Outcomes from Local Cancer Campaigns Survey February 2016 Purpose The purpose of this report is for the Clinical Network and our key stakeholders to understand if Local Authorities have identified specific cancer priorities within their local populations and if they are planning to commission or deliver local campaigns to improve cancer awareness in 2016/17. Background Following on from the report The role of Local Government in improving cancer outcomes and reducing cancer inequalities published in June 2015 by the Clinical Network, it was agreed by the Clinical Network to undertake a further survey. At a Clinical Network Yorkshire and the Humber Cancer Commissioner s Symposium held in December 2015, Local Authority colleagues expressed an interest in learning and sharing practice across organisations. The link to the event is provided here. A Guide to Community-Centred Approaches for Health and Wellbeing published by Public Health England in 2015, suggest Local Authorities and the NHS have important roles in building confident and connected communities as part of efforts to improve health and reduce inequalities. The report introduces a new family of community-centred approaches to represent some of the practical, evidence-based options that can be used to improve community health and wellbeing. The link to the report is provided here. Aims The aims of the survey were to: 1. Further understand the roles and responsibilities of public health in commissioning local cancer campaigns 2. Continue to strengthen relationships with public health within Local Authorities and identify how the Clinical Network can enhance and add value to their role and responsibilities 3. Identify areas of good practice and share learning across Yorkshire and the Humber 4 Inform the development of the cancer priorities in the Sustainability and Transformation Plans Methodology The survey was distributed to all 15 Local Authorities in Yorkshire and the Humber in February 2016 and completed by Public Health Cancer Leads. A total of 11 Local Authorities completed the survey, see Appendix 1. The results were collated and presented in the Sustainability and Transformation Plan (STP) footprints (, and ) which can be found in Appendix 1. The key findings that emerged are similar across the STP footprints and are collated below. Page 1
Findings: Cancer is a priority for the majority of Local Authorities, identified within their 2016/17 Joint Strategic Needs Assessment National campaigns were promoted locally in most Local Authorities, including the recent 16 cancers campaigns National campaigns [recently blood in pee] are often enhanced by targeting messages to local communities Local cancer campaigns were often developed dependant on cancer priorities, focusing on communities and health inequalities Local Authorities used a variety of methods for cancer campaigns depending on resources available to them and which communities there were targeting. The methods ranged from large scale promotional events in football grounds to social media campaigns. Some of these methods also correspond with those outlined in the report. A Guide to Community- Centred Approaches for Health and Wellbeing See Appendix 2 for further details Most campaigns were developed with other stakeholders including Clinical Commissioning Groups (CCGs), GPs, Acute Trusts, and local health workers and communications teams. A reduction in funding / staff may have impacted on Local Authorities ability to commission/develop new local cancer campaigns All Local Authorities were interested in learning and sharing good practice from others Good practice examples provided in Appendix 1 are: Conclusion - The 'Fear or Smear' campaign is an eye-catching way of raising awareness of cervical screening in young women. Further details are provided here Doncaster Organised a number of successful skin, testicular, breast and bowel awareness campaigns in workplace and care home settings - There is a series of videos to promote bowel and cervical cancer screening which are being developed - Got a cough get a check and bowel screening take the test. The evaluations have demonstrated that people who saw campaign messages were more likely to take positive action (return screening test or attend a chest x-ray) The Public Health Department produced a report to identify variation in risk factors, diagnosis and treatment outcomes for lung cancer across District. The NHS, Local Authorities and third sector have a vital role to play in supporting communities. There is a compelling case to deliver cancer campaigns according to local needs and to reduce health inequalities in order to reach those at highest health risk. Reflecting on the aims of the survey and the report The role of Local Government in improving cancer outcomes and reducing cancer inequalities published in June 2015, it is evident that public health has become more established in Local Authorities. The roles and responsibilities of public health in commissioning local cancer campaigns have become stronger. It is encouraging to see Page 2
