Living With and Beyond Cancer Programme

The Living With and Beyond Cancer Programme aims to enable and empower patients to recover as fully as possible and to live well with cancer throughout their treatment and beyond.

The Programme consists of five main interventions (you can read more about these below):

  1. Holistic Needs Assessment and Care Plan
  2. Treatment Summaries
  3. Living Well Offer
  4. Cancer Care Review (by your GP)
  5. Person Centred Follow Up

Why are Living With and Beyond Cancer Services so vital?

There has been a lot of positive feedback about the treatment patients/people living with cancer received whilst at the Trust:

“Cancer treatment and care at SaTH is second to none – with efficiency, kindness, personal service and good communication”

“Treatment at SaTH is world class – the staff are always available for questions and support”

However, it also identified gaps regarding the after care:

“After care is a bit of an afterthought. We feel cast adrift after our treatment without consistent info and support. Who gets what afterwards is a lottery!”

“After care towards the end of treatment is perhaps the least understood part of the cancer services but as my family and I are finding, it is the most vital part and could be so much better”

In response to this, the Living With and Beyond Cancer Programme was formed to introduce the five main interventions mentioned above. These interventions aim to improve the quality of life of anyone living with cancer and their loved ones.

A HNA is a simple questionnaire that is given to the patient within 31 days of being diagnosed. It is a way that they can highlight the issues that they are concerned about. Everybody is individual, and their concerns may be completely different to someone else who has also been recently diagnosed.

The HNA enables the person to think about other needs they might have that they may not have considered. These could include physical, practical, emotional, spiritual and social needs.

Once the questionnaire has been completed, a health professional will discuss the highlighted needs with the patient and signpost to the relevant services or support groups. This will be documented in a care plan which is available for the person to take away for future reference. The HNA may be repeated at the end of treatment or at any other time upon request should you feel this is required during your pathway.

The HNA can be completed by any health professional but the first one will usually be completed by your Clinical Nurse Specialist  (if one has been appointed) or a member of their team. If you have not been appointed a Clinical Nurse Specialist, the HNA can also be completed by the Macmillan Information and Support Managers who are based at the Hamar Centre at the Royal Shrewsbury Hospital and within the main hospital site at the Princess Royal Hospital, Telford as well as other practitioners within the hospital.

A treatment summary is a document you receive at the end of your treatment which is produced by the health care professionals within the hospital. The Treatment Summary will be given to the patient and sent to the GP with important information post treatment.

In addition to empowering the patient/person living with cancer by providing relevant information for them to use in everyday life, it aims to strengthen the communication between the secondary care and the primary care. Secondary care services are based within the hospital setting or clinic by someone who has specialist expertise whereas the primary care setting is the day-to-day healthcare available in your local area and includes services such as: your GP, chemists and community practices and nurses.

The Treatment Summary aims to guide the patient and the GP post treatment about what actions should be taken in addition to what signs and symptoms would highlight a referral back to Secondary Care.

The Living With and Beyond Cancer Team have spent time gaining feedback from the public, GPs and Consultants about their knowledge and opinions about Treatment Summaries and what content should be included. The next stage that will take place will be a ‘Task and Finish’ group which will include practitioners from the Primary and Secondary Care Settings. It will be a platform to discuss what content and format the Treatment Summary should take.

These sessions are designed to provide support throughout treatment and beyond.

The Macmillan Living With and Beyond Programme invites you to join one of our free living well sessions.

Over 220 people have already benefited from the Macmillan Living Well sessions:

“ Very informative and informal. Lots of useful tips and information. Well worth attending”
“ I am a carer so found the event very useful for me and my wife”
“This is the best day I have had in the last year”

Benefits of attending a Living Well Session:

  • Self-Help ideas and tips
  • Sharing and listening to experiences
  • Signposting to local support
  • Information and support about cancer and it’s side effects

The sessions are:

  • Free to attend
  • Available for anybody affected by cancer: patient, family, friend, carer or supporter
  • Catered with light refreshments
  • Filled with plenty of rest stops
  • In community settings throughout Shropshire to make it more accessible (details below)
  • Set in a friendly, informal environment
  • Interactive; sharing self-help ideas and tips within the group

For more information or to book a place:


Call: 01743 492 424

The Wakes, Oakengates, Telford, TF2 6EP (opposite Oakengates Theatre):

How to get there:

  • All details of how to get The Wakes via car, train and bus can be found on their website.
  • Parking: located within Oakengates Theatre Car Park; it is free and The Wakes is located at the top of a wheelchair accessible ramp

Mayfair Community Centre, Easthope Road, Church Stretton, Shropshire, SY6 6BL (next to the GP Surgery):

How to get there:

  • Parking: Easthope Car Park, SY6 6BZ – 1 minute walk from Mayfair Community Centre. Open 24hrs. Charged hourly, free 6pm-8am. Blue Badge charges apply – one extra hour added to time purchased.
  • Walk from the train station via Easthope Road: approximately 5 minutes (0.2 miles)
  • Ring & Ride: if you are a member of this service for this area, please contact them in the usual way to arrange transport.

A cancer care review is a discussion between a patient and their GP (or practice nurse) about their cancer journey. It helps the person affected by cancer understand what information and support is available to them in their local area, open up about their cancer experience and enable supported self-management

Often, with the patient’s consent, they will bring someone to support along with them so that they can act as an advocate when discussing their care. A supporter will often help turn any recommendations into manageable solutions.

The person centred follow up (previously known as stratified care pathways) enables follow-up care tailored to an individual patient. This will either take place through a supported self-management approach, with rapid access back into the specialist team should this be needed, or continued face-to-face follow up appointments with health care professionals.

Research has shown that these pathways have empowered patients to self-manage their condition. 78% of patients responding to the survey stated that they had the information, advice and support that they needed to manage their condition.

Of the patient’s that responded, 83% reported that they were more confident in managing their own care than before.

Patients also reported that the emotional impact of moving from treatment, where contact with healthcare professionals was frequent, to aftercare was difficult to manage.

In response to this evaluation, the Living Well Offer was formed. Further information about the programme can be found on this page, including the opportunity to attend a Living Well Session which offers support, advice and signposting to local services within the community as well as in the hospital. This offer is open to anybody affected by cancer. They can book on to the sessions as many times as they wish at any point within their pathway; at diagnosis, throughout treatment and after treatment has completed.

(reference: Macmillan. (2013). The Recovery Package. Available: Last accessed 11th January 2019.)

Contact Us

Programme Lead: Edith Macalister

Project Manager: Leah Morgan (note: currently on Maternity Leave)

Telephone: 01743 492 424