The cancer services that never stopped
Maggie’s centres found a way to stay open for patients since last May, finds Claudia Rowan
This time last year, Britain had just completed a second national lockdown and was preparing for a Christmas in tiers. Cancer patients were enduring a desperately lonely winter, with many support services reduced or moving online, or to over the phone. We now know that many thousands of cancers were being missed too. Last week, the National Audit Office reported that up to 740,000 fewer urgent referrals for cancer have been made since the first lockdown because patients struggled to get a GP appointment, or kept away for fear of Covid, with charities warning of “the biggest cancer catastrophe ever to hit the NHS”.
Yet Maggie’s found a way to keep its centres open, continuing to offer crucial in-person support and advice to people with cancer throughout the Covid pandemic.
For the visitors at Maggie’s in Oxford, which reopened after the first lockdown in May 2020, the centre and its team have been a lifeline. A note in the visitors book thanks the centre for staying open during the crisis, while another describes it as “always a great comfort to know that there will be a warm, friendly welcome at Maggie’s”.
At a time when so many services are reducing their face-to-face contact, there is much to learn from the culture at Maggie’s, which is one of four charities The Telegraph is raising funds for this Christmas.
Much of its care ethos and warm approach emanates from the physical: the smiling staff, the impeccably furnished, brightly lit spaces, the trademark “kitchen table”, where emotional conversations are had over tea and cake.
The centre, an elegant wooden structure designed to look like a treehouse, is situated just yards from the Cancer and Haematology Centre at Oxford’s Churchill Hospital.
Visitors can access free resources such as a bereavement group, and a structured programme that includes courses and workshops. Workshops include monthly makeup sessions tailored for people experiencing skin changes associated with cancer treatment, and nutrition classes with a specialist oncology dietician.
Steve Easton, 52, has stage-four kidney cancer and has been a regular visitor at Maggie’s since his diagnosis in 2010. “You come in here and it’s just like, gosh, you can just relax a little bit,” he says, from a quiet side room overlooking an expanse of trees.
Easton first turned to Maggie’s, then a portable cabin attached to the hospital (the current building opened in 2014), at a time when his “whole world had crashed in”. His diagnosis was a massive shock.
He joined the centre’s kidney cancer support group, which he now runs. Since then, he says, “I’ve had a rollercoaster ride of treatments, and spread and it’s been tough. But I’ve leaned on this group of amazing people.”
Easton has accessed psychological support at the centre intermittently during his cancer journey. After learning that his cancer had progressed to a non-operable area, Easton went through a “very dark time”. After leaving that consultation, he says, he walked straight to Maggie’s. “I think that highlights the fact that, when you’re at your most vulnerable, Maggie’s is there,” he reflects.
While he’s often unable to take anyone into consultations and treatment rooms with him because of Covid regulations, these restrictions don’t apply at Maggie’s.
Despite knowing that catching Covid would be disastrous for him because of his treatment, Easton was one of the first patients to return to the centre when it reopened last May. “I felt safe going because I was confident in the measures they’d taken.”
When it reopened, the centre asked visitors to book an appointment when possible, and required face masks and social distancing. Masks are available to anyone that doesn’t have one, and are required when not sitting down.
Easton says nothing can replicate the nuances and practicalities of in-person Maggie’s support. “You come in here and you’re just surrounded by kindness,” he says. “When you see the whites of someone’s eyes and you can see that they genuinely care, it means so much more than reading something mething on a bit of paper.”
It’s around the large e kitchen table that many of the centre’s support groups are held, eld, and Easton says he “can’t emphasise enough” how ow crucial face-to-face communication is in these settings. “I think k that any organisation should look to Maggie’s e’s to see how they can make people feel better through human interaction,” he concludes.
Hellen Mason-Spyry, 69, is visiting Maggie’s for the first time when I meet her at the centre. She was recently diagnosed with primary lung cancer. Rather than directing visitors to an automated phone message and call centre music on a loop, Maggie’s is there to welcome them in person. This is a relief for patients such as Mason-Spyry: “I can’t bear being told ‘Go to the app’, ‘Call this number’, ‘You’re No 17 in the call’ – it drives me bonkers.” Her companion, compan Liz Roberts, 66, points out: out “Within a clinical and medical environment, the result of lockdown has been enormously stressful str on patients, families fa and carers. [When] you’re on a phone call or video call, there’s a psychological and technical barrier. It’s difficult to get through sometimes: you’re on hold for ages.” A lack of in-person medical support can also be challenging “if you’ve got bad news, if you’ve had a difficult appointment”, she adds. “You need to be sitting with somebody who has got a box of tissues to hand.”
The Maggie’s staff I speak to are similarly engaged with the impact of in-person care they provide.
“When we were all told [in the first lockdown] that we can’t connect with each other, to stay away from each other… that struck at the heart of what we’ve always done,” says Claire Marriott, centre head and clinical psychologist at Maggie’s Oxford.
“It’s really damaging for people to feel alone and that there aren’t people to help, support and connect with.”
Initially the centre moved most of its work online and over the phone, and encouraged people who did want to see them in person for cancer support to call in advance so as to manage numbers.
‘Seeing that someone cares means so much more than reading something on paper’
Marriott has continued to offer in-person psychology sessions since the centre reopened, and was able to do so “by using [the] large rooms and sitting by the big open doors. That way we were sat in full fresh air yet remained within the safe, confidential space of the centre.”
Some visitors at the centre have preferred to stay outside, and the staff use the balcony to speak with them.
“All the way through we have been able to maintain social distancing, and manage the numbers of people inside at any one time,” Marriott says. “We haven’t had any instances of staff testing positive, so we think we have done a good job so far.”
While Marriott acknowledges that “GPs are under incredible strain”, she emphasises the importance of providing at least the option of in-person support. For patients like Steve Easton, these connections are particularly valuable. “I don’t know how long I’ve got,” he says. “When you connect with people, it’s much more special than it was before.”
Maggie’s is one of four charities supported by this year’s Telegraph Christmas Charity Appeal. The others are Dogs Trust, Alzheimer’s Society, and the Duke of Edinburgh’s Award. To make a donation, please visit telegraph.co. uk/2021appeal or call 0151 284 1927