Empowering patients: Bridging healthcare and social work in blood cancer care

[00:02:36] Maryanne: Hello, my name is Maryanne Skarparis. Welcome to Talking Blood Cancer. I’m very excited to welcome here with me today, Angela Daly. She’s the Senior Social Worker at Sunshine Coast University Hospital here in Queensland. Good morning.

[00:02:50] Angela: Good morning, Maryanne.

[00:02:51] Maryanne: How are you?

[00:02:52] Angela: Yeah, good thank you. Very happy for Friday of course.

[00:02:55] Maryanne: Oh yes, Friday’s always end of week, end of a busy week and looking forward to the weekend. Today’s theme, or this month, the Leukaemia Foundation are looking at navigating the healthcare system and all the intricacies involved in navigating the healthcare system. Can you tell us in your role as senior social worker at a regional tertiary hospital, what are the top three priorities that you discussed when meeting a newly diagnosed blood cancer patient?

[00:03:20] Angela: So I guess one of the primary things, one of the very first things that we discuss with patients and families once they have that initial bomb dropped as to what’s happened is “Who’s in their family? What supports do they have?” and “Where do they live?” as well, “How easily can they access our hospital?”

[00:03:42] Maryanne: Yeah, access to treatment is really quite a vital thing, isn’t it? Is it easy for the financial aspect of getting to treatment?

[00:03:49] Angela: Yeah. Many people live in quite remote areas, even though we’re on the lovely Sunshine Coast and we don’t associate that necessarily with very country, small towns. We associate it with lovely, beautiful beaches and a new, shiny, wonderful hospital that’s now been here about eight years, I think. Wonderful, wonderful service. But we are still working on all the support services around our region. And what that’s meant with an increasing number of specialists is that we can offer some fabulous treatments for our patients. But it also means that more people are coming from very remote areas and that can also mean traveling from north of Gympie. Even though, for some of us from more remote areas like myself, days travel isn’t seen as a big thing. However, when it is every day, you’re not well. You may have a very fatigued carer as well. You are also navigating city traffic for the very first time.

The stress of knowing where to park, turning up on time for your treatment costs. As we know, cost of living and petrol is not easy these days, so that adds another stress for our patients. And I think it’s the importance of being very close to your tertiary facilities for your treatment. And I think that’s something that’s very different for our haematology patients. The length of the treatments, how frequently you have to come, and it’s actually not just your treatments. It’s your appointments with the doctor, with the nurses, your regular blood tests, your allied health team reviews. As well as unexpected hospital admissions as well.

[00:05:34] Maryanne: Absolutely. So that access to treatment is really quite a pivotal consideration that you need to make for many variables.

[00:05:41] Angela: Yeah, it certainly is. Some of us, until this thing happens to many of our friends or family members, we don’t realise that this happens on top of everything else. It doesn’t happen in a vacuum. So what that can actually mean if you already have those existing life stresses, as we often do, it means how are you going to get your children to school? How are you going to actually drive to treatment if you don’t have a car that’s safe to drive because you’re due to get a service next week? How are you going to get to treatment if you look after a family member who is elderly and they need your care 24 hours a day? So this happens on top of everything else and for a lot of people it’s also about income.

[00:06:25] Maryanne: Yes.

[00:06:26] Angela: How will you actually afford to pay for your accommodation? How will you afford to pay for your transport? How can you afford to pay for parking? Once that initial diagnosis happens, you may have been to your GP, rushed into emergency, admitted to a ward, rapidly called family members, and been told that you actually need to be admitted for three weeks and start your first round of treatment. It is trying to navigate all of those changes very quickly. And care and put things in place for the people that you love and other responsibilities that you have. 

A lot of people that we meet as well might have part-time jobs, they may have multiple part-time jobs, they may be unemployed at this point in time or not able to work for other medical reasons. They may be accessing a government pension for caring for their loved one. As we know, that actually doesn’t meet basic healthcare needs and it is expensive enough to go to the GP. When these things happen, on top of all of those life stresses, it’s really hard to navigate anything, really. When you’re processing all the new words that the haematologists are saying to you, and quite rapidly giving you lots of information that you might take in within the first 30 seconds, and then not much after that. So it is quite challenging with these diagnoses happening on top of everything else in your social situation. So, that’s often where social work can come in.

