The Service Pledge

If you want to find out more about the Service Pledge, please email service.pledge@breastcancernow.org.

What is the Service Pledge?

We know that people’s experiences of care can affect their clinical outcomes. That’s why we need to keep them at the heart of NHS services.

But we also understand that pressures to meet targets and stretched resources can make this hard. That’s why our Service Pledge is here to help both hospitals and their patients.

The Service Pledge helps create a culture of continual improvement across NHS teams and hospitals. And by sharing best practice at a regional and national level, we can help deliver consistently high-quality services for both breast cancer patients and the professionals who support them.

1. We help hospitals gather feedback from primary and secondary breast cancer patients and hospital staff on their breast cancer services.
2. Then, we work with patients and hospital staff to come up with a plan – a ‘Service Pledge’ – to act on that feedback and create positive change.

This gives hospitals a chance to directly engage with patients and understand their views. And it gives healthcare professionals the chance to share their experiences, so they can be given better support and ultimately provide the best in breast cancer care.

Breast Cancer Now's Service Pledge 2023/2024 has been sponsored by Novartis Pharmaceuticals UK Limited. Breast Cancer Now's Service Pledge 2025/2026 has been jointly sponsored by Eli Lilly and Company Limited, Novartis Pharmaceuticals UK Limited, and Roche Products Ltd. Lilly, Novartis and Roche have not had any control or involvement in this programme.

What are our successes so far?

We developed the Service Pledge in 2003 to help patients and healthcare professionals work in partnership to improve patient experience in breast cancer across the UK. Since then:

• We’ve worked with over 150 breast services across the country
• We’ve helped deliver over 400 improvements for primary and secondary breast cancer patients over the past 5 years alone

Below you can find the action plans of hospitals we’ve worked with recently. And the improvements they’re making to their breast cancer service as a result of working with patients through the Service Pledge.

What are the stages of the Service Pledge?

1. We work with breast cancer services across a Cancer Alliance or region and their staff to identify and recruit patients and staff to take part  
2. We use focus groups and patients and staff surveys to find out what people think about their breast cancer service 
3. We review, analyse and collate the feedback 
4. We discuss the feedback with patients and hospital staff 
5. Patients and hospital staff work together in partnership to co-design improvements for their breast cancer service 
6. We help to facilitate putting the improvements into practice 

How are patients involved?

The Service Pledge actively involves local patients at each breast cancer service to develop a more complete understanding of the challenges and opportunities to improve treatment and care. Patients can use their experience of breast cancer as an empowering way to help improve the services others will receive in the future. 

As well as working with local patients, we recruit patient advocates, who are trained volunteers with a personal experience of breast cancer. They play a key role in the Service Pledge, helping to support patient involvement and provide an expert sounding board. 

How do we work with healthcare professionals?

Through the Service Pledge, healthcare professionals can share their experiences. Combined with patients’ feedback, this provides a deep, broad understanding of how to improve the services teams provide and helps do the best for patients.

We provide support throughout the process – sharing expert insight, streamlining the process and keeping healthcare professionals motivated, so that services get as much out of it as possible.

How do we involve Cancer Alliances?

One of the main aims of Cancer Alliances is to drive local change in the quality of cancer services to improve cancer outcomes and patient experience. 

The Service Pledge recognises that patient experience is as important as clinical effectiveness and safety. By continually improving services, Cancer Alliances can help more people with breast cancer to live and receive the support they need to live well. 

By working with Cancer Alliances across the country, the Service Pledge makes sure that learnings and best practice are shared across teams, hospitals and regions, creating consistency in the standard of breast cancer care. 

Read about the hospitals we’ve helped so far 

Below you can find the action plans of hospitals we’ve worked with recently. And the improvements they’re making to their breast cancer service as a result of working in partnership with patients through the Service Pledge.