What is Personalised Care and Support Planning (PCSP)?

Personalised Care and Support Planning (PCSP) helps people living with cancer to take an active and empowered role in the way their care is planned and delivered, with interventions and care tailored around the things that matter most to them.

It is achieved through a series of supportive conversations in which the patient, or someone who knows them well, actively participates to explore the management of their own health and well-being in the context of their life and family situation.

What are the benefits of PCSP?

Personalised Care and Support Planning will help you to:

  • facilitate conversations with patients
  • identify their needs (with Holistic Needs Assessments)
  • develop a Personalised Care and Support Plan
  • share the right information, at the right times
  • signpost to local support services.

We've always championed a personalised approach to care. Building on our success with the Recovery Package, we are committed to supporting the NHS Long Term Plan to deliver PCSP for people living with cancer.

What are the interventions of PCSP?

PCSP is achieved with the following interventions:

  • Personalised Care and Support Plans (based on Holistic Needs Assessments)
  • End of Treatment Summaries
  • Primary Care Cancer Care Reviews
  • Health and Well-being Information and Support.

We have the tools and resources to help you deliver these interventions below.

Personalised Care and Support Plans

A Personalised Care and Support Plan ensures people’s physical, practical, emotional and social needs are identified and addressed at the earliest opportunity.

A Personalised Care and Support Plan will help you to:

  • keep a record of conversations, decisions and agreed outcomes
  • understand a patient's care and support needs, their life and family situation
  • know what is required to make the plan achievable and effective.

Holistic Needs Assessments

To develop a care plan, you will need to carry out an assessment of the person's holistic needs to understand how to support them. We've created tools and resources to help you carry out a Holistic Needs Assessment (HNA), on paper or electronically (eHNA).

Learn about Holistic Needs Assessments

End of Treatment Summaries

A Treatment Summary is a document produced by the hospital clinician at the end of initial treatment for cancer. It's designed to be shared with the patient and their GP.

The End of Treatment Summary usually contains:

  • an overview of any treatment the patient has received
  • details of any potential side effects of treatment
  • the signs and symptoms of cancer recurrence
  • contact details to address any concerns.

The End of Treatment Summary also supports GPs with Cancer Care Reviews.

Download our guide for professionals

We have created a how-to guide with information, advice and templates to help secondary care professionals with End of Treatment Summaries for people living with cancer.

Download the guide

Primary Care Cancer Care Reviews

A Cancer Care Review (CCR) is a conversation between a patient and their GP or Practice Nurse about their cancer journey. A CCR can help patients to:

  • talk about their cancer experience and concerns
  • understand what support is available in their community
  • receive the information they need to begin supported self-management.

The NHS's Quality and Outcomes Framework (QOF) requires primary care professionals to carry out a CCR within six months of a patient's cancer diagnosis.

We have listed our 10 top tips for effective Cancer Care Reviews.

How to access the CCR templates

We've developed electronic CCR templates on all major GP IT systems:

  • INPS Vision

    To access the CCR template in INPS Vision:

    • In the Vision+ Consultation Manager, select the arrow on the right-hand side of the + icon and select ‘clinical templates’.
  • TPP SystmOne

    To access the CCR template in the TPP SystmOne:

    • System > Resource Library > type 'macmillan' as the key search term and look for 'Macmillan Cancer Care Review Template 2019'.
  • EMIS

    To access the CCR template in EMIS, follow this pathway:

    • EMIS Library > EMIS Protocols > Third Sector Partnerships > Macmillan/Cancer Support > Macmillan Cancer templates.

If you would like more information on how to access the CCR template within your system, please email macdocs@macmillan.org.uk.

Health and Well-being Information and Support

Sharing information helps people living with cancer, their family and friends get the support they need before, during and after cancer treatment. You can share it in many ways, such as at an event, a clinic or virtually to ensure people are fully supported.

We know people who receive the right information, at the right times, have a much better understanding of their cancer, as well as the confidence to make informed choices about their treatment. They will also have a better knowledge of:

  • the signs and symptoms of cancer recurrence
  • the consequences of cancer treatment
  • how to deal with the physical and emotional impacts of cancer
  • what support is available and how to access it.

How we can support your patients

Learn out about all the ways we can support your patients.

How to access training and support

We're committed to delivering personalised care for people living with cancer, and we need your support to help us deliver it. We offer a free e-learning course for health and social care professionals.

Access our free training course