As part of the Health as a Social Movement programme the RSA has been working with Greater Manchester Cancer Vanguard Innovation on their Cancer Champion Social Movement project. The initiative recognises how it is often people in local communities who have the skills, community-specific knowledge and personal experience or interest needed to increase early diagnoses of cancer, as well as preventing the occurrence of the disease in the first place.
In the last 40 years, cancer survival rates have more than doubled to reach 50% in the UK, an achievement which reflects medical advances in the formal healthcare system, as well as the efforts of activists and charities who have raised awareness, funded research and campaigned for improved treatments.
Survival rates continue to rise, but the UK is lagging behind in the improvements being made, with significantly worse survival rates after 5 years than European averages.
It is tempting to look at improving NHS services as the only way to address this, particularly in a context where we spend less on cancer in the UK as a proportion of our health budget than in other European countries. Former Health Secretary Andrew Lansley recently drew attention to the impact of NHS budget cuts on cancer treatment: the delayed roll-out of a bowel cancer screening programme would have detected his own tumour at an earlier stage.
However, NHS and health care professionals are not the only ones with a valuable role to play. It is not just about early diagnosis, but also about understanding how to avoid the 38% of cancer diagnoses which are preventable.
In Greater Manchester, the Cancer Champion project is working to grow a social movement of citizens who utilise their knowledge and experiences to tackle cancer, by supporting people in their communities at risk of developing the disease, or who have been recently diagnosed.
The project has collaborated with pre-existing groups that work around cancer to co-design the Cancer Champion approach, to ensure that the work builds on existing strengths, reflects local experiences and responds to local priorities.
While the formal health system often prioritises reducing cancer risk factors such as smoking and alcohol, this model has developed a different approach. Instead, they are focusing on how health inequalities within, and between, different communities impact people’s experiences of having, treating, or preventing cancer.
To date, 2,000 Cancer Champions from a range of backgrounds have been recruited across Greater Manchester. For some it is the first time they have been involved with something like this, while others have come to the project through similar activities they are already part of.
Some younger volunteers have focused on peers diagnosed with cancer, who are likely to have less financial stability and may be more concerned about issues such as future fertility. Others have drawn on their own experiences to engage with older men who are often unlikely to share their concerns with friends or family, or to seek screening or treatment at an early stage.
Voice of BME Trafford is a Trafford Council funded project which has collaborated with the Cancer Champion project and coordinated volunteers with a range of language skills to talk to people about the importance of screening and addressing any barriers to accessing services. This approach has contributed to a notable improvement in Trafford’s cervical screening rates - the area has bucked the concerning national trend of falling cervical screening rates and now has one of the highest rates in the country.
In Salford, volunteers who speak Urdu, Punjabi, Arabic, Farsi and Swahili have engaged with their communities, while across the city region volunteers have focused on the cancer-related needs of a range of groups and demographics.
This approach is prescient, coming at a time of growing awareness about how particular groups are at higher risk of developing certain types of cancer, or of not receiving appropriate support and treatment.
For example, black men in England are twice as likely to be diagnosed with prostate cancer than white men, and are 30% more likely to die from the disease. Research has also shown that BME and LGBT cancer patients have significantly poorer experiences of cancer services, ranging from delayed diagnoses and referrals to insufficient or inappropriate information or support.
But these issues go beyond how our health system treats people with cancer, and are often the result of ingrained assumptions and practices which fail to recognise the needs of different groups of citizens. The NHS has made a clear commitment to moving away from one-size-fits-all approaches, but this is a major departure in how a large, complex organisation has worked for a very long time. It will be a long journey and one which the formal health system would struggle to make on its own.
Recognising, and meeting, the needs of different people and communities must be an iterative process of collaboration between the formal health care system, the voluntary sector and individuals in their communities. In this way, it is clear that projects such as Greater Manchester’s Cancer Champions are doing the invaluable work of forging new ways forward.
If you are based in Greater Manchester and interested in getting involved as an individual in the Cancer Champion project, sign up here. If your organisation is keen to get involved, please sign up here.
You can also follow the work of the project on Twitter: @GMCancerChamps #GMCancerChampions or Facebook: @gmcancerchampions