Holistic Needs Assessment
Case reference FOI2026/05717
Received 17 August 2026
Published 20 October 2026
Request
I am writing on behalf of Little Ripples, a charity working to improve emotional wellbeing and support for children and young people affected by a family member's cancer diagnosis. Little Ripples (Registered Charity No. 1218526) is building the evidence base for future work on this issue.
Our interest in this area began with the experience of families who found that support for children after a cancer diagnosis varied significantly depending on where they were treated. Some received timely Holistic Needs Assessments and clear referral pathways for their children. Others did not. We want to
understand how widespread this variation is, and to use that evidence to support NHS trusts, Cancer Alliances and policymakers in closing the gap.
Our questions are as follows.
Section I: Holistic Needs Assessment (HNA)
1.Does your Trust have a written policy, guideline or standard operating procedure describing when a Holistic Needs Assessment (HNA) should first be offered to adult cancer patients following
diagnosis, including any specific target timeframe? If yes, please provide a copy or link to the document, and state the target timeframe if one is specified.
2. Is the timing of the first HNA monitored through any local quality standard, performance indicator or audit? If yes, please provide the relevant documentation or description.
3.Is the offer or completion of HNAs monitored, recorded, or reported against any equality characteristic (for example ethnicity, disability, or deprivation) or against patients' first language? If yes and readily available, please provide the relevant documentation. If no, please confirm this.
Section II: Supporting Children and Families
4. Does your Trust have any written policy, guidance or assessment process requiring healthcare professionals to identify whether an adult cancer patient has dependent children (under 18 years of
age)? Please provide copies where available.
5. Where dependent children are identified, does your Trust have a documented pathway or protocol describing what information, advice or support should be offered to the patient and their family? Please provide copies where available.
6. Does your Trust provide any written information, leaflets, webpages or digital resources specifically intended to help parents diagnosed with cancer communicate with or support their
children? Please provide copies or web links.
7. Are the materials referred to in question 6 available in accessible formats (for example easy read or large print) or in languages other than English? If yes, please list which formats or languages,
where this is readily available. If no, please confirm this.
Section III: Referral Pathways
8. Does your Trust have formal referral arrangements for patients with dependent children to any of the following? Please indicate Yes/No for each, and provide the relevant pathway or protocol if
documented.
a) Psychological support –
b) Social work -
c) Family support services -
d) Children's services -
e) Voluntary sector organisations -
f) Other (please specify)
9. Does your Trust work with any external charities or voluntary organisations that provide support to children affected by a parent's cancer? If yes, please identify the organisations.
Section IV: Workforce
10. Are healthcare professionals involved in delivering HNAs provided with any guidance or training relating specifically to supporting patients with dependent children? If yes and centrally held, please provide the training materials or guidance.
Section V: Quality Improvement
11. Has your Trust undertaken any audit, evaluation, quality improvement project or service review since April 2024 relating to Holistic Needs Assessments or support for dependent children of adult cancer patients? If yes, please provide copies of any published reports or summaries.
Section VI: Governance and Engagement
12. Who within your Trust has executive or clinical responsibility for overseeing personalised cancer care and Holistic Needs Assessments? Please provide the job title(s) rather than personal names where appropriate.
Response
I am writing on behalf of Little Ripples, a charity working to improve emotional wellbeing and support for children and young people affected by a family member's cancer diagnosis. Little Ripples (Registered Charity No. 1218526) is building the evidence base for future work on this issue.
Our interest in this area began with the experience of families who found that support for children after a cancer diagnosis varied significantly depending on where they were treated. Some received timely Holistic Needs Assessments and clear referral pathways for their children. Others did not. We want to
understand how widespread this variation is, and to use that evidence to support NHS trusts, Cancer Alliances and policymakers in closing the gap.
Our questions are as follows.
Section I: Holistic Needs Assessment (HNA)
1.Does your Trust have a written policy, guideline or standard operating procedure describing when a Holistic Needs Assessment (HNA) should first be offered to adult cancer patients following
diagnosis, including any specific target timeframe? If yes, please provide a copy or link to the document, and state the target timeframe if one is specified.
No we do not have a trust written policy, however we use the Macmillan guidance which is to offer a patient at diagnosis and at 1 other point in their cancer pathway, or whenever the patient requests one.
2. Is the timing of the first HNA monitored through any local quality standard, performance indicator or audit? If yes, please provide the relevant documentation or description.
HNA data is supported through the Macmillan portal, however timing is not clearly defined in weeks/months but in titles such as ‘at diagnosis’ ‘at discharge’ , data is submitted to the Thames Valley Cancer Alliance. This data has now been incorporated in the Trusts cancer improvement group as part of the personalised care work.
3.Is the offer or completion of HNAs monitored, recorded, or reported against any equality characteristic (for example ethnicity, disability, or deprivation) or against patients' first language? If yes and readily available, please provide the relevant documentation. If no, please confirm this.
No, however we are able to provide HNAs in different languages as required
Section II: Supporting Children and Families
4. Does your Trust have any written policy, guidance or assessment process requiring healthcare professionals to identify whether an adult cancer patient has dependent children (under 18 years of
age)? Please provide copies where available.
No
5. Where dependent children are identified, does your Trust have a documented pathway or protocol describing what information, advice or support should be offered to the patient and their family? Please provide copies where available.
No
6. Does your Trust provide any written information, leaflets, webpages or digital resources specifically intended to help parents diagnosed with cancer communicate with or support their
children? Please provide copies or web links.
We use the charity SeeSaw for relevant documents and advise - SeeSaw | Grief support for children and young people in Oxfordshire
7. Are the materials referred to in question 6 available in accessible formats (for example easy read or large print) or in languages other than English? If yes, please list which formats or languages,
where this is readily available. If no, please confirm this.
No
Section III: Referral Pathways
8. Does your Trust have formal referral arrangements for patients with dependent children to any of the following? Please indicate Yes/No for each, and provide the relevant pathway or protocol if
documented.
a) Psychological support –
All patients within oncology are offered this but not specifically those with children
b) Social work -
No
c) Family support services -
No
d) Children's services -
No
e) Voluntary sector organisations -
No
f) Other (please specify)
9. Does your Trust work with any external charities or voluntary organisations that provide support to children affected by a parent's cancer? If yes, please identify the organisations.
Yes Maggies, Sobell, Hummingbird centre, SeeSaw, Mummy’s star, Shine
Section IV: Workforce
10. Are healthcare professionals involved in delivering HNAs provided with any guidance or training relating specifically to supporting patients with dependent children? If yes and centrally held, please provide the training materials or guidance.
No
Section V: Quality Improvement
11. Has your Trust undertaken any audit, evaluation, quality improvement project or service review since April 2024 relating to Holistic Needs Assessments or support for dependent children of adult cancer patients? If yes, please provide copies of any published reports or summaries.
HNAs are audited monthly by the personalised care lead these are not published
Section VI: Governance and Engagement
12. Who within your Trust has executive or clinical responsibility for overseeing personalised cancer care and Holistic Needs Assessments? Please provide the job title(s) rather than personal names where appropriate.
Lead Cancer Nurse oversees personalised care and holistic needs assessments
Documents
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