# The National Cancer Survivorship Initiative in England, and the Recovery Package

Source: https://onco.cc/terms/rejuv-history-ncsi-england/  
OnCo record `rejuv-history-ncsi-england` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

England ran a national programme on life after cancer from 2007. It produced a named bundle of four things every patient should get at the end of treatment, and a 2013 report that measured how rarely they got them.

## Summary

The National Cancer Survivorship Initiative was launched in England in 2007, a partnership of the Department of Health with the cancer charities and the NHS. Its own 2013 report describes the starting position in a sentence: "When the National Cancer Survivorship Initiative (NCSI) was launched in 2007, most of the focus in terms of improving cancer services was on the diagnosis and treatment of cancer." It published a vision in 2010 and then, on 29 March 2013, "Living With and Beyond Cancer: Taking Action to Improve Outcomes", a 135-page document addressed to commissioners and providers rather than to patients.

The arithmetic in that report is the reason it exists. Around 1.8 million people in England were living with a diagnosis of cancer, increasing by over 3 per cent a year, projected to rise to over 3 million by 2030. Its own summary page of England cancer survivorship in numbers records that 47.3 per cent of survivors express a fear of their cancer recurring, 40 per cent of prostate cancer survivors report urinary leakage, 19 per cent of colorectal cancer patients report difficulty controlling their bowels, 2.4 million follow-up appointments for clinical and medical oncology were made in 2011 to 2012, and 24 per cent of people were offered a written assessment and care plan, averaged across trusts. The last of those figures is the one that makes the others actionable: three quarters of people finishing treatment were not offered the thing the programme existed to give them.

The programme's main product was the Recovery Package, which the report describes as "a combination of assessment and care planning, Treatment Summary, and a patient education and support event (Health and Wellbeing Clinic)" and calls "potentially the most important building block for achieving good outcomes". The executive summary adds a fourth component to the integrated package: advice about, and access to, schemes that support people to undertake physical activity and healthy weight management. The report's recommendation on follow-up is explicitly financial, that any cost efficiencies achieved through changing follow-up be re-allocated to other parts of the survivorship pathway rather than banked.

This is the clearest national statement anywhere of what the end of treatment should contain, and it is a decade old. Whether the Recovery Package improved outcomes was not established by a randomised trial, and the English four-level model of psychological support that services were built around has since been retired without an equivalent replacement, which is recorded on the psychological access record in this front. OnCo did not verify the current commissioning status of the Recovery Package in the NHS from a primary source in this round and therefore does not state one.

## Fields

- Kind: Term
- Last checked: 2026-10-02
- Also known as: National Cancer Survivorship Initiative; NCSI; Recovery Package; Living With and Beyond Cancer
- Tags: rejuvenation; survivorship; history; uk; nhs

## Sources

- Department of Health, Living With and Beyond Cancer: Taking Action to Improve Outcomes (England, 29 March 2013): https://www.gov.uk/government/publications/living-with-and-beyond-cancer-taking-action-to-improve-outcomes
- Macmillan Cancer Support: After treatment: https://www.macmillan.org.uk/cancer-information-and-support/after-treatment

## Connected records

- terms: [Lost in Transition: the 2006 report that defined survivorship care, and the care plan it invented](https://onco.cc/terms/rejuv-history-lost-in-transition/)
- technologies: [Fear that the cancer will come back: how common it is, and when it stops being ordinary worry](https://onco.cc/technologies/rejuv-mind-fear-of-recurrence/), [Getting psychological help after cancer: the stepped-care model, and what is actually commissioned](https://onco.cc/technologies/rejuv-mind-access-to-psychological-care/), [Long-term follow-up in the United Kingdom: what a survivor is actually offered](https://onco.cc/technologies/rejuv-paed-uk-long-term-follow-up/), [Survivorship care and late-effects surveillance](https://onco.cc/technologies/survivorship-care-plan/)
- bottlenecks: [Rehabilitation is recommended everywhere and commissioned almost nowhere](https://onco.cc/bottlenecks/rejuv-agenda-rehabilitation-not-commissioned/), [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/)
- roadmaps: [Recovery and rejuvenation roadmap: cure is not enough → survivorship gets a name → the cohorts that measured the cost → exercise proven as treatment → biological ageing measured and sold → repair, if anyone funds it](https://onco.cc/roadmaps/rejuvenation-roadmap/)
- institutions: [Macmillan Cancer Support](https://onco.cc/institutions/macmillan-cancer-support/)
- fronts: [Recovery & Rejuvenation](https://onco.cc/fronts/rejuvenation/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- ideas: [Write a rehabilitation prescription at the end of treatment, and fund it like a drug](https://onco.cc/ideas/idea-rejuv-rehabilitation-prescription-at-discharge/)

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