Establishing an evidence base about experiences of young people's ambulatory cancer care

Complex cancer treatment usually given as an inpatient throughout the NHS has been transitioned to an outpatient pathway in a few UK cancer centres. Called Ambulatory Care, this treatment modality is made possible using portable infusion pumps and with patients taking responsibility for aspects of their clinical monitoring themselves. Patients have 24-hour access to specialist advice and stay close to the hospital overnight in case of need.
Within young people’s cancer services in particular, the drive for the development of Ambulatory Care (AC) was its potential to offer an enhanced, less clinical experience of cancer treatment. Anecdotally, we knew that young people liked receiving care away from the inpatient ward, but little was empirically known about how AC meets the needs and supports the well being of patients and their families. 
With growing interest in developing AC, this research set out to explore experiences of both delivering and receiving this: building knowledge to inform current and future services for those aged 16-24 and their families. A key aim was to understand whether refinements to the service were needed to better and more equitably support young people and their companions. 
Undertaken at University College Hospitals NHS Foundation Trust (UCLH), this was a participatory research project in which young people and companions from a wider cancer community became co-researchers, contributing to every stage and phase of this qualitative research. Funded by an NIHR doctoral fellowship, this research offers the first comprehensive exploration of stakeholder experience of the AC pathway within the UK.
This research was funded by NIHR through a Clinical Doctoral Research Fellowship [NIHR-ICA-CDRF-2018-04-034] awarded to Alison Finch, a cancer nurse. 
Key Findings

Click here or on the image above to be taken to the interactive resource.
Ambulatory Care contributes positively to young people’s experiences of cancer treatment, helping deliver more tailored, personalised care. Crucially, it retains aspects of life that are important to young people, fostering their autonomy and a sense of wellbeing. Journeying daily to care creates a requirement to go outside and keep active. Being more rooted in society rather than a clinical space during intense periods of cancer treatment was found not only to help physical strength and wellbeing, it supported their mental health.
The research identified the concept of agency as a fundamental and valued component of AC. We suggest that Ambulatory Care is an example of assets-based healthcare, contributing to positive health and wellbeing during cancer treatment. We would like as many people as possible to experience some of its known benefits and have developed a practical resource for health care professionals, to inform the development and delivery of young people's ambulatory cancer care.
This research offers the young people's cancer and wider NHS community evidence to inform policy, practice and future research inquiry and recommendations for the further national development of Ambulatory Care.

This study was the focus of an ARC NT blog, following a presentation at HSR UK. You can read this here: Ambulatory Care: Empowering Patients and Shaping the Future of Healthcare. You can also watch a summary of Alison and Rob's presentation here:

This study also featured at the exhibition on sense of our selves & hidden reflections. This exhibition took place at UCLH July-September 2022, sharing a selection of phone images that young people took as part of this research to depict aspects of their day-to-day life in AC.

Partners & Collaborators

University College Hospitals NHS Foundation Trust (UCLH)

Teenage Cancer Trust

Young Lives vs Cancer

Lead Investigator
Investigating Team
Faith Gibson (School of Health Sciences, University of Surrey & GOSH NHS Foundation Trust)
Rachel M Taylor (UCLH)
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