the impact of secondary lymphoedema and the lack of specialist lymphoedema services for people affected by cancer across Wessex within organisations and ICSs.
Recommendation 2 – WCA, Healthcare service providers
Undertake scoping for lymphoedema services across the Isle of Wight.
Recommendation 3 – WCA, ICSs, NHS Trusts
Support organisations to build business cases to develop and expand specialist lymphoedema services with an initial focus on Hampshire.
Recommendation 4 – WCA, Service Users and Third Sector Organisations
Co-design a guide for service providers which should include information on: a) Raising awareness of lymphoedema; b) Reducing risk of lymphoedema; c) Self-management of lymphoedema and d) Specialist lymphoedema services.
Recommendation 5 – WCA, NHS Trusts
Scope other acute cancer care services, for example therapy radiographers and the medical workforce, with regards to their knowledge of lymphoedema and how they manage patients with lymphoedema symptoms, including their access/links to specialist services and training.
Recommendation 6 – WCA, Healthcare service providers
Scope across primary care and community services, including tissue viability services and palliative care services, especially those supplying support to lymphoedema patients in a non-specialist capacity, with regards to how they manage patients with lymphoedema symptoms and their access/links to the specialist services and training.
Recommendation 7 – WCA, NHS Trusts, Lymphoedema Education Providers, NHSE WET team
Identify and promote funding and training opportunities to develop universal level knowledge of lymphoedema and its management within the cancer workforce.
Recommendation 8 – WCA, NHS Trusts
Undertake future workforce planning exercise into the supply and training of specialist lymphoedema practitioners across Wessex.
Recommendation 9 – WCA, HHFT
Undertake an audit to better understand the perceived increase in rates of breast lymphoedema.
Further information
Read the full report on our findings and our recommendations
Read the executive summary report
For further information please contact Kathy Cooke, Workforce Programme Manager Wessex Cancer Alliance – Kathy.cooke@wca.uhs.nhs.uk