[00:07:57] Maryanne: Lovely and such a vital role really because when you look at the impact of a diagnosis and that whole, as I say, that whole process of taking in a new language, the haematology language, navigating who’s who in the zoo in a hospital setting when you’re not really familiar with roles, familiar with what to expect. Having to also look at your own personal life and navigating how that works for you as well. It would be an overwhelming time. You’ve touched on some of the themes that you mainly deal with, as in your role as a social worker in a regional hospital. With those remote people in that rural area. Can we just tease out what are the most common themes? We’ve talked about navigating the healthcare system and knowing who’s who whilst you’re an inpatient. But what are the most common themes that you actually have a pivotal role in helping patients and their families?

[00:08:49] Angela: Well, I guess one of the biggest things is we look at the hierarchy of needs. When someone is admitted to hospital, they essentially have accommodation. They have care, they have access to treatment, health professionals. The carers don’t, the family doesn’t, so that’s often when social workers called immediately. Our accommodation providers such as Leukaemia Foundation, other local organisations that we have here on the Sunshine Coast, our hospital charity teams. I know in Brisbane, they also have Ronald McDonald House, Cancer Council, as well as Leukaemia Foundation accommodation centres. So it’s having close partnerships with those centres to support family members in having access to their patients, to their loved ones, and being there as a key support person for them. One of the biggest things to navigate is Information overload. Our team have to give people a huge amount of information in a short amount of time to make sure that they’re understanding, agreeing to the treatments that they’re having, even though they might not necessarily be comprehending all those details.

So sometimes social work’s role, along with our specialist nurses, is to sit with patients and families after they’ve been provided with that information, to just listen to what they’ve heard. And help them process what’s actually happening and what that actually means for them and it means different things for different people. Everyone’s story, everyone’s social pressures are different. Everyone’s understanding of the system is different, so we talk about health literacy quite a lot. And that means your ability to understand and navigate our healthcare system. Say for example, I’m a health care social worker, I know our services pretty well, but even moving to a different hospital. So I’ve worked in Metro, in Brisbane, I’ve also worked in regional areas. So I worked in Townsville for the Leukaemia Foundation, and had close links with the Townsville Hospital.

But even working across those services, it was hard for me to wrap my head around the differences in those hospitals and even public and private services as well. Each system and service works really differently and from my perspective, having the knowledge that I do has been absolutely vital in navigating tertiary health services. For myself, for other family members that may have been through a cancer diagnosis too. So, if you don’t have that knowledge, or add that to the stress, even if you may have some of that knowledge, it’s really, really challenging. Add that to the worry of financial stress, not knowing how you’re going to pay your mortgage, not knowing how you’re going to put fuel in the car to get yourself to treatment, or to get your child or loved one to treatment.

The role of social work would be helping people navigate the actual pathways and the systems within the healthcare system. Knowing their role and being able to advocate for their loved one, and that’s also a key role of social work too, is advocating for the patients. If they don’t have anyone else at the time, or patients and their loved ones got so many other things on their plate. They are struggling with the information that is being provided. Because as patients and families know that have been through treatments in the system. It’s a completely different language. It is, yeah, and I found that when I first started working for the Leukaemia Foundation many many years ago. I think it might have been 2005, Maryanne. Like I had the patients and the family members knew much more than I did about their actual diseases. Once they’d been in treatment, had met all the care team, they were talking about all sorts of acronyms like, I guess R-CHOP, for example, as a particular treatment, or a hyper-CVAD. And I had no idea what any of these acronyms meant. So, in my professional role, I would go and talk to the nursing and the medical teams to find out that information, so I could understand what was actually happening. It was really helpful, I think, having that non-medical perspective too. Because that helps us to put into plain language for patients and families, what it actually means and to show them that it’s okay to ask questions.

[00:13:04] Maryanne: I love that. I think you’ve articulated that beautifully because you’re right. It’s like entering a new country. It’s a different language. And you’ve got that void of, “Oh my goodness. I’ve just received this diagnosis,” and then knock, knock, everything drops off after then, which is a normal response to the shock. But having someone who, like yourself, who has invested in building relationships with the allied, with the nurses, with the treating team, but also that, just that lovely share that you’ve just done of, “Okay, well I don’t know this either.” But together we can ask the questions or shape the questions to ask the treating team so that we have a better and deeper understanding of what’s happening with us.

