The mirrored burden and accountable handovers in cancer survivorship: co‑designing a post‑treatment transition standard
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Post-treatment transitions after active cancer care often lack clear ownership, timelines and closure rules, shifting coordination work onto survivors and staff. We aimed to identify how these failures arise and to co-design a handover standard for post-treatment survivorship care. In a two-stage qualitative study, Stage A involved semi-structured interviews with survivors and professionals (n=65) across head and neck, colorectal and gastrointestinal stromal tumour pathways; Stage B comprised four co-design workshops (n=21). We identified a mechanism we term mirrored burden, in which routine letters and electronic records fail to make responsibility explicit and both survivors and staff end up chasing care. Co-design produced a four-component handover standard centred on accountable correspondence, a clinically senior survivorship lead practitioner with delegated authority, clinic-based resolution capacity, and equity safeguards for non-digital access and communication needs, plus four equity-stratified audit-ready feasibility indicators for service-level evaluation.
Date Issued
2026-08-05
Date Acceptance
2026-06-03
Citation
npj Health Systems, 2026, 3 (3)
ISSN
3005-1959
Publisher
Nature Research
Journal / Book Title
npj Health Systems
Volume
3
Issue
3
Copyright Statement
© The Author(s) 2026. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1038/s44401-026-00125-9
Subjects
Aftercare
Cancer Survivors
Community-Based Participatory Research
Qualitative Research
Stakeholder Participation
Publication Status
Published
Article Number
ARTN 4
Date Publish Online
2026-08-05