From survival to quality of life: why PROMs must become routine in cancer pathways

Guest author: Dr Charlotte Roberts, Client Delivery Lead, My Clinical Outcomes

On 4 February 2026, the UK government and NHS England published the first-ever National Cancer Plan for England. It set out a long-term, system-wide ambition: by 2035, three in four people diagnosed with cancer will survive for five years or more – supported by care that is faster, more joined-up and more responsive to what patients experience.

The plan is notable not only for its survival targets (where England has historically lagged behind many comparable countries), but also for its wider philosophy: cancer care shouldn’t be judged solely by clinical and operational metrics. It should also reflect how people live with, through and beyond cancer. That’s where patient-reported outcomes come in.

What PROMs add that clinical metrics can’t

Patient-Reported Outcome Measures (PROMs) are structured questionnaires that patients complete about symptoms, wellbeing and quality of life. Unlike traditional clinical data – scans, lab results and tumour markers – PROMs capture the lived experience of treatment and recovery.

When collected consistently, they can inform:

• personalised symptom management
• early detection of treatment side effects
• shared decision-making in clinics
• service design that reflects what matters most to patients

PROMs in routine practice: where are we now?

Despite a strong evidence base demonstrating the value of PROMs (including the work of Professor Ethan Basch and others), uptake in routine cancer care has been uneven.

In May 2024, Dr Sally Wheelwright, Professor Ollie Minton and colleagues from the University of Sussex, conducted a survey of PROM use in routine cancer care across NHS trusts in England providing cancer services using a Freedom of Information (FOI) request. Of the 112 Trusts (94%) that responded, 20 (18%) reported using PROMs to support routine cancer care (published June 2025).

But the direction of travel is now clearer because of the new National Cancer Plan: services are increasingly encouraged – and expected – to embed PROMs into routine pathways, from diagnosis and active treatment through to survivorship and palliative care.

Why digital enablement matters

One of the practical barriers to widespread PROMs adoption is that collecting, scoring, interpreting and acting on PROMs at scale is hard to do with manual or fragmented approaches. To be sustainable, PROMs need to fit into day-to-day clinical workflows and information governance requirements, while also producing usable insight for teams.

That’s why NHS organisations should make full use of the digital tools available to them to support routine PROMs collection and use.

My Clinical Outcomes

My Clinical Outcomes is one example of a tool that has been used by over 280 hospitals in the UK and with many NHS Trusts in England to measure PROMs across oncology services – supporting teams to capture patient-reported outcomes and apply them in service improvement. For example, helping to address particular challenges in the most common cancer in the UK, breast cancer, where new drugs (including CDK5/6 inhibitors) have been approved by NICE in the last year [1].

People with early breast cancer are set to benefit from expanded access to a treatment combination designed to help prevent their cancer from returning. This puts increased pressure on breast cancer treatment services which need to provide additional capacity for treating patients with these new drugs and the subsequent monitoring that is required during and after treatment cycles. This is where My Clinical Outcomes comes in, providing a way to monitor patients remotely through real-time symptom monitoring, adverse event management, tracking of quality of life.

Trials [2] have also shown that PROMS can support patients to stay on life-prolonging therapies for longer which improves survivability.

As with any digital tool used in clinical services, the key considerations are around information governance, security assurance, implementation support, and whether the tool integrates sensibly with existing pathways and systems. At My Clinical Outcomes, we’ve done the Data Protection Impact Assessments, the Digital Technology Assessment Criteria, the NHS Data Security and Protection toolkits, and we’re on national procurement frameworks. We’re safe, secure and audited to the highest industry standards (see our website for specific details) and we’re working towards NHS app integration.

Within Kent and Medway, Surrey and Sussex (KSS), My Clinical Outcomes is already in use in University Hospital Sussex (across palliative care and oncology – and award winning!  Learn more here), Royal Surrey (Head and Neck cancer) and in additional has recently gone live for use in breast cancer services in both Royal Surrey and East Sussex hospitals.  We’re delighted also to have the support for PROMs from the Surrey and Sussex Cancer Alliance as all Cancer Alliances bring together the key organisations, stakeholders and advocates in their area to coordinate cancer care and to improve outcomes for patients locally.

Vicki Havercroft, Programme Director – Cancer Nursing and AHPs, Surrey and Sussex Cancer Alliance reflects: “ePROMS is vital for the long-term management of cancer patients, with the increase in available treatments and the complexity of the associated toxicities, it is vital that organisations have the capacity and time to manage these patients. By utilising ePROMS tools it enables more patients to be carefully monitored remotely and therefore ensures that patients who really need a face to face assessment are given the time.”

The real goal: improving day-to-day lives

The ultimate prize is the impact on people’s lives. PROMs help put quality of life on a more equal footing with survival – so that services can respond to what patients actually experience, not just what is easiest to measure.

National plans can be powerful cultural signals. The National Cancer Plan’s emphasis on outcomes and quality of life, alongside stronger direction to embed them systematically, creates an opportunity: to move PROMs from “good idea” to routine practice – enabled by digital tools that make that shift achievable at scale.

[1] Information for our patients: NICE approval of ribociclib combination therapy: The Clatterbridge Cancer Centre

[2] Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial – PubMed

The views expressed are the author’s own and do not necessarily represent those of Health Innovation KSS. Content is for general information only and not medical advice; references do not imply endorsement. Information was accurate at publication and may change; Health Innovation KSS is not responsible for external links.