NEARLY HALF OF NHS TRUSTS LACK FORMAL PSYCHOLOGICAL SUPPORT PATHWAY FOR CANCER PATIENTS AFTER TREATMENT

New research by Future Dreams reveals a postcode lottery in post-treatment psychological support, with access varying dramatically across England  

• Freedom of Information responses from 81 NHS Trusts providing acute cancer care reveal cancer patients in England face a postcode lottery in post-treatment mental health support, with almost half (48%) lacking a formal survivorship pathway that includes psychological support and 15% reporting no post-treatment support at all 

• Support available after treatment varies significantly depending on where patients live, with the proportion of Trusts reporting a formal survivorship pathway ranging from 88% in the South West to 20% in the East of England 

• Almost a quarter (22%) of Trusts place formal time limits on psychological support, with access in some areas ending within months of treatment finishing or after a fixed number of sessions 

• Future Dreams research found that 76% of its users sought emotional support more than two years after completing primary treatment, highlighting how the need for support can persist long after treatment has ended 

Cancer patients across England are facing a postcode lottery in the psychological support available to them after treatment, according to new research from breast cancer charity Future Dreams. 

Freedom of Information responses from 81 NHS Trusts providing acute cancer care revealed significant variation in the support available once treatment has ended, with almost half (48%) reporting no formal survivorship or aftercare pathway that includes much-needed psychological support and one in seven (15%) providing no post-treatment support at all. 

The findings come as the Government develops its National Cancer Plan, which includes a commitment that every cancer patient will receive a personalised support plan covering their physical, emotional and practical needs throughout and beyond treatment. 

Separate research conducted by Future Dreams* found that 76% of its users surveyed sought emotional support more than two years after completing primary treatment, highlighting how support needs can continue long after treatment has ended.  

The charity’s analysis suggests access to post-treatment psychological support currently varies significantly depending on where patients live and which Trust provides their care. 

More than a third of Trusts analysed (39%) reported providing some form of post-treatment support but had no formal survivorship pathway in place, meaning patients may instead rely on referrals to external services rather than a clearly defined aftercare process. 

The variation was evident across England. Among the Trusts analysed, the proportion reporting a formal survivorship pathway ranged from 88% in the South West to just 20% in the East of England. 

In London, fewer than half of Trusts analysed (42%) reported having a formal survivorship pathway that includes psychological support after treatment. 

The research also found significant differences in how long support remains available. Almost a quarter of Trusts (22%) place formal time limits on psychological support, with access in some areas ending within months of treatment finishing or after a fixed number of sessions. By contrast, other Trusts described support as ongoing, needs-based or available for several years after treatment. 

Future Dreams also found that 12% of Trusts rely solely on external referral pathways for post-treatment psychological support, while more than a third (38%) referenced charities or third-sector organisations such as Macmillan, Maggie’s and Tree of Life as part of their post-treatment support offer, highlighting the role charities play in supporting patients after treatment ends. 

Future Dreams says the findings are particularly concerning because the need for emotional support often continues long after active treatment has ended. 

Sam Jacobs, CEO  at Future Dreams, said: “These findings paint a worrying picture of the support available to cancer patients once treatment ends. 

“At Future Dreams, we see first-hand how the emotional impact of breast cancer can continue long after treatment has finished. Our own research found that three quarters of our users surveyed sought emotional support more than two years after completing primary treatment. As the Government develops its National Cancer Plan, survivorship support must become a core part of cancer care rather than something patients have to navigate alone.” 

Dr Fharat Raja, Consultant Medical Oncologist and Future Dreams Trustee, said:“For many cancer patients, diagnosis is followed by an intense focus on getting through treatment. There is rarely the time or space to process how this life-changing event is affecting someone, their family, career and wider life. 

“Once treatment ends, many people experience a rush of emotions as they begin to process what they have been through. For some, that ‘back to normal’ moment never comes, which is why access to psychological support can be such an important part of recovery.” 

Joanna Franks, Consultant Breast and Oncoplastic Surgeon and Future Dreams Trustee, said: “Breast cancer treatment doesn’t end when treatment ends. Many patients go on to live long and fulfilling lives, but the physical and psychological effects of cancer can remain for years afterwards. 

“As more people survive cancer than ever before, survivorship must become a much bigger part of the conversation. Recovery is about more than treating the disease – it’s about helping people regain confidence in their future.” 

Zoe Yessaian, Senior NHS Mental Health Nurse and breast cancer survivor,  said: “During treatment I was focused on survival. There was always another appointment, another decision and another hurdle to get through. It wasn’t until active treatment ended that I really began to process everything that had happened and how much cancer had changed my life. 

“Despite working in mental health, I still found the emotional impact of breast cancer incredibly difficult. Cancer had taken away so much of the control I felt I had over my future, which is why support after treatment is so important. Recovery doesn’t simply begin and end with the physical side of cancer.” 

For further information about Future Dreams, please visit: https://futuredreams.org.uk/ or to ensure that long-term, holistic support is recognised as an essential part of the cancer care pathway – today and in the years to come. 

About Future Dreams

Future Dreams Breast Cancer Charity is the only dedicated breast cancer support service of its kind supporting people across the UK. The charity offers a wide range of in-person and online services, providing practical, emotional and psychological support for those impacted by breast cancer – from diagnosis, through treatment, and for many years beyond. This includes tailored support for people living with secondary breast cancer, alongside investment in groundbreaking research and the promotion of breast health awareness. 

For media enquiries, please contact media@futuredreams.org.uk

FOI Methodology 

Future Dreams submitted Freedom of Information requests to NHS Trusts in England providing acute cancer care. 

The request asked whether Trusts provide dedicated mental health or psychological support for adult cancer patients following the completion of primary treatment, whether a formal survivorship or aftercare pathway exists, the nature and duration of support available, and whether referrals to psychological services are recorded. 

For the purposes of the request: 

• “After treatment” was defined as the period within 12 months following the completion of primary cancer treatment. 

• “Mental health or psychological support” included services provided directly by the Trust or via commissioned partners, including psycho-oncology services, counselling, support groups and NHS Talking Therapies. 

A total of 81 NHS Trusts providing acute cancer care were included in the final analysis. 

Responses were received between April and June 2026 and analysed by Future Dreams. 

Percentages are based on the 81 in-scope NHS Trust responses included in the final dataset. 

Regional findings are based on the NHS Trust responses included in the final dataset and should not be interpreted as a ranking of all NHS Trusts within each region. 

*Future Dreams Visitor Survey 2025 

An anonymous online survey was conducted among the Future Dreams community. The survey was distributed by email between November 2025 and December 2025 to more than 5,000 registered users, with 340 respondents completing the survey in full. Responses were self-reported and analysed in aggregate.