The Christie is a major cancer centre in the North West with satellite centres in three hospitals’ sites (Wigan, Oldham and Salford) and a Chemotherapy Mobile Unit (CMU). The Trust’s complementary health and wellbeing service has expanded to maintain an equitable service at all sites. The team consists of 36 therapists and health advisors, including seven volunteers. It is nurse-led, with both Clinical Leads having a background in research (PhDs), teaching and clinical work. We offer support from diagnosis into treatment through to recovery and survivorship or progressive disease and end of life care. Patients present with a range of physiological and psychological concerns related to their illness and treatment side effects. In addition to supporting patients, we provide services for carers and staff to assist with anxiety, wellbeing and making lifestyle changes. Because our flagship work is charity-funded, it is imperative that we are vigilant in validating the efficacy of our interventions and we use various methodologies to provide such data. The team collaborates with universities to conduct single and multisite trials, in addition to undertaking local audit and evaluation projects.

To provide data so that our services can be replicated and made accessible to patients with cancer nationally. To continue evolving our work to offer additional management tools for clinical issues, which are complex and hard to manage using standard care alone. To provide training to therapists and healthcare professionals, as well as teaching patients and carers interventions. To disseminate our audits, service evaluations and research work via publication and national/international conference/poster presentations.

Learnings Therapists are allocated clinical areas according to their expertise and individual clinical interests (eg the palliative care team). There is capacity to address acute situations such as panic attacks, plus a system for at-risk patients to be seen ahead of treatment to teach them coping strategies. We have outpatient clinics where patients are referred by consultants for specific treatments (eg acupuncture). The clinical leads are approached regularly by senior clinicians with requests for support, sometimes proactively (eg the new Proton Beam treatment unit) or because of clinical challenges (eg vaginal atrophy). New projects are discussed by the management team and relevant clinicians to ensure capacity and funding prior to initiation. An integral part of planning each new initiative is to explore the correct methods for evaluation from the outset. Examples of recent evaluation projects include a CQUINS project as part of our smoking cessation and alcohol advice service, which identified a need to support patients with head and neck cancers to go smoke- and alcohol-free during head and neck radiotherapy treatment. Another example is a qualitative study looking at teaching patients to self-needle after a series of practitioner-delivered acupuncture for cancer-related fatigue. The aim was to explore its efficacy in maintaining the effects of practitioner-delivered acupuncture in a sustainable way. 

The team has had a profound impact on the lives of thousands of patients and their families within the Trust and our published evaluations have been used by other centres to initiate similar services. An early example of this was data on providing massage to patients with haematological malignancies in the late 1990s. It was shown to be a safe, effective method of reducing stress and anxiety for patients in long-term isolation. At that time, it was the only service nationally as clinicians were concerned about the risks of bruising and/or cross infection. There are now multiple centres throughout the UK providing similar services. We have had many teams thank us for our publications as they were able to use them to convince their clinicians that such practice was safe and beneficial.