Qualitative Lead(s)
Dr Clair Le Boutillier
Project Lead & Team
Dr Clair Le Boutillier, THIS Institute Research Fellow, King’s College London
Project Dates
2022-2026
Funding Source(s)
The Healthcare Improvement Studies (THIS) Institute
Qualitative Design used
- Participatory and Creative Research
- Implementation Research and Improvement Science
- Developing and Adapting Interventions
- Methodological Research
Field of Research
Psycho-Oncology, Participatory Research
Geographic/Contextual Setting
The study followed five colorectal cancer teams (across three NHS Trusts) as they completed the HNA process from service offer to personalised care and support planning meeting. The study started out by exploring the experience of the HNA through video-reflexive ethnography, before going on to co-design improvements.
The improving personalised care and support study was undertaken to gain a better understanding of how personalised care and support planning works (or not) from the perspectives of people who are living with colorectal cancer, and their clinicians, and to co-design improvements. Funded by THIS Institute and sponsored by King’s College London and Guy’s & St Thomas’ NHS Foundation Trust, the study explored the experience of the Holistic Needs Assessment (or HNA) and asked what’s important to people involved in the personalised care and support process.
Qualitative Approach and Methods
Which qualitative methods were used?
The study used a collaborative, participatory, multi-method approach that blended the double diamond design process, Video-Reflexive Ethnography and Experience-Based Co-Design, and engaged people at professional, policy and practice levels.
Findings, Learning & Impact
Summary of main findings
People who are supported to participate in their own health and care have improved patient experience. Holistic assessments, such as the HNA, personalise care by offering the opportunity for patients to work in partnership with clinicians to identify needs and goals that are most important to them. The challenge is that the HNA is not yet widely embedded, and where it is implemented, there are variations in quality (the content, delivery, and timing).
Why were qualitative methods used in this project, and what did they enable?
Patients and clinicians worked together to co-design a suite of seven final products to improve patient experience.
This scribe timelapse offers an overview of the co-design conversations:
We listened to people’s stories and learned what was important to everyone involved in the HNA process. Patients and clinicians explained that people often feel overwhelmed, have other treatment priorities at the time of diagnosis, and would benefit from reminders about the HNA. Patients told us that they were not aware of the HNA or did not understand what it was about. We noticed a difference in the language and terminology used by the care team (for example, clinical talk (words like ‘holistic’, ‘assessment’ and ‘care plan’)) and what the HNA means to patients (like, ‘it’s about my wellbeing’). The co-designed content attempts to bridge this gap, to better inform people about the benefits and process of the HNA, and to bring the HNA closer to patients.
The final co-designed products are national resources that are hosted centrally by South East London Cancer Alliance and Macmillan Cancer Support.
You can also access the video products here, and download visual materials for printing under “Creative/Visual materials” below:
Improving the HNA offer: Patient-facing animation
Improving the personalised care and support conversation: Staff-facing pocket conversation guide
Improving the personalised care and support conversation: Staff training video with voiceover and flipbook
Please email clair.le_boutillier@kcl.ac.uk for access to mp4 files, if needed, for hosting on websites, intranets, or on clinic screens.
Impact & influence
Winner of the 2026 King’s Engaged Research Award for participatory approaches to research (national level).
Links, Outputs & Resources
Creative/visual materials
- Improving the HNA offer: patient-facing visual guide
- Improving the HNA offer: patient-facing trifold leaflet
- Improving the HNA offer: clinic poster for patients and staff
- Service blueprint: for those working at a policy level
©2026 King’s College London. All rights reserved, except for permission is granted to use, reproduce, distribute, adapt, and modify these materials for non-commercial purposes in clinical, educational, and research settings, provided that:
Proper acknowledgment is given to the copyright holder, identified as “© 2026 King’s College London”, in a reasonably prominent location in any reproduced or adapted/modified version; and the original source funder, “Funded by THIS Institute”, is acknowledged.
If you wish to obtain a commercial copyright licence for this work, then please contact King’s College London’s IP& Licensing Team: licensing@kcl.ac.uk.
Acknowledgements
The improving personalised care and support planning study was funded by a The Healthcare Improvement Studies (THIS) Institute fellowship award and co-sponsored by King’s College London and Guy’s & St Thomas’ NHS Foundation Trust. We would like to thank patients and staff from Guys & St Thomas’ NHS Foundation Trust, Imperial College Healthcare NHS Trust, Northern Care Alliance NHS Foundation Trust and Macmillan Cancer Support for taking part in this study. Thanks also to Nifty Fox Creative for providing the artwork and joining the co-design team.
Find out more about the research here: Dr Clair Le Boutillier – THIS Institute – The Healthcare Improvement Studies Institute