Local Authorities have cancer as a priority area, despite reduced funding and increased pressures and priorities on Local Authorities. The Clinical Network can enhance and add value to the role of public health in Local Authorities in the following ways: Continuing to share good practice and learning across Yorkshire and Humber Promoting the vanguards and new models of care that are focused on prevention. An example is the West Health and Wellbeing vanguard which is developing a multidisciplinary team of teams approach which centres around Connecting Care hubs, in which groups of GP practices work as a network with a team of community nurses, social care staff, therapists and voluntary organisations to organise services around the needs of the registered population Continuing to develop the needs assessment and stocktake of the range of services commissioned for lung cancer in Yorkshire and Humber To strengthen relationships with public health within Local Authorities through events, seminars and future work programmes including prevention and health and wellbeing activities. Next steps This report will: Be circulated to all Local Authority public health leads, CCG commissioning leads, cancer lead nurses and managers Provide information to assist the development of Sustainability and Transformation Plans and Cancer Alliances action plans Provide an opportunity for Local Authorities to gain information on good practice from other local authorities Enable discussions within the Clinical Network team to support Local Authorities on the prevention and health and wellbeing agenda. For more information on successful cancer campaigns in 2015/16 and good practice outlined in the findings please contact: Chetna Patel Quality Improvement Lead (Cancer) Clinical Networks Email: chetna.patel8@nhs.net Tel: 0113 8249731 Mobile: 07795 685132 http://www.yhscn.nhs.uk/ Page 3
Appendix 1: Local Authorities who completed the survey Yes East Riding of Yorkshire North East Lincolnshire York Doncaster Rotherham Calderdale No Hull North Lincolnshire North Yorkshire Sheffield * did not complete the survey. They are currently consulting on the Sheffield Cancer Work programme which is being led by the CCG. For cancer awareness they are supporting the BCOC campaigns. 1. Is cancer a priority within your 2016/17 Joint Strategic Needs Assessment? Yes North East Lincolnshire Doncaster Rotherham Calderdale No East Riding of Yorkshire York Page 4
2. Have you commissioned any local cancer awareness campaigns for 2016/17? Yes Doncaster No East Riding of Yorkshire *(promotion of national campaigns). North East Lincolnshire however considering a lung cancer campaign * (Contributed to commissioning of regional 16 cancers mass media campaign) Rotherham * (No separate commissioning; however have worked with CRUK, Jo s Trust, NHSE and PHE to deliver campaigns across the district). Calderdale* (promotion of national campaigns and tailored to local communities) York* (no specific lead for cancer, therefore keep up to date with national campaigns and use some of the graphics as part of email signatures. Contributed to commissioning of regional 16 cancers mass media campaign). Page 5
3. How did you decide which cancer types/populations to prioritise? Local Authority Cancer types/populations East Riding of Follow national priorities Yorkshire North East Incidence, late presentation, impact on deprived areas (lung cancer) Lincolnshire Priority areas identified with the CCG (cervical, bowel and testicular) Doncaster National campaigns. CCG priorities which the Local Authority contribute to (lung/breast/prostate and colorectal) Local cancer programme board. Variations in bowel screening uptake across the borough PHE and national priorities (breast, bowel and cervical cancer) Health inequalities in the local area. Amplifying the national campaigns, local health inequalities. Currently developing plans to promote uptake of breast screening to coincide with the upcoming visit of the breast screening vans. Also exploring the promotion of the Jo s Trust cervical screening campaign for salons. Breast, bowel and lung focusing on citywide priorities. Local priorities and low uptake of cervical screening services Page 6
4. What methods will be used to raise awareness? Local Authority Methods to be used North East To be decided Lincolnshire The local football club were involved in the testicular cancer campaign and promotional materials included club programmes, posters, scratch cards and wrist bands. The cervical cancer campaign included the development of a webpage Fear or Smear posters and promotional events in local retail outlets. Doncaster Front line training and interventions in workplace, care homes, community events/health bus. Training for trainers for front line staff. Bowel screening pilot with GP practices. Social media campaigns targeted at young people, outdoor events and ethnic minorities. Targeted events e.g. international women s day. Work in schools/colleges raising awareness with young people around skin, breast and testicular cancers Wider dissemination via newsletter bulletins, libraries and internal communications A mix of traditional and social media messaging and working directly with communities for example, GPs or specific charities Strengthen national campaigns by targeting messages to local communities using social media campaign, local resident publications, and council and housing provider staff newsletters. community engagers will be targeting higher risk groups, local groups with health inequalities, specifically those with disabilities and ethnic minority populations. Using previous materials which have been updated after public consultation. The materials include leaflets, social media campaigns and briefings provided for pharmacies in West CCGs. has a 2yr prevention & early diagnosis action plan Multimedia channels for whole population based campaigns. Educating GPs and practice staff in prevention to implement in their practice populations and those most at risk groups. Page 7
