The Electronic Holistic Needs Assessment allows people to identify and record any concerns that they may have following a cancer diagnosis or treatment, whether these are physical, practical, emotional, family, or spiritual. These can then be used by their health or care team, to help co-create their holistic care and support plan.

Why was this work needed?

A diagnosis of cancer can affect many aspects of someone’s life, and they can have concerns that go beyond their immediate clinical diagnosis and treatment. When a person is working with their health or care team to develop a care and support plan, it is important that this plan can reflect the full range of concerns that they have.

What happened?

Macmillan has developed its Electronic Holistic Needs Assessment (eHNA). It prompts people with a simple set of questions and allows the person to identify and prioritise any that have caused them concern. These are then shared with their health or care professional and used to focus their discussion, so that a personalised care and support plan can be developed between them.

What were the benefits?

The eHNA allows the holistic needs of the individual, and not just their clinical needs, to be better understood and addressed. It can allow issues to be flagged up earlier than would otherwise be the case, and provides a structured framework for discussing and recording how these issues can be resolved. Where appropriate, in providing individual care, the health or care provider can share the care and support plans with other professionals such as the individual’s GP or as the patient pathway moves from an acute to a community setting.

50,000 of these assessments have now taken place, with 275,000 individual concerns registered. This is a live system, so numbers are growing all the time. Organisations can use de-personalised data to look at their own group of patients and identify any patterns in the concerns raised locally, and Macmillan can carry out this analysis at a local or national level. This can then be used to inform care in the future, and to develop and enhance local and national support.

What type of data was involved?

The eHNA allows individuals to record their concerns, ranging across physical, practical, emotional, family and spiritual areas. It collects only data necessary for the care planning process, but with items such as the NHS number to allow health and care teams to follow patients’ concerns throughout their cancer pathway. Other items such as diagnosis and pathway stage allow more detailed analysis. Alongside the discussion with the health or care professional, the actions taken are also recorded as data items, so that further analysis can be done on which actions arise from each of the concerns.

Individuals give consent before completing the assessment, and while their health or care provider has access to all of the information recorded, Macmillan is only ever able to view de-personalised information.

Who funded and collaborated on this work?

This tool was developed by Macmillan Cancer Support, and the assessment and care planning tools developed by HealthUnlocked.

Where can I go for more information?

Planning your care and support: Having a holistic needs assessment

Collecting the data that matters, My Data, My Care, p.10