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The healthcare heroes: Life during a pandemic and beyond | Meet Rachel

Clinical lead physiotherapist at The Christie Private Care

Rachel Dean, Clinical Lead Physiotherapist at The Christie Private Care, part of HCA Healthcare UK, has been a physiotherapist for cancer patients for over 15 years, and has spent four of those working at HCA UK. Here, she speaks to us about how important physiotherapy is to cancer patients and how the support she was able to provide to patients differed during the height of the pandemic.

Why is physiotherapy support so important for cancer patients?

When people think of physiotherapy, I think they often associate it with recovering from a musculoskeletal or sporting injury or surgery, when in fact we do so much more. Physiotherapists like myself who specialise in cancer care are involved in every stage of a patient’s journey, from diagnosis to living beyond treatment and in palliative care. We help individuals manage their pain and other complex symptoms of cancer. We provide a diverse range of intervention including respiratory, neurology, musculoskeletal, haematology, lymphoedema, mobility, exercise therapy and cancer rehabilitation.

For many cancer patients, their primary goal is survival, but often as they start to come out of ‘emergency’ mode, physiotherapy can help patients find their purpose again and return to being able to do what they enjoy the most. This may be anything from spending time in the garden, playing with their children or grandchildren, attending a special family event or running a marathon.

Many of the patients we see have demanding jobs and were previously active individuals with many interests and hobbies. Our cancer rehabilitation aims to support and facilitate a graded approach to the return of these activities. We know that physiotherapy exercise helps manage the longer-term side effects of cancer, helping people return to work, increasing quality of life of individuals and survivorship.

What did a typical day look like for you before the pandemic?

We're ultimately here to support patients, so what we do on a day-today basis can change significantly according to our patient’s needs. My team and I typically spend the day seeing inpatients who have been admitted for symptom management support, surgery, chemotherapy, radiotherapy and those requiring end of life care. We provide specialist oncology physiotherapy assessment, treatment and support across our inpatient units, outpatient department, chemotherapy and radiotherapy suites. We attend daily multidisciplinary team meetings and work very closely with the allied health professionals and wider multidisciplinary teams (MDTs).

We try and be flexible with regards to when we see our patients so that they minimise the number of visits they make to hospital. We’ll always try to fit our appointments around when they’re having their chemotherapy or radiotherapy.

Alongside this, I also lead the physiotherapy service at The Christie Private Care, so I will also attend meetings with my team, have 1-2-1s and organise clinical supervision. I lead on the development of the service and contribute to all clinical governance processes.

Did your role change during the COVID-19 pandemic?

During the height of the pandemic, we were still able to continue to provide specialist inpatient physiotherapy services for patients who were having surgery, chemotherapy and radiotherapy, and for those admitted with acute or symptom management needs. As a team we continued to assess, deliver and adapt to a changing health environment in a really positive and proactive way.

Naturally, during this time my patients were concerned about COVID-19 and their individual risk, so I ensured that I called all of my outpatients after the UK lockdown was announced to check how they were doing, inform them that for the time being we would be pausing our outpatient services, but that we’re contactable whenever they need us.

All of our patients already had tips on how to aid their recovery at home, so they had this information to hand. For us, it was about letting patients know that if they had any questions, we are only a phone call away. After speaking to my patients, I realised that I was worrying more about them than they were!

Thankfully, after a couple of months of providing care virtually, the majority of our physiotherapists are now back in clinic, assessing individual needs and providing care to patients in the most appropriate and flexible way. I am still working from home as I contracted COVID-19 and am still recovering. I hope to be back on the ward soon!

What are the positive things you’ve taken from working during a global pandemic?

It has really surprised me how much support you can provide to a patient and your team virtually. I was apprehensive about it before, because as a clinician you’re used to being there and having that face-to-face patient interaction, but it has been quite easy to adapt to and has demonstrated to me the benefits and enhancements that virtual working can bring to our already established services.

I am very proud of the team at The Christie Private Care, the way in which they have continued to adapt, deliver and support our patients during the challenges of a global pandemic.
Watch this short video to learn more about the way HCA Healthcare UK has adapted the way healthcare is provided in its hospitals and clinics.  
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