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Transforming Cancer Support with Enhanced Supportive Care App

Royal Surrey NHS Foundation Trust

Experience the revolutionary collaboration between Enhanced Supportive Care department at the Royal Surrey NHS Foundation Trust and Piota, transforming cancer support through innovative patient-reported outcome data and remote app-based services.

Transforming Cancer Support at Royal Surrey NHS Foundation Trust

Enhanced Supportive Care (ESC) is a fresh and modern approach to supporting people through cancer treatment. It focuses on providing better access to expertise in managing the adverse effects of cancer and cancer treatments.


The Royal Surrey’s ESC service was set up in September 2019 and has been seeing patients since January 2020. It aims to support all patients with recently diagnosed locally advanced or metastatic cancer who are receiving anti-cancer treatment at St Luke’s Cancer Centre, Royal Surrey NHS Foundation Trust (RSFT).

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As the coronavirus (COVID-19) pandemic started in 2020, the ESC team approached Kent Surrey Sussex Academic Health Science Network (KSS AHSN) to find an innovative solution to enable the clinical team to receive patient-reported outcome data and to provide signposting support for patients.


Based on the options KSS AHSN researched and presented, the ESC team selected Piota to support them to codesign an app. Using an app focused on remotely obtaining patient-reported outcomes was completely new to the ESC team and a departure from traditional working practices.

Piota has developed a digital health app for healthcare settings that represents a quickly customised two-way communication portal, allowing clinical units and services to directly communicate with a range of stakeholders through a single channel.


The app allows patients to complete a pre-consultant symptom assessment questionnaire (MSAS-SF) using their own digital devices and aims to replace paper questionnaires. In addition, the app provides updates and notifications along with condition-specific guidance material to help to support ESC patients remotely alongside their appointments.


The app benefits focus on reducing the amount of time spent in appointments completing the symptom assessment questionnaire so clinicians can focus on what matters most to the patient; helping clinicians to review answers before their consultations; and helping signpost patients to other relevant information or websites.


Patients do not have to use the app if they feel it is not right for them, or if they do not have access to a digital device. The traditional MSAS-SF is still available for patients to complete with their clinicians if preferred and paper information leaflets are also still available.



Unity Insights supported KSS AHSN to conduct a real-world evaluation and budget impact model to understand the app and its potential benefits. The analysis was conducted between 1 Jan 2021 – 28 February 2022 (14 months). The evaluation included patient satisfaction scores and patient and staff user feedback. 155 ESC patients were included in the analysis.

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Patients (n=37) were interested in using the app.


Patients who gave feedback on the app (n=6) would recommend it to other ESC patients.


Patients (n=24) registered their device to the app.


Patients who gave feedback on the app (n=6) rated it 'good' or 'great'.

We chose Piota due to their track record with other NHS hospitals, the simple set-up process, ease of use for patients and clinicians and cost-effectiveness. After two years, the app is embedded in our service, and we can see the potential to expand its use moving forward.

— Emma Dillsworth
ESC Project Manager Royal Surrey Country Hospital

Learning to use smartphone

We are pleased that the ESC service found the app easy to implement and
popular with the patients who used it. It is notable that patients using the
app completed 3.1 forms per person compared to 1.3 forms per person
using paper. 

— James Dickson,
Founder and Director of Piota

It's great to have an overview of a patient’s symptoms and how bothered they have been by them before a consultation. This means we can focus on what is important to the patient - essentially, they set the agenda.

— Joanne Thompson,
ESC Clinical Nurse Manager, RSCH

We extend our gratitude to the Kent Surrey Sