Cancer, Older People and Advocacy Programme

Cancer, Older People and Advocacy programme

Health Engagement StrategyMarch 2017

General:

Effective communication and engagement with health professionals is key to optimising the potential for the Cancer, Older People and Advocacy (COPA) programme to reach and support as many older people affected by cancer (OPABC) as possible.

Background:

Evaluations of the programme to date have consideredperceptions of the service by health professionals. Beth Johnson Foundation’s (BJF) external evaluation of June 2016, noted “NHS staff either didn’t know of, or were sceptical of, a service provided by voluntary organisations and volunteers”.

“The short and medium term outcomes for 'stakeholders' in BJF’s project were stated as:

•Improved understanding of the benefits of independent advocacy for older people diagnosed with cancer

•Improved understanding of the role of independent advocacy & support as complimentary to clinical/mainstream/Mac services.

It appears that a great deal of good work has been done in making contacts with professionals beyond the Service and its partners and in publicising the service more widely at events and in the media. The number of referrals has increased, yet there are suggestions in the evidence that the Service, as the COPA project before it, has struggled to achieve these outcomes.”

Dorset Macmillan Advocacy’s (DMA) own external evaluation report, produced in August 2016, states that health professionals regard DMA as a “highly professional service thatdelivers a high quality service that meets the needs of OPABC and the NHS. It helpsNHS staff to do their jobs more effectively by ensuring that OPABC attend appointments, use any consultation as effectively as possible, including engagementin decision making, and follow treatment regimes. This is achieved by addressingemotional and practical considerations of their medical treatment and other issuessuch as financial.”

OPAAL’s own external interim evaluation report of February 2016 looked at all delivery partner projectsaround the country. Dorset Macmillan Advocacy was noted as an example ofgood practice because it had taken time to understand the needs of health professionals and had increasing numbers of referrals. A case study detailing DMA’s relationship building with Clinical Nurse Specialists (CNS) is contained in the interim evaluation report which can be found at

BRAP’s (Birmingham Race Action Partnership) interim evaluation, published in November 2016, also considered relationships with health. The report notes: “there were barriers to integrating the COPA programme with local health and social care systems. This was seen as partly due to a lack of knowledge about advocacy or negative views about advocacy held by some health care professionals.”

Strategy:

1. Ask what the priorities are for the health professionals that you engage with. Consider where the provision of advocacy support might help with those priorities. Explain this as clearly as possible without using jargon.

1. Local delivery partners should aim to get health professional representation on their Local Cancer Champions Board (LCCB).

1. LCCB members are expected to promote the service and share learning with a wide audience, i.e. health colleagues. They are also expected to make personal introductions between health professionals and COPA staff wherever possible.

1. As part of their wider strategy to promote the COPA service, delivery partners should target specific influential individuals and key groups of health professionals. CNS’s are widely recognised as playing an important role in supporting older people affected by cancer. Their help in telling OPABC about the service and in making direct referrals can be significantly beneficial to referral rates.

1. Directly ask any CNS, or whichever heath professional you have an existing relationship with, to introduce you to any of her/his colleagues who may also be interested in utilising the COPA service.

1. If unsure how to find and/or approach an individual or group of health professionals assistance could be sought from other local voluntary sector agencies who may already have working relationships, i.e. use a friend of a friend to garner an introduction.

1. Health professionals will be reassured to know that your organisation has policies in place to safeguard service users, maintain confidentiality and professionally manage volunteers. Ensure health professionals are aware that volunteers need references and a satisfactory DBS check, as part of the recruitment process. Supplying a list of organisational policies at an initial meeting may help encourage trust.

1. Ensure that in discussions about the service, health professionals are given an opportunity to explain what they see as the issues for OPABC in their part of the service. What outcomes would they like to see both for their patients and for themselves in their role as a health professional?

1. Consider and explain how advocacy support can help achieve some or all of those outcomes.

1. Generating referrals from healthcare professionals is dependent on building relationships – they are very unlikely to refer ‘their’ patients to a service/person they do not know and trust. Many of them may have little understanding or experience of the voluntary sector beyond Macmillan. Emails and leaflets alone are generally not enough to build this relationship - although good clear simple leaflets which can be given to patients are very helpful.

1. At meetings with health professionals consider spending less of the limited time on formal presentations telling them about the service and more time on discussing the issues they face with OPABC in their service – so that you can show them how the service might address these ‘live’ issues. You are really selling yourself; it is you they are likely to remember.

1. Listen to what health professionals tell you about why they will or will not refer to the service. Allay fears where possible and provide good practice examples.

1. Local delivery partners should make best use of nationally produced resources such as Every Step of the Way, Facing Cancer Together and films developed as part of the Older People’s Cancer Voices project to positively influence health professionals.

1. Local case studies, and others developed nationally, should be used to help explain the benefits of independent advocacy for OPABC.

1. A story is best told by the person who has lived the experience. Local delivery partners are therefore encouraged to maximise the potential for OPABC to work alongside them in promoting the benefits of the service. This applies to service users, peer advocates and LCCB members who have themselves been affected by cancer.

1. Older People’s Cancer Voices has produced train the trainer training materials designed specifically to support OPABC to sell COPA through telling their own stories. These resources can be accessed at

1. Ideally, when referrals are received from a health professional, delivery partners should provide feedback on the outcomes and benefits to the OPABC referred, bearing in mind confidentiality constraints. This encourages a partnership approach, strengthens relationships and can further boost referral numbers.

1. Local delivery partners should be conscious of not only their own but health professionals’ workloads. It is likely that developing strong relationships with individual health professionals will take time. Patience but persistence is to be encouraged.

1. If a particular health professional is supportive then utilise that developing relationship to extend reach to others within that person’s sphere of influence.

1. Local delivery partners could ask service users who have successfully used a COPA service to spread the word, especially when they are talking to health professionals. Recommendations from service users can go a long way to influencing future referral potential.

1. Tell health professionals about the COPA blog and offer to forward them some examples posts. This can help give them a broader view of the programme.

1. It is for COPA service managers to determine who is best placed within their service to implement specific aspects of this strategy. They should ensure that all appropriate staff get sight of the strategy and are supported to implement it.

Marie McWilliams, 29.03.17

Action / Carried out by / Date / Comments on usefulness/impact