Developing a 'Living with Cancer' programme in a rural and coastal setting: Experiences of collaborative and innovative co-production across an Integrated Health System

Kathie McPeake; Louise Jeanes; David Nelson; Peter Selby; Samuel Cooke; Mark Gussy; Ros Kane

doi:10.1016/j.jcpo.2023.100452

Developing a 'Living with Cancer' programme in a rural and coastal setting: Experiences of collaborative and innovative co-production across an Integrated Health System

J Cancer Policy. 2023 Dec:38:100452. doi: 10.1016/j.jcpo.2023.100452. Epub 2023 Nov 4.

Authors

Kathie McPeake¹, Louise Jeanes², David Nelson³, Peter Selby⁴, Samuel Cooke⁵, Mark Gussy⁶, Ros Kane⁵

Affiliations

¹ National Health Service Lincolnshire Integrated Care Board, Sleaford, UK; Macmillan Cancer Support, London, UK.
² National Health Service Lincolnshire Integrated Care Board, Sleaford, UK.
³ Macmillan Cancer Support, London, UK; Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK. Electronic address: dnelson@lincoln.ac.uk.
⁴ School of Medicine, University of Leeds, Leeds, UK; Lincoln Medical School, Universities of Nottingham and Lincoln, Lincoln, UK.
⁵ School of Health and Social Care, University of Lincoln, Lincoln, UK.
⁶ Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK.

PMID: 37931888
DOI: 10.1016/j.jcpo.2023.100452

Abstract

Introduction: With projected increases in cancer prevalence, and demonstrated unmet need, there is an urgency for a collaborative approach to improving the lives of those living with cancer particularly in rural and coastal areas where cancer survivors face unique challenges. We report on an innovative 'Living with Cancer' (LWC) programme in the rural and coastal English county of Lincolnshire.

Methods: In 2016, the Lincolnshire LWC programme was established to develop person-centred, local support for people living with cancer, their carers and significant others in Lincolnshire. This article reports on the setup of the LWC programme, our innovative approach to delivering cancer care in a rural and coastal setting, as well as our most salient achievements.

Results: This work, developed within a policy context of tackling health inequalities and personalised approaches to care, started with stakeholder and community engagement where people described the challenges to living well after cancer and the need to focus on 8 themes further exacerbated by rurality. Recognising the limitations of conventional approaches, led to the development of a strategy underpinned by a shared set of principles and a philosophy of the importance of a transformative, whole-system, place-based, asset-based, and person-centred approaches. The strategy is now being coordinated and delivered across all cancer pathways and Lincolnshire communities. In 2022, permanent funding was secured, and our success was also demonstrated by a national Macmillan Integration Excellence award.

Discussion: The initial success of the LWC programme in Lincolnshire is a result of an explicit focus on 'transformation' rather than 'improvement', and a programme not solely situated in an acute setting, which needed a whole systems approach with a focus on person-centred support and community engagement.

Keywords: Cancer; Coastal Communities; Community Care; Health Inequalities; Living with Cancer; Medically Underserved Area; Rural Health; Stakeholder Participation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Caregivers
Delivery of Health Care, Integrated*
Government Programs
Humans
Neoplasms* / therapy