[00:13:44] Angela: Yeah, most definitely. And it’s a very different position that I’m in, having the experience that I do, and those relationships that I have where it’s not happening to me. Even though I may not understand exactly what’s happening for patients, and I would never put myself in that position for patients and families, because their experiences are unique. I can help them navigate and walk alongside them as they’re going through this. And part of that is being able to ask those questions of the medical and the nursing teams and breaking it down further for me. And also talking to the patients and families and asking them. “Is it okay if I pass this information on to the doctors? Is it okay that we break down these questions a little bit better?” and also timing. I have a little bit more time sometimes, not all the time. Communication is one of our key skills within social work. We often can pay attention to the things that aren’t often said or seen or one of my strategies, often is to sit in with a patient if they are comfortable with that happening when the doctor might be doing ward rounds.

If I do have a relationship with the patient and they’re wanting me, I’ll ask, “Do you feel comfortable with me sitting in with you?” And we talk about the things that I might ask and they may change their perspective the whole way through. And they don’t want me to ask any of the questions at all. That is completely fine as well. So we try and put the person in the position of “boss”, where they feel comfortable to do so. Sometimes I think when the bomb hits, you don’t really feel the boss of anything and you’re not really sure what to ask.

[00:15:24] Maryanne: You’re very vulnerable, aren’t you?

[00:15:26] Angela: Yeah. Absolutely.

[00:15:28] Maryanne: You mentioned earlier about the importance of connection and relationships. Also, with the lovely background and the experiences that you’ve had as a social worker. I’m imagining that’s built on your knowledge. So, for you as an individual, that beautiful, lateral, broad understanding of the hierarchy of needs. You can start with the basics, they’ve got shelter if they’re needing to come to, you know a regional hospital for treatment. They’ve got their finances in place, all of those basic needs. But having knowledge about how they manage that and what they can tap into is also important. So are you able to expand on, you know, your ability to connect with knowing the different organisations that people can tap into from rural and regional areas?

[00:16:13] Angela: Yeah, I think one of my learnings from having been in a regional area, both as someone from a very remote centre, as well as someone who has worked in a regional as in Townsville, which is different to regional as in the Sunshine Coast, or a little bit closer to a metropolitan city. One of the key things is actually working with the other professionals in those local communities. And they may be people from organisations that aren’t Queensland Health, or that are places like the Leukaemia Foundation, places like the Cancer Council, and also reaching out to non-health based organisations. So we do a lot of advocacy, sometimes with Centrelink, where we possibly can, and facilitate information, understanding about what people can access. One of my learnings within navigating the healthcare system and doing my role as best I can for our patients is supporting them with knowing what’s out there.

We, Queensland Health, as much as we’d like to be, can’t be everything to everyone. And, meeting the community support needs, that’s where Leukaemia Foundation and other organisations can come in really handy. So having that relationship with our wonderful support coordinators is a big help to our patients that are going through these often long, challenging treatments for them and their families. Patients that might be in and out of hospital as well, being able to work across both settings. So I know our support coordinators here on the Sunshine Coast do have the capacity if patients and families are open to it, at different times being seen in the community. As well as maybe having a cup of coffee and being seen all the patients in hospital. So for the carers and the loved ones, because I think, within our health services, we’re focusing on the acute side of treatment. And that’s our job, and that’s what we’re really, really, good at. And the Leukaemia Foundation and our other organisations within the community are wonderful at providing that community support and doing that often all the way through treatment. 

A good example is when I worked at the Leukaemia Foundation many years ago, and I certainly worked alongside the oncology social workers at different regional hospitals as well. So that was a key part of our support services team and working with our local fundraising branches, I mean it was not about fundraising. It was because they knew the local communities really really well and in our remote areas, they’re often the reason why people know about the Leukaemia Foundation. Often linking people in to Leukaemia Foundation if they’ve had a diagnosis and they’re flying to Brisbane, coming to the Sunshine Coast, flying over to Townsville.

So, I think having those core links for me already, and knowing about the Leukaemia Foundation as an organisation has been really, really helpful in understanding the organisation’s role. And over my time as an oncology social worker and different roles within different services, I’ve been able to let my colleagues know as well about the supports that are available with the Leukaemia Foundation. Even throughout the changes of the organisation over a number of years, because I’m sure they’ve reviewed how they deliver their services and what suits the needs and particularly during our times with COVID, we’ve had to make all of our supports more accessible.

