Holistic Needs Assessments

A Holistic Needs Assessment can help you identify and address the needs and concerns of people living with cancer to develop a Personalised Care and Support Plan.

What is a Holistic Needs Assessment?

A Holistic Needs Assessment (HNA) is a simple questionnaire for your patients. You can carry out the assessment at any stage of the cancer pathway, on paper or electronically, to help you:

  • identify a patient's concerns
  • start a conversation about needs
  • develop a Personalised Care and Support Plan
  • share the right information, at the right times
  • signpost to relevant services.

Watch the video below to learn more about a Holistic Needs Assessment and why you should use it.

HNAs are a key intervention of personalised care for people living with cancer.

What happens at the assessment?

A Holistic Needs Assessment usually has three parts:

  • A questionnaire for patients
    This allows patients rate their concerns by giving them a score out of ten. These can be answered on paper (with an HNA Concerns Checklist) or electronically (with an electronic Holistic Needs Assessment). It usually takes 10 minutes for patients to complete the assessment.
  • A conversation to discuss the answers
    This is an opportunity to talk about your patient's needs and concerns, which may be physical, emotional, practical, financial or spiritual. Your patient may like to bring a carer, family member or friend to this meeting if they find it helpful. The conversation usually lasts around 20 minutes.
  • You create a care plan together
    You can now develop a Personalised Care and Support Plan to help address your patient's concerns. This can include information to help people self-manage, along with contact details of any helpful organisations or services. You can give patients a copy of their care plan to take away with them.

Electronic Holistic Needs Assessments (eHNA)

The electronic Holistic Needs Assessment (eHNA) is a web-based means of providing a Holistic Needs Assessment (HNA) in a way that's simple and secure. All you'll need is a digital device, such as a smartphone, tablet or computer with a web browser.

In the video below healthcare professionals talk more about the benefits of the eHNA.


When using Macmillan's eHNA, the patient's answers are securely sent to the clinician, where they can be developed into a Personalised Care and Support Plan. Allowing the patient to complete the assessment at home on their own device, and then carry out the care planning discussion virtually helps to support some of the new remote ways of working.
The care plan can be printed, saved or shared with the patient and their health care team once it's been completed. Your patient can also access an online portal to check their care plan at any time.

Macmillan's eHNA can also send copies of the completed care plans to many of the trust patient record systems, allowing Personalised Care and Support Plans to form a permanent part of the patient's medical record. Where local trusts work closely together and where patients have complex pathways, we can support the sharing of care plans with other providers so that as the care of the patient moves, visibility of the care plan can move with them.

When your organisation signs up to Macmillan's eHNA, you'll also have access to anonymous data from your own patients for reporting and analysis. This can help you to understand more about the needs of different groups of people. It can also be used to inform the planning and development of local cancer services.

Our Learning Hub has an online community for those using Macmillan’s eHNA, which includes: How to videos, webinar recordings of partner organisations explaining their implementation and use of eHNA, frequently asked questions and questions and a useful resources list.

Sign up your organisation today

You'll need to sign up your organisation to begin using the eHNA. When you've signed up, you'll get access to training and support to get you started.

Not sure how to sign up? Read our step by step guide.

Sign up now

Holistic Needs Assessment resources

We have developed resources to help you carry out HNAs, which include:

HNA Concerns Checklists

If you are not using the eHNA, download and print our HNA Concerns Checklist to offer the assessment on paper.

You can also use our 'What Matters to You' Checklist, which contains our concerns checklist, and new questions to help you understand what matters most to patients. We have a separate Palliative Care Concerns Checklist.

You can find checklists available in other languages below.

Information to address concerns

We produce information to help you address your patients' concerns. All of our information is written and approved by experts and is updated regularly, so it's always accurate. Our printable information lists Macmillan services and any relevant organisations, with space for you to signpost to local services.

If you're using Macmillan's eHNA you can access these information sheets directly from the care planning screens, and attach them to any care plans you share with patients electronically or in the eHNA Portal.