Support for Preston and Chorley hospital staff fearing 'cancer wave' caused by coronavirus
The direct effects of the coronavirus pandemic have already been devastating enough for those at the forefront of caring for its sufferers and victims.
With almost 1,000 hospital patients across Lancashire having lost their lives with Covid-19 since the outbreak, NHS staff – like the rest of us – will no doubt have been gazing at the horizon for any glimmer of light that they could find during the darkness of the past three months.
A steady decline in identified cases – and deaths – has recently offered some long-overdue, albeit tentative, hope. However, there is a growing fear amongst staff who specialise in supporting cancer patients that coronavirus could take a further, as-yet-unseen toll.
At the height of the pandemic, referrals for suspected cancer dropped off dramatically, with the theory being that many of those who would ordinarily have sought medical help delayed doing so, because of the perceived threat of contracting Covid in the process. The number of patients in Central Lancashire referred by their GP to be seen by a cancer specialist within a fortnight more than halved between March and April – from 1,529 to 658.
“We’re worried about getting a massive wave during the autumn of people coming in with later stage disease,” explains Anne Tomlinson, lead cancer nurse at the trust which runs the Royal Preston and Chorley and South Ribble hospitals.
“I think it’s going to be harder for cancer staff, because we’ll be dealing with people who are a lot more poorly – and we won’t necessarily have caught them early enough.”
That ominous prospect has prompted a plan to provide specialist help for healthcare workers who may be faced with the fallout from the delivery of desperately difficult news.
Preston-based charity Cancer Help has extended a version of the counselling which it usually offers to cancer patients and their families to those NHS staff in Central Lancashirewho may otherwise be left without the kind of support which they so readily give to others.
While some staff have access to so-called “supervision” – or debriefing sessions – there are others at the sharp end of caring for cancer patients for whom it is not currently available. As part of a lottery-funded project, cancer support workers and Macmillan information centre employees will now be able to access Cancer Help’s telephone therapy service.
The charity’s complementary therapy lead, Sue Kraft – a nurse herself – says that hospital staff will be affected by dealing with any diagnoses which have been “taken out of their control” as a result of Covid-related delays.
“They’ll feel it personally, because cancer tends to follow a set pathway. When they see a patient who has had a diagnosis, nurses will usually know exactly what is going to happen next.
“But they may now be seeing people who haven’t gone to the GP [when they normally would] and instead they’ve hung on months,” reflects Sue, who says that one of the biggest benefits of the Cancer Help project will be in its provision of an immediate point of contact for distressed staff.
“There is a real need amongst healthcare professionals. Their own lives have been impacted by the virus and their work has also changed, which can affect their mental health and wellbeing.
“Just having someone there to listen is the thing that can make a difference.”
According to Anne Tomlinson, staff have already had a worrying foretaste of the challenge of supporting cancer patients whose suffering has been compounded by coronavirus.
While urgent surgical and non-surgical cancer treatment – and diagnostics – has continued at Lancashire Teaching Hospitals throughout the pandemic, some treatment plans initially had to be changed in line with national guidance about balancing risk.
“We might be doing more radiotherapy than surgery in some cases – for people with upper gastrointestinal cases, for instance, it’s too dangerous to do surgery. If you’ve just been told that you’ve got gastric cancer and you thought you were going down one treatment route and then you’re sent down another, it’s a lot to take on board,” says Anne.
“Some patients might not be having chemotherapy. They know if they get Covid they are at a higher risk, so there is more anxiety than ever amongst patients and pressure on staff, particularly on the lower-band cancer support workers – some of whom aren’t even registered nurses.”
Cancer Help’s general manager Jeanette Smalley says that she has benefited herself from the sort of support which the charity is now going to be offering to NHS staff.
“It’s a way of offloading and hopefully not taking things home with you. It can be a really helpful process when you find that you can’t see the wood for the trees – they will give you a bit of direction and get you thinking about things differently.
“The care co-ordinators are the ones who have tended to build the relationships with patients and their families and so will be especially in need of it.”
The project to help staff better cope with the trauma of caring for the deeply traumatised formed a key plank of a recent lottery funding bid which has secured £86,000 for Cancer Help. The Ribbleton-headquartered organisation has also just been awarded more than £25,000 from Children In Need.
For its treasurer, Rachel Mallett, the cash injection came at a crucial moment as the charity – like so many others – was hit with the closure of its four second-hand shops during the lockdown and the cancellation of planned fundraising events.
It also bucked a trend in which Cancer Help – which has offered psychological support and bereavement counselling in the city for more than 30 years, including a specialist service for children – has tended to be overlooked when applying for funding in competition with larger regional and national counterparts.
“The money is great, but we also hope that it puts us on the map and makes people think about whether they can volunteer in our shops or help us in some other way.” explains Rachel.
The charity has now reopened one of its four shops, which in a more typical year generate around a third of the £400,000 which it needs to operate annually.
“This new project will mean that we are able to offer more of what we already do,” Rachel adds.
Sadly, all the signs are that what Cancer Help does is set to become more demanding and indispensable than ever.