[00:19:45] Maryanne: The value of connection and the value of knowledge, I think, is really profound, and you’re the perfect capture in from what I see, because you’ve had that experience with us as a support worker. But you’ve also had the value of knowing and understanding of what it’s like to live in a regional area. The importance of building relationships with key social work team and other allied health care professionals within the regional areas. Also that understanding of how beautiful that connection is with rural people because it is that word of mouth, isn’t it? And if you’ve made an impact you know, you’re more likely to say, “Hey, I know Angela from the Sunshine Coast University Hospital who has had a personal experience with the Leukaemia Foundation.” You’ve even had a connection with as remote as Mount Isa which is central Queensland. You’re able to expand a little bit about that, how our roles of connection within healthcare professionals, understanding and navigating the healthcare system, with knowing who’s who in the zoo. Can you expand on your personal experience with knowledge of that space?

[00:20:51] Angela: I certainly can and very happy to do so because it’s something that I’m very proud of as well, something I hold very dear to my heart. So, part of my story is that, and I’m happy to share this as well, that I was born and raised in the remote outback town of Outback City of Mount Isa. And..

[00:21:10] Maryanne: How about distance is that? Because we’re a national organisation, so it’s really lovely to have a bit of an idea of distance.

[00:21:16] Angela: So I think it’s about 900 kilometres from Townsville, which is the closest treating centre for a lot of haematological conditions. I’m not sure exactly what they offer locally at the moment, but in my experience, if you were diagnosed with an acute leukaemia, you either had to travel to Brisbane or Townsville. And again, that was often at short notice. So, as I was growing up, we always had Leukaemia Foundation as part of our lives. Going back as well, Mount Isa is probably, 2,000 kilometres, maybe more, from Brisbane. So I know it takes at least 24 hours drive, potentially. I guess remote travel was actually very much part of our lives. And we were very, very, very lucky as a family not to have to travel 900 kilometers to a health care appointment, to acute health treatment, or relocate for services. So certainly Mount Isa is extremely remote. 

But going back to what I was saying, Leukaemia Foundation has always been a big part of my life. Growing up we had these big blue bins at our homes. And they were for recycling cans. Part of that is that we knew that these were the leukaemia bins. We had no concept of what that actually meant. But that was actually a fundraising activity. The fundraising was for the Leukaemia Foundation. The purpose of that fundraising was that those funds went to patient support services. And those support services were offered through accommodation, through our support care coordinators, through the ancillary staff that is now what is called the Leukaemia Foundation of Australia. The person that was a key part of that was my great auntie’s best friend, and her name’s Kathy Swift. I’m very, very lucky to have their family as closely connected with my family, and I’m good friends with her granddaughter. So, Kathy and I think one of her very close friends, Elaine Gamer were fundamental in helping develop the Leukaemia Foundation of Queensland Branch in Mount Isa. And the reason why that was developed is, correct me if I’m wrong Maryanne, but I think Elaine had a family member who was extremely unwell and had acute leukaemia. Is that correct?

[00:23:35] Maryanne: Yeah that’s correct.

[00:23:36] Angela: What used to happen back in the 70s and 80s, there was no such thing as patient travel and subsidy scheme. So I think that’s called PATS in New South Wales, or IPTAAS, and I think PATS in some other states. I’ll get back to why I know that in a minute. What that actually meant for people who were diagnosed with an acute leukaemia or any other haematological diagnosis was that they had to relocate often to Brisbane. Or if they wished to keep their family home, it meant relying on family and friends in Brisbane or Townsville. And often that meant living in a car for periods of time. And some people had to sell their family homes and relocate from their friends and family and everything that they knew, often with quite poor outcomes. So that was actually quite distressing for the families of those remote.

The awareness raising and fundraising that was done within the community, like Cancer Council and all those other organisations, was really to fund those additional support services of accommodation support coordinators near our tertiary facilities. And then when the patient travel subsidy came on board to work with Queensland Health to support these patients and their families. So they could relocate for long periods at a time with wonderful accommodation facilities, self-contained, apartments for family that could stay close to the hospitals. For patients who could stay close by, when they were discharged, and people weren’t financially impacted. They could keep their homes. They could still have family relocating, and going couple of months at a time if they needed to go back and forth. So, the Leukaemia Foundation, so Kathy was a key part of that fundraising and a key part of awareness raising within the community. I always knew what Leukaemia Foundation did thankfully, with our remote health services. Everyone knows that those supports are not available locally. So the awareness of those community organisations outside of our little town was always quite high. But that’s not always the case in many other remote towns. And when I was talking to a number of people when I first moved to the Sunshine Coast, not many people were actually aware of the Leukaemia Foundation and what they did. And that came as a big surprise to me because it’s always been a huge part of my life. And, I’ve had a number of family friends that have had to relocate to Brisbane with poor outcomes. Which is very, very sad, but what was so valuable was that they could have time with their families, close by to treating centres. Get the treatment that they need, do their utmost and what they could to stay with their families and get that quality time, regardless of the outcome.

