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.
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.
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.
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.
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.
A-Z of concerns information
The links below are PDFs that open in a new window.
Anger or frustration
Changes in weight
Diet and nutrition
Difficulty making plans
Dry, sore and itchy skin
Eating, appetite and taste
Exercise and activity
Giving up smoking
Health and well-being
Heartburn and indigestion
High temperature or fever
Hot flushes or sweating
Loneliness and isolation
Loss of interest in activities
Making a will or legal advice
Memory or concentration
Nausea or vomiting
Numbness or tingling in hands or feet
Patient or carer's support group
Person who I look after
Person who looks after me
Planning for my future priorities
Problems with alcohol and drugs
Regret about the past
Sadness or depression
Sex and intimacy
Sight or hearing
Speech or voice problems
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
Unable to express feelings
Worry, fear or anxiety
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.
Videos for patients
For your patients
Our specialist advisers can give advice and support to your patients. Encourage them to call us on 0808 808 00 00 (7 days a week, 8am-8pm).
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.