When Macmillan launched its Fair Cancer Care campaign, it reflected issues that we see regularly through our Fenland Community Cancer Champions project. Across the UK, people’s experiences of cancer care are not equal, and where someone lives can directly affect their access to diagnosis, treatment and ongoing support.

In rural areas such as Fenland, these differences are not abstract. Geography, transport, digital connectivity and the availability of local services all combine to shape how people experience their cancer journey, often in ways that place them at a disadvantage compared to those living in larger towns or cities.

Fenland: rural strengths, structural challenges

Fenland has strong communities and a high level of local resilience. At the same time, its rural nature creates barriers that are less common elsewhere. Through our work, we consistently encounter challenges including:

• long travel distances to major hospitals
• limited or unreliable public transport
• poor digital connectivity, reducing access to online information and support
• a lack of local, community‑based cancer support services

Individually these factors may appear manageable, but taken together they can significantly affect whether someone is able to seek help, attend appointments or access ongoing emotional and practical support. As a result, someone living in Fenland may have a very different experience of cancer care from someone living a relatively short distance away.

Why local support is needed

In Fenland, very little cancer support is delivered locally and in person. Cambridgeshire ACRE’s Fenland Cancer Champion Project exists to address this gap, providing one‑to‑one emotional and practical support, alongside locally‑based group sessions, for people affected by cancer.

This support is offered close to home and, where needed, through home visits. For some people, travelling to larger centres such as Peterborough, Huntingdon or Cambridge is simply not realistic due to illness, anxiety, lack of transport or caring responsibilities. In these circumstances, the availability of local support can determine whether people receive help at all.

As one individual told us:

“I wouldn’t have spoken to anyone about this if you hadn’t come to my home.”

Feedback such as this reinforces the importance of meeting people where they are, rather than expecting them to overcome multiple barriers at a time of significant stress.

What we see through delivery

Macmillan’s Fair Cancer Care campaign highlights how inequalities can shape access to support. In Fenland, our delivery experience reflects this directly. We regularly work with people who:

• miss appointments because public transport options do not align with hospital times
• delay seeking support as they struggle to access GP services
• are unaware of available help until contact is made locally
• are unable to engage with online provision due to poor connectivity or lack of digital equipment

These are not minor inconveniences. They can influence decisions about whether to seek help in the first place and can exacerbate feelings of isolation during treatment and recovery. The project aims to reduce these barriers by providing support that is accessible, local and flexible.

What the project has achieved

The Fenland Cancer Champion Project is now entering its final year of Macmillan funding. During the first two years of delivery, the project has operated with two part‑time staff and has:

• supported over 155 individuals through one‑to‑one sessions, tailored to need and duration
• delivered more than 35 local support groups across Fenland
• reached people who would otherwise have had no accessible local cancer support

Levels of engagement indicate a clear and ongoing demand for locally delivered provision. The take‑up of services suggests that unmet need exists and that barriers related to travel, confidence and access can be reduced when support is provided within communities.

Looking ahead

The number of people living with or affected by cancer is expected to increase over time. In rural areas such as Fenland, this reinforces the importance of ensuring that services are not only available, but genuinely accessible.

As the project moves through its final funded year, we will continue to highlight the realities of cancer care in rural communities and the role that local provision plays in addressing inequality.

Fair cancer care should not depend on postcode and progress relies on effective partnership between community‑based organisations and wider cancer services.

If you are Fenland-based and you, or someone you know, would like further support through our Fenland Community Cancer Champions project, please get in touch with Caitlin Evans, our Rural Health and Wellbeing Manager.