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Jo McGrath, a clinical nurse specialist, posing for photos outside Norfolk and Norwich hospital.

The Service Pledge

Our Service Pledge is a programme dedicated to improving breast cancer services.

The Service Pledge brings patients, healthcare professionals and Cancer Alliances together to work in partnership to design and deliver a concrete action plan of improvements, for everybody’s experience of breast cancer.

We understand that the coronavirus (COVID-19) pandemic will have a lasting impact on the NHS and the services it provides. The Service Pledge is vital in future-proofing breast care services and ensuring patient-centred improvements continue to be made.

Hear from patients and healthcare professionals about why they would recommend the Service Pledge.

Why we recommend the Service Pledge

How does it work?

We help hospitals gather patient and staff feedback on their breast care service through surveys and focus groups.

The feedback gathered is discussed to find practical ways of making meaningful improvements. Through listening and learning from each other, patients and healthcare professionals work in a true partnership.

Breast Cancer Now draws on 20 years’ experience of improving breast cancer services across the country.

To date, more than 140 breast services across the UK have worked with patients to develop their local Service Pledge, delivering over 400 improvements for primary and secondary breast cancer patients in the past 5 years.

The stages of the Service Pledge

  1. We ask patients and staff what they think about their breast cancer service
  2. We collate and analyse their feedback
  3. We review and discuss the feedback with patients and hospital staff
  4. Patients and hospital staff work together in partnership to co-design improvements for their breast service
  5. Improvements are implemented

How are patients involved?

The Service Pledge actively involves people with different perspectives of breast cancer, 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.

Every person's experience of breast cancer is unique and each one matters.

Linda, a middle-aged lady with blonde hair, is shown wearing a multi-coloured striped long-sleeve top. Her left arm is raised during a conversation she is having at a conference table. There are glasses of water on the table.

To be able to input our voices and thoughts into the big NHS machine and see our ideas come to life was fantastic.

Patient representative

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.

Joan, a middle-aged lady, is shown here sitting beside a whitish-gold pet dog. She is wearing a pink fancy-dress wig, a red and white hat, a pink top and blue trousers.

For me, becoming a Patient Advocate was about making a difference. I felt with my background and diagnosis of breast cancer I could speak up and represent others who might not themselves be able to do so.

Patient advocate

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. 

I wanted to get involved in order to take ideas from our past patients to make the experience better for our patients in the future.

Advanced nurse practitioner, Service Pledge lead

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.

Hear from patients involved in our Service Pledge

What improvements have been made to breast cancer services as a result of the Service Pledge?

We’ve been working with hospitals across different Cancer Alliances and regions. Hospital staff and patients, with the support of Breast Cancer Now staff and volunteer patient advocates, have worked in partnership to develop improvement action plans, which will make a real difference to patients receiving treatment and care for breast cancer in the future.

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.

East of England South Cancer Alliance, 2019 to 2021

Milton Keynes University Hospital


Southend University Hospital


Basildon University Hospital


New QEII Hospital and Lister Hospital


East of England North Cancer Alliance, 2021/2022

Colchester Hospital


Ipswich Hospital


Luton and Dunstable University Hospital


Norfolk and Norwich University Hospital


Bedford Hospital


South Yorkshire and Bassetlaw Cancer Alliance, 2021/2022

Barnsley Hospital NHS Foundation Trust


Chesterfield Royal Hospital NHS Foundation Trust


Doncaster and Bassetlaw Teaching Hospitals NHS Trust


Rotherham NHS Foundation Trust


Sheffield Teaching Hospitals NHS Foundation Trust - Royal Hallamshire Hospital


Sheffield Teaching Hospitals NHS Foundation Trust - Weston Park Cancer Centre


Any questions?

To find out when we’re next recruiting for Patient Advocates, keep an eye out on this page or join our Breast Cancer Voices community - where you can find out about opportunities like this to use your voice and experiences to create change. 

If you’d like to find out more about the Service Pledge, please contact Fran Berry, service pledge manager, on 020 7960 3592 or email


Breast Cancer Now’s Service Pledge 2022/2023 has been jointly sponsored by Eli Lilly and Company Limited and Roche Products Ltd. Breast Cancer Now’s Service Pledge 2023/2024 has been jointly sponsored by Novartis Pharmaceuticals UK Limited. Lilly, Roche and Novartis have not had any control or involvement in this programme.

Breast Cancer Voices

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The Lilly logo is shown. It is comprised of the word "Lilly" in a stylised, thick red font.

Eli Lilly and Company Limited

	The Roche logo is shown. It consists of the word "Roche" in navy blue lettering, with a blue hexagon-shaped line around the word.

Roche Products Ltd

	The Novartis wording is displayed in capital blue letters. To the left of the word is the rest of the Novartis logo, which resembles the outline of a harp, in orange, yellow and blue.

Novartis Pharmaceuticals UK Limited