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.

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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.

This video explains what a Holistic Needs Assessment is and how it helps people talk about their concerns. It shows how an HNA can support you to get the help you need at the right time.

This animation has been co-designed with patients and staff from: Guy’s & St Thomas’ NHS Foundation Trust, Northern Care Alliance NHS Foundation Trust, Imperial College Healthcare NHS Trust and Macmillan.

It is part of the Improving Personalised Care and Support research study. The study is funded by The Healthcare Improvement Studies (THIS) Institute and co-sponsored by King’s College London and Guy’s & St Thomas’ NHS Foundation Trust. Artwork was prepared in partnership with Nifty Fox Creative.

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.  Alternatively, we provide the HNA Concerns Checklist paper versions that is Head & Neck Specific. 

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.

Leaflet, poster and infographic

Improving personalised care and support study hand logo

These resources were co-designed with patients and staff as part of the Improving Personalised Care and Support research study, the same study mentioned in the animation.

Patient leaflet

A guide to the Holistic Needs Assessment for people living with cancer. Including what to expect, how it works, and how you can prepare for your assessment.

Poster

You can display this poster in clinical and support settings to help people understand what a Holistic Needs Assessment is and why it’s offered.

Infographic

This is a visual overview of the Holistic Needs Assessment process and how it helps identify and discuss a person’s needs.

eHNA invitation leaflet

If you’re using Macmillan’s eHNA you can download and print this invitation leaflet. Printing it double sided will give you four invitation leaflets on a sheet of A4 paper.
Print page

For your patients

Macmillan Support Line

Our specialist advisers can give advice and support to your patients. Encourage them to contact us us on 0808 808 00 00, 7 days a week, 8am to 8pm.
Cancer information in other formats and languages

We have cancer information in different languages and formats, including audio, Braille, British Sign Language videos, easy read booklets, eBooks and large print.
Booklets

It’s quick and easy to order free booklets to give to your patients, their families and carers. Topics include cancer types, treatment, and emotional support.
For your patients
We do whatever it takes for people living with cancer, no matter what their situation. Find out about Macmillan’s support services.