Test of Change Phase 1 Evaluation Report: Northern Ireland
Overview
The Macmillan Personalised Care Support Worker (PCSW) Test of Change was a 14-month pilot delivered across the Northern Health & Social Care Trust and Southern Health & Social Care Trust between January 2025 and February 2026. Funded by Macmillan Cancer Support, the programme tested the impact of introducing Band 4 Personalised Care Support Workers into cancer services to enhance personalised care and support people affected by cancer.
The evaluation demonstrates that PCSWs play a valuable role in supporting people affected by cancer through Holistic Needs Assessments (HNAs), personalised care planning, timely signposting and coordination of support services, while enabling Clinical Nurse Specialists (CNSs) to focus on complex clinical care.
Key Achievements:
Improving Personalised Care
During the pilot:
- More than 2,000 patients were offered a Holistic Needs Assessment.
- Over 570 personalised care plans were generated.
- Patients received earlier support for emotional, practical, social and wellbeing concerns.
- Personalised care conversations helped identify what matters most to individuals throughout their cancer journey.
Supporting Patients
The most commonly identified concerns included:
- Fatigue
- Anxiety and worry
- Sleep difficulties
- Financial concerns
- Thinking about the future
- Diet, nutrition and physical activity needs
Patient feedback highlighted the value of feeling listened to, supported and empowered during a challenging time, with many describing the service as reassuring, informative and highly impactful.
Strengthening the Workforce
The evaluation found that the PCSW role:
- Released Clinical Nurse Specialist time for advanced clinical practice.
- Improved workforce capacity and sustainability.
- Enhanced multidisciplinary working.
- Supported more consistent delivery of personalised care across cancer pathways.
An estimated 570 hours of CNS time were released during the pilot, creating opportunities for nurses to focus on patients with more complex clinical needs.
Why It Matters
The findings demonstrate that Personalised Care Support Workers can make a significant contribution to delivering the ambitions of the Northern Ireland Cancer Strategy, particularly ensuring patients have access to holistic needs assessment and personalised care planning.
The pilot has shown measurable benefits for:
- Patient experience
- Workforce sustainability
- Service efficiency
- Equity of access to personalised care
- Living Well With and Beyond Cancer outcomes
Looking Ahead
Building on the success of Phase 1, Macmillan Cancer Support has committed £1.6 million over the next three years to support regional expansion of the PCSW model across all Health and Social Care Trusts in Northern Ireland.
Key priorities include:
- Regional rollout of the PCSW service.
- Recruitment of additional Personalised Care Support Workers.
- Independent external evaluation.
- Continued workforce development and standardisation.
- Improved integration with personalised care services and neighbourhood models of care.
Download the Full Report
Macmillan Personalised Care Support Worker Test of Change NI Evaluation Report May 2026
Read the full report to learn how personalised care support workers are helping transform cancer care across Northern Ireland.