Does Personalised Stratified Follow-Up (PSFU) meet the health and wellbeing needs of people from under-served groups who have completed treatment for breast cancer? A qualitative study.

Background Personalised Stratified Follow-Up (PSFU) is an approach to follow-up after cancer treatment which involves patients re-accessing care when they think they need to, rather than attending predetermined clinic appointments.

The intended benefits of this approach include a more personalised experience for patients and increased capacity in outpatient clinics. 2.

Aims The aim of this study is to improve the health and wellbeing of people from under-served groups in England who have completed treatment for breast cancer by exploring whether PSFU meets their needs, and to develop supportive interventions for feasibility testing.

Specific objectives are: Workstream 1 (WS1): To identify what is already known regarding the implementation of PSFU for breast cancer across England.

Workstream 2 (WS2): To gain insight into the perceptions of relevant professionals regarding PSFU provision for breast cancer.

Workstream 3 (WS3): To explore the perceptions of patients from under-served groups regarding PSFU, and to propose interventions for future development and feasibility testing that will enhance PSFU. 3. Methods WS1: A mapping exercise to include: A scoping review of the literature relating to PSFU for breast cancer.

A qualitative interview with the lead for implementation of PSFU at each of the 21 cancer alliances in England.

A review of Office for National Statistics (ONS) demographic reports to identify three cancer alliances with the highest proportion of under-served groups.

WS2: Qualitative interviews with relevant professionals involved in delivering PSFU in NHS organisations within the three cancer alliances identified in Workstream 1 (n=15) as well as up to five people who support people with breast cancer through charities, to explore their experiences of PSFU (total=20) recruited through a snowballing technique.

WS3: Using a sampling frame informed by WS2 findings, we will conduct qualitative interviews with 8-10 patients from each of these three cancer alliances (n=30). Following data analysis, we will invite interviewees to attend a discussion group. We will hold two or three groups each with up to 6 participants (max total =18).

These groups will discuss our findings and their potential use to inform the development of interventions. Data will be analysed using thematic analysis1 with a thematic frame based on Normalisation Process Theory2. Timeline for delivery The duration of this project will be 21 months.

We will submit our scoping review for publication in month six (August 2024) and will develop our interventions in months 20 and 21 (October and November 2025).

Anticipated impact and dissemination This study is the first to explore the ability of PSFU to meet the needs of people with breast cancer from under-served groups, and to propose recommendations that will inform interventions for future development and feasibility testing.

Our findings will be disseminated to NHS Organisations across England through the networks we develop in WS1 and WS2 as well as the extensive networks of our team. We will also disseminate our findings via the UK Oncology Nursing Society (UKONS) and relevant charities.

Following completion of this project, we intend to apply for funding to further develop our recommendations and conduct feasibility testing.