5. Which other stakeholders are involved in developing the campaigns? Local Authority Other stakeholders involved North East To be decided Lincolnshire CCGs, GPs 16 cancers BHNFT, CCG, Yorkshire Smokefree Doncaster GPs, via Cancer Board, Macmillan, pharmacists, champions based at Acute trust and other allied health professionals for example Learning disability teams NHSE, PHE and charities public health, communications, community engagement team, CCGs communications and cancer leads Pharmacies, CCGs, 3rd sector organisation, CRUK, Macmillan GP lead, PH England Immunisation & Screening team Mid Yorkshire Trust, CCG and health and wellbeing workers Page 8
6. How do you plan to evaluate the campaigns? Local Authority Evaluation methods North East To be decided Lincolnshire All the campaigns have been previously monitored and where possible the same evaluation methodology will be utilised. The 16 cancers campaign will be evaluated through regional arrangements. Doncaster Baseline assessments are undertaken with target audiences. Social media campaigns will be evaluated with numbers of hits/voting buttons/responses to bulletins etc. For bigger campaigns a pre and post evaluation is undertaken to try and measure any impact Due to limited resources, evaluations will be limited. The level of awareness of media coverage, social media reach and distribution will be evaluated. The community engagers are providing details of groups they have promoted the campaign to, numbers they engaged with at each session, feedback e.g. was it well received and if they have requested a more detailed awareness and information session etc. The communications team will be providing summary information on the response to the social media aspect of the campaign, and we will be getting feedback from primary care providers, commissioners and patient representatives on the distribution and use of the printed campaign materials. Previous campaigns have been independently evaluated. Evaluation will be through local cancer surveillance being undertaken by the lung cancer task and finish group and the local cancer partnership group. Page 9
7. Are there any successful cancer campaigns from 2015/16 which you would like to share with stakeholders? Local Authority Previous campaigns Fear or Smear http://fearorsmear.co.uk Doncaster Skin campaign plus workplace campaigns on various cancers. There are a series of videos to promote bowel and cervical cancer screening which are being developed. They have worked closely with CRUK to support a pilot bowel cancer screening campaign. Got a cough get a check and bowel screening take the test. These campaigns have been evaluated. The evaluations have demonstrated that people who saw campaign messages were more likely to take positive action (return screening test or attend a chest x-ray). Report on Lung cancer in district (2015) Page 10
Appendix Two: Summary of community-centred approaches for health and wellbeing Approaches How do they work? Common models Strengthening communities These approaches build community capacities to take action on health and the social determinants of health. People come together to identify local issues, devise solutions and build sustainable social action. Volunteer and peer roles Collaborations and partnerships Access to community resources These approaches enhance individuals capabilities to provide advice, information and support or organise activities in their or other communities. Community members use their life experience and social connections to reach out to others. These approaches involve communities and local services working together at any stage of planning cycle, from identifying needs and agreeing priorities, through to implementation and evaluation. Involving people lead to more appropriate, equitable and effective services. These approaches connect individuals and families to community resources, practical help, group activities and volunteering opportunities to meet health needs and increase social participation. The link between primary health care and community organisations is critical. Community capacity building, community development, asset-based methods, community organising, social network approaches and time banking. Peer support, peer education, health trainers, health champions, community navigators, befriending and volunteer schemes such as health walks. Community-based participatory research, area-based initiatives, Healthy Cities, area forums, participatory budgeting and coproduction projects. Social prescribing, green gyms, community hubs in libraries and faith settings, healthy living centres, and community-based commissioning. Page 11