[00:26:25] Maryanne: Look, I love that you’ve had that history, haven’t you Ange? You’ve had that exposure to what a rural community and how they can rally together if they’re passionate about something. You’ve also had that exposure to recognising the value of connection and an understanding of how relationships are built. The importance of knowing who to contact, who to reach out to, who do you need in your corner. Which is vital in your role as a senior social worker in a rural tertiary hospital. You’re also a key member of the OSWANZ. Do you want to talk about that and the reason why you joined that and your value there? Because Leukaemia Foundation are now a national organisation. So we’ve got some wonderful staff all around the country.

[00:27:08] Angela: Yeah, so a few years ago I joined as a member of Oncology Social Work Australia and New Zealand, so OSWANZ. And I’ve been a member over the years. They certainly do a lot of education, advocacy and coordination of awareness raising of social work services within oncology across Australia and New Zealand. My role currently is that of Queensland representative. One of my key reasons for doing that is, I think I was nominated, and as Maryanne knows, I’m not afraid of putting my hand up for something,

[00:27:42] Maryanne: Perfect.

[00:27:43] Angela: Including this wonderful podcast. You know, the reason why I did get involved is I am very interested and very passionate about the role of oncology social work and how we can actually add to a patient’s experience. Now that I am a key member of OSWANZ, I am very well connected to representatives across South Australia, Perth, Tasmania, New South Wales, Victoria, and have learnt so much from those colleagues. And we’ve also had a recent conference where there was actually quite a few presentations centring along haematology.

So that conference was held in Melbourne and I got the opportunity as well as listening to those conferences, those presentations, was meeting the, I think the national coordinator for the online cancer support services. Yeah, so it was wonderful to meet Linda and we were actually able to share a story about someone that I actually had linked into a support service online. And it was really cool that she actually knew the person and had been supporting the person that I had also worked with and the value that had. So, I’m very lucky with Leukaemia Foundation because our support services coordinators within Brisbane and linking in with them, we know exactly what’s being provided. A key one was when we were support, talking about a family member in the recent months, that was struggling with navigating a service, and Maryanne did some work, and then I did some work with the person, and we’ve been able to get a good outcome. I think those links has been really, really helpful. Because often, yes, we do refer into the never, never, and sometimes we know what’s happening. Cancer Hub’s another great organisation that we get good feedback with, our local organisation here, Wishlist, Bloomhill as well, so it’s wonderful having those links. It was really, really lovely to actually catch up with Linda and know the faces and the people behind these online services.

[00:29:44] Maryanne: Oh, absolutely. And she’s so passionate in that area. And I love that knowing that power of connection, then you’ve met the person. So you’re more likely to say to the patient and their family when you’re meeting them, “This is available to you. Have you explored what they offer in this area?” You know, that pivotal role that you play in sitting with the patient, listening, understanding what their needs are, just helping them understand what’s happening with them. And then navigating what is accessible to them, what can benefit them with whatever it is, whether it’s access to Centrelink, whether it’s an advocacy letter to help out there, or just even connecting them through to us as an organisation. It’s such a pivotal role, social work, in a regional hospital.

[00:30:29] Angela: And I do believe, working as part of a team within our healthcare team, so our inpatient services, our specialist clinical nurses, our treatment team as well as our admin team who help people navigate their appointments. Like I said our local accommodation services, which are run by a hospital charity and places like the Leukaemia Foundation are all a key part of someone’s experience. And how we can actually contribute and communicate as a team to people navigating those very challenging diagnoses. And everything that comes with it and the treatments, and the post care you know, the more and more we know about these conditions is we understand that it’s life-changing and it doesn’t just stop at the end of treatment.

[00:31:17] Maryanne: No, that’s exactly right, Ange. Just a personal share. What drew you to immerse yourself in haematology and oncology and what inspires you to work in this area?

