People with cancer need good access to palliative care, but not everyone gets the same access to these services. This can leave some patients with unresolved problems which may affect their quality of life.

The purpose of this study was to test whether it was feasible to conduct a large clinical trial of a new needs assessment tool (NAT-C) for clinicians to use with cancer patients in primary care.

About the project

Funder: Yorkshire Cancer Research
Time frame: October 2015 to January 2019
Contact for more details: Professor Miriam Johnson ( and Dr Joseph Clark (

We recruited 47 cancer patients and 17 carers from four general practices in Hull to take part in this initial small scale study. Eleven doctors, nurses and research support staff also took part in interviews and focus groups to give their views on the NAT-C and the possibility of a larger trial.

At the start of the study nearly three-quarters (72%) of patients had unresolved problems. When the needs assessment tool was used, after one month the proportion of patients with unsolved problems had reduced to just over half (54.8%).

Carers also filled out questionnaires and their unresolved problems also reduced as the study continued.

As well as testing the needs assessment tool we wanted to find out whether the questionnaires we were using were meaningful to people taking part in the study. This would help us select the best questionnaires to use for the large scale trial, CANAssess2.

Patients, carers and clinicians all supported a larger trial to find out if the NAT-C is effective in reducing patient carer problems. We now have the information we need to be confident that this large scale trial can be conducted successfully and it will be going ahead from 2020.

To read more about this study please download the patient results booklet.


Clark J, Amoakwa E, Wright-Hughes A, Blenkinsopp J, Currow DC, Meads D, Farrin A, Allgar V, MacLeod M and Johnson M. A cluster randomised trial of a Needs Assessment Tool for adult Cancer patients and their carers (NAT-C) in primary care: A feasibility study. Plos One. 2021.