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.
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. Alternatively, we provide the HNA Concerns Checklist paper versions that is Head & Neck Specific.
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									Concerns Checklists in other languages
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									Concerns Checklists - Head and neck cancers in other languages
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.
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									A-Z of concerns information The links below are PDFs that open in a new window. 
 
 Anger or frustration
 
 Breathing difficulties
 
 Changes in weight
 
 Complementary therapies
 
 Constipation
 
 Cough
 
 Diarrhoea
 
 Diet and nutrition
 
 Difficulty making plans
 
 Dry mouth
 
 Dry, sore and itchy skin
 
 Eating, appetite and taste
 
 Education
 
 Exercise and activity
 
 Fertility
 
 Giving up smoking
 
 Guilt
 
 Health and well-being
 
 Heartburn and indigestion
 
 High temperature or fever
 
 Hot flushes or sweating
 
 Housing
 
 Hopelessness
 
 Independence
 
 Loneliness and isolation
 
 Loss of interest in activities
 
 Making a will or legal advice
 
 Managing symptoms
 
 Memory or concentration
 
 Money concerns
 
 Moving around
 
 My appearance
 
 My medication
 
 Nausea or vomiting
 
 Numbness or tingling in hands or feet
 
 Pain
 
 Passing urine
 
 Patient or carer's support group
 
 Pet care
 
 Person who I look after
 
 Person who looks after me
 
 Planning for my future priorities
 
 Practical tasks
 
 Problems with alcohol and drugs
 
 Regret about the past
 
 Relationship with your partner
 
 Sadness or depression
 
 Sex and intimacy
 
 Sight or hearing
 
 Spiritual concerns
 
 Sore mouth
 
 Sleep problems
 
 Speech or voice problems
 
 Swallowing
 
 Swelling tummy (ascites)
 
 Swelling – lymphoedema
 
 Taking care of others
 
 Talking to children
 
 Talking to family and friends
 
 Talking or being understood
 
 Thinking about the future
 
 Thinking about the future (with advanced cancer)
 
 Tired, exhausted or fatigued
 
 Transport and parking
 
 Travel
 
 Unable to express feelings
 
 Uncertainty
 
 Work (employment)
 
 Work (self-employment)
 
 Work (unemployment)
 
 Worry, fear or anxiety
 
 Wound care
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									Young Lives vs Cancer If your patient is under 25, they may find the below information from our partner charity Young Lives vs Cancer helpful. The factsheets cover a range of topics relevant to young people facing cancer, including diagnosis, treatment side effects, education and work, and managing money. Diagnosis and tests for cancer Emotions when you're living with a terminal illness Exercise, diet and vitamin supplements Getting back to 'normal' after treatment ends How bad will treatment make me feel? Reasonable adjustments at work Where will I have my treatment and do I get a say?