[00:31:27] Angela: I think I’m not really sure, to be honest. My last placement as a social worker was within a palliative care team. And that was in North Queensland, and palliative care is certainly, can be part of oncology and haematology, it is a different space. But I just liked the way that the team approached the care of the whole person. And in working with oncology and haematology teams, I’d gone away to a different job as well when I worked in the UK. I was working in a interesting and challenging ageing care system. And we would do assessments for people in the community. And it was those people with an oncological diagnosis I was always drawn back to. I think, the longer term nature of the treatments, you actually get to know the patients a little bit better. I think that certainly the challenge and the grief process that people go through from their very, very first diagnosis, the first time that they get that life-changing news. And certainly all health diagnoses are very, very challenging, but certainly working as key part of the team within haematology, health care connections, having come from a remote area myself, and the importance of navigating those, oncology and haematological pathways and the challenges of that. And I think there are so many hidden things that people don’t see on the outside, so I’ve had a number of people in my family with different variety of cancer diagnoses and I think you know it happens to all of us potentially at some stage in our lives. But I do believe haematological diagnosis is a completely different thing.

[00:33:09] Maryanne: It is. It’s relationships that can be built over a long period of time. And they reconnect. They move on with treatment. They may finish the acute stage of treatment, but they come back for their yearly checkups. And it’s a relationship that remains, that builds over a long period of time. And you’re that pivotal person who brings with them just that stability, someone they can trust. A warmth that has an understanding of what they’ve been through. If they need to express and talk about whatever challenges they may have moving forward. It’s a relationship, isn’t it? It’s a long term relationship that’s built. So trust is really vital as well.

[00:33:45] Angela: And I think that a lot of social work is that, community networks, knowing the different services that are available. Working as a team alongside the inpatients care team. We’ve got some wonderful inpatient social workers here at the Sunshine Coast University Hospital. And I know we do throughout the state as well. There’s larger metro hospitals such as the Royal that have got a number of teams in a number of different areas. I know they’ve got a specialist, BMT or bone marrow transplant unit, outpatient social workers. And certainly, everyone adds their own perspective and has their own specialist level of knowledge in their particular area., And different things impact people as an outpatient to what is the impact as an inpatient. And I think having that knowledge and sharing that knowledge is so very important.

[00:34:35] Maryanne: It’s also nice from what I know from patients, if they’ve built a good relationship with someone in the Metro, and that that Metro social worker is then familiar with who the regional social workers are. There’s that personal, oh look, you will be introduced to Angela Daly. When you return home, you’ve got a name, you’ve got that stability of being offered someone, not just get yourself in touch with, and it’s sort of a loose arrangement. You’ve got a person, you’ve got a name, you’ve got an opportunity to build a relationship, which I think is, again, for a haematological journey, which is long, having people in your corner is important.

[00:35:11] Angela: It certainly is, and I think I’m certainly not the only person here on the Sunshine Coast. And I do occasionally have a day off, so we certainly have some other wonderful colleagues. I know it’s actually much easier for me if I know a name of a Metropolitan colleague or just a number of a role that I can contact and say, “hey, we’ve got this person coming down to Brisbane, these are their current concerns, they’ve given me the go ahead to have a chat with you, who do I best link them in with, what can I tell them about the local services,” and vice versa. So the metropolitan teams having a regional person that they can contact. Even if it is not me directly that the people liaise with we’ve got a wonderful clinical assistant, we’ve got another two social workers here now in outpatients, and then we’ve got a couple of social workers. We’ve got a senior social worker and a HP3 or entry-level social worker on our ward. Certainly, if it’s not me, just having that local contact person. Just like we have our clinical nurses as well, specialist clinical nurses.

[00:36:18] Maryanne: Absolutely. Look, I think you’ve shared some really wonderful insights and aspects of who you are, what your role is, your background, what drives you. So I’d like to take this opportunity to thank you, Ange, for joining me here this morning. Having known you over a number of years. I do feel privileged to have that connection. Connection and communication is key from what I see and how I work. So thank you for joining us this morning on Talking Blood Cancer.

[00:36:44] Angela: Thanks so much for having me, Maryanne, and certainly having that long-standing connection with the organisation helped me with a depth of knowledge as to how the organisation can support a lot of the patients with haematological conditions.

[00:36:59] Maryanne: Lovely.