11/11/2024 The Macmillan Community Cancer Link Worker Service

A pioneering service in London is supporting people living with cancer through social prescribing. The results demonstrate improved wellbeing and a reduction in non-medical GP appointments.

Because cancer patients may receive treatment and support from various hospitals, it can also be difficult to understand the different forms of support that are available, resulting in gaps in accessing effective community-based services. Under-represented groups are particularly likely to experience these gaps.  

The Macmillan Community Cancer Link Worker service was set up in the London Borough of Wandsworth in 2019 to address these inequalities. Since 2023, it has also operated across Merton and Croydon. It is delivered by Enable – a not-for-profit organisation - in partnership with Macmillan Cancer Support. 

The service delivers personalised, holistic support to people affected by cancer, with a particular focus on providing targeted support to people from socioeconomically deprived areas and Black, Asian and minoritised ethnic communities.  

By taking a holistic view, specialist Macmillan Community Cancer Link Workers can ensure that people’s emotional, practical, and social needs are addressed alongside their medical care. Each client’s needs, preferences, and circumstances guide the support they receive.  

The service complements the work of hospital-based Macmillan Support Workers, who provide non-medical support to people completing treatment for cancer. Unlike Support Workers, Community Cancer Link Workers support people at any stage of their cancer journey – from first diagnosis to end of life care. They also meet people in community settings rather than in hospitals or GP surgeries, with can help people to feel more relaxed.  

The service that operated from 2020 – 2022 provided support solely in Wandsworth, receiving a total of 256 referrals. The extended service began in 2023 and has been funded for two years. It will end in March 2025 if no further funding is secured. The service has received 633 referrals to date. 

The service has demonstrated impressive results: 

• 89% of clients reported a significant reduction in the severity of their self-identified concerns.  
• 85% reported significant improvements in overall wellbeing  
• 85% of healthcare staff who referred patients to the service agreed it benefitted their patients.  
• There was 17% reduction in GP appointments for socially focused issues among clients, thanks to the implementation of this service.  
• The service collects co-morbidity data from clients to understand the impact cancer has on other long-term conditions and vice versa. It supports all aspects of clients’ health and their needs associated with their long-term health conditions. 33 referrals to date. 

Phoebe Jeffrey, a Community Cancer Link Worker in Croydon, had previously worked as a non-specialist Link Worker. She said: “In my role, the focus is on becoming experts in all the non-medical support available both nationally and locally for people affected by cancer. Social Prescribing Link Workers do not have the time to look into and keep up to date with such a wide range of different support options. In my role, I can really work on exploring and building relationships with these services and also to focus more on supporting people in a personalised approach at different stages of the treatment pathway.  

“For example, someone who has just finished treatment might want to access different types of support to someone who has just been diagnosed. I also think that we build good knowledge and understanding of medical terms, which even though we are non-medical, can make a difference when having conversations with people who are in treatment.”  

A carer who accessed the service said: “. I think cancer brings a new perspective, and Sam (Macmillan Link Worker) definitely helped me talk through that. And those changes have really helped my mental health, but also my physical health.” 

• Reduced barriers to entry for the service – referrals can come from other Social Prescribing Link Workers and from a variety of other sources, providing equity of support. 
• Engagement with existing community services – ensuring strong relationships, without stepping on toes or duplicating what was already happening.  
• Working with health professionals – aiming for a joined-up approach to care. 
• Working in a community setting: cancer is very clinical, with appointments medically focused and sometimes overwhelming. Hosting the service in the community means that people are more relaxed.  
• The delivery model: a Project Manager is responsible for overseeing the strategic elements of the project and managing resources. A Senior Macmillan Community Lead focuses on developing the service, with an emphasis on forming partnerships and expanding reach. Each of the three Link Workers covers one borough, but they are ware of each other’s work and can pick up areas where capacity allows.   

• Working with health professionals: the system does not always allow for joined-up working, as each system is different. Engagement with individual teams was needed to ensure buy-in, ensuring they sat on working and steering groups for the project. 
• Funding: the service has a limited amount of funding. Without future funding, there is a risk of losing the service and the relationships that have been built.  

The project aims for better integration with primary and secondary healthcare systems to streamline referrals and ensure that all cancer patients have access to the support they need. This would also mean integrating with other areas of health, focusing on long-term health conditions and the needs associated with these conditions.  

Data collection and reporting will also continue to be a priority, to monitor the service's impact and identify areas for improvement. This data will be crucial in making informed decisions about future funding and service adjustments. 

If you would like to find out more, please contact Lydia Singer: [email protected].  

You can also contact the service at [email protected]. Referrals can be made via this email or via this webpage.