The Newham community-based prostate clinic was aimed at supporting the healthcare needs of men from hard-to-reach groups who often feel excluded from accessing healthcare support.
Based in an African and Caribbean Community Centre, the clinic attempted to map itself onto the needs of the service user rather then the other way round. Men could self-refer and did not need an appointment to attend; opening hours were flexible and specialist nurses and doctors provided a one-to-one service providing information and support about all aspects of prostate health. Following on from a consultation service users could access diagnostic investigations on site with a follow up in Secondary Care if necessary. Blood could be taken for PSA testing in clinic and the test carried out in the Acute Trust.
Prostate cancer is the second largest cancer in men and worldwide incidence has increased.
Research has shown that the incidence is three times higher in African Caribbean men and that as a group they are also less likely to access appropriate healthcare for a variety of reasons (lack of knowledge regarding disease and symptoms, lack of understanding of the NHS or mistrust of large statutory bodies).
The Cancer Reform Strategy identified community-based Prostate Health Clinics as a possible vehicle for improving access, support and strengthening knowledge and decision-making regarding treatment.
The borough of Newham in East London has one of the most diverse populations in England and includes a high proportion of black men. There are considerable health inequalities within Newham in terms of location, gender, level of deprivation and ethnicity. For example, life expectancy of men and women from the most deprived group is four years shorter than those in the least deprived group.
Further, the experience of cancer patients living in London was reported as poorer when compared with those living elsewhere in the 2010 National Cancer Patient Experience survey. It has also been identified that those from black and minority (BME) ethnic groups a poorer patient experience then those from non-BME groups.
Newham Hospital Trust also scored poorly in the National Cancer Patient Experience survey when compared with other Trusts (both in London and across England).
On this basis, Newham was identified as a strong location for establishing a pilot prostate health clinic to support the local population and explore the effectiveness of the model. In Spring 2009, Dr Frank Chinegwundoh submitted an expression of interest to the Department of Health to host a pilot clinic in Newham. The bid was successful and the pilot clinic ran in Newham from December 2010 to December 2011.
There were specific DH critieria that the pilot was required to support. These included:
- Community location
- Open access (self referral)
- Flexible opening times
- Being led by a clinical nurse specialist (CNS) with support from a local GP and consultant urologist
- Having close links to local groups and national charities
- Offering point of care testing (where possible).
In addition the local project team identified a key number of outcomes to be achieved. These included testing out if the clinic was able to:
- Attract men/women from Newham to discuss issues around prostate health
- Engage men from hard-to-reach groups who do not use GP services
- Result in diagnosis of prostate cancer
- Improve awareness of men’s health issues in the local population
- Generate high levels of user satisfaction.
In addition the project team wanted to assess the practicality of delivering the clinic in terms of:
- Effect on organisations
- Most effective methods of advertising/promotion
- Factors affecting set up and sustainability.
Back to the top