Personalised Stratified Follow-Up

For Patients

• Access to better care that is personalised, based on individual needs
• Provides more support for those with complex conditions
• Help detect/manage cancer-related issues, connect people to suitable services and improves follow up rates
• Support for self-management includes early detection of symptoms, direct access to healthcare teams, improved understanding and confidence and lifestyle changes to reduce cancer risks
• Enhanced patient experience by minimising hospital visits and reducing anxiety through timely results

For Professionals

• Improved continuity of care with better query triage, quicker access to specialists and stronger communications with primary care teams
• Enhanced knowledge of managing side effects and navigating referral pathways for further support
• Referral/signposting to services and third sector support
• For Systems
• Enhances productivity by optimising professionals time, outpatient capacity and minimising duplicate tests
• Strengthens care integration and communication
• Reduces unplanned care demand and increases cost transparency, ensuring resources go to patients with complex needs

For Systems

• Enhances productivity by optimising professionals time, outpatient capacity and minimising duplicate tests
• Strengthens care integration and communication
• Reduces unplanned care demand and increases cost transparency, ensuring resources go to patients with complex needs

“I am extremely enthusiastic about my role and I feel it is a privilege to support patients through this service. Patient feedback on this service or remote surveillance is always positive – patients find it easy to navigate, very accessible and are so relieved and have so much more time freed up by not having to attend in-person follow-ups.”

“I see first hand how cancer care is improving by personalising care to meet the multitude of needs that need to be addressed throughout post-treatment surveillance. Clinical needs and diagnostics now follow an optimal pathway with results being relayed to patients in a more timely manner, reducing the anxieties that can occur. The role of the support worker allows continuity of care and better relationships between acute primary care settings. Patients feel empowered because they know there is a support network that is easily accessed if its ever needed. Education plays a huge part in a patients ability to self manage and through stratified follow up we can deliver a tailor-made educational package to all patients, giving them the means and knowledge to ensure that they are both mentally and physically well. I am incredibly proud of what I do and feel this role is extremely rewarding. It is a privilege to be involved with the future of cancer follow up and personalised care and the improvements being facilitated across our cancer alliance".