After recurrence surveillance recedes: professional accounts of how non-recurrence concerns become service work in cancer survivorship aftercare
File(s)
Published online version
Author(s)
Kierkegaard, Patrick
Su, Bowen
Simson, Gavriella
McGregor, Alison
Grayer, Justin
Type
Journal Article
Abstract
After cancer treatment, suspected recurrence often retains a clear service form through appointments, tests, specialist review and escalation. Other treatment-related concerns, including swallowing, nutrition, bowel, sexual, functional and psychosocial problems, may persist or emerge as scheduled surveillance recedes. We examined how professionals described such concerns becoming easier or harder for services to recognise and act on.
We conducted a focused interpretive qualitative analysis of 27 professional interviews with participants working in two London NHS trusts and additional supportive-care services, including third-sector provision outside London. Using the Framework Method, we analysed accounts of service timing, accepted remit, capacity and cross-boundary work. Professional accounts were treated as evidence about service organisation and reported practice, not as proxies for survivor experience.
The analysis identified five related findings that converged on three dimensions of organisational placeability: whether a concern remained visible within service attention, whether at least one service accepted it within its remit, and whether a feasible, authorised response could follow. When these dimensions did not align, concerns depended more heavily on self-initiation, local workarounds or discretionary professional brokerage.
The study does not estimate unmet need, compare follow-up models or evaluate patient-initiated follow-up. It indicates that a contact route alone is insufficient. Service redesign should also specify which service can take up a concern and what response can follow after recurrence surveillance recedes.
We conducted a focused interpretive qualitative analysis of 27 professional interviews with participants working in two London NHS trusts and additional supportive-care services, including third-sector provision outside London. Using the Framework Method, we analysed accounts of service timing, accepted remit, capacity and cross-boundary work. Professional accounts were treated as evidence about service organisation and reported practice, not as proxies for survivor experience.
The analysis identified five related findings that converged on three dimensions of organisational placeability: whether a concern remained visible within service attention, whether at least one service accepted it within its remit, and whether a feasible, authorised response could follow. When these dimensions did not align, concerns depended more heavily on self-initiation, local workarounds or discretionary professional brokerage.
The study does not estimate unmet need, compare follow-up models or evaluate patient-initiated follow-up. It indicates that a contact route alone is insufficient. Service redesign should also specify which service can take up a concern and what response can follow after recurrence surveillance recedes.
Editor(s)
Timmermans, Stefan
Date Issued
2026-09
Date Acceptance
2026-09-18
Citation
SSM: Qualitative Research in Health, pp.100876-100876
ISSN
2667-3215
Publisher
Elsevier
Start Page
100876
End Page
100876
Journal / Book Title
SSM: Qualitative Research in Health
Copyright Statement
© 2026 Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/
Subjects
Aftercare
Cancer Survivors
Health Services
Health Services Needs and Demand
Health Services Research
Qualitative Research
organisational placeability
Publication Status
Published online
Article Number
100876
Date Publish Online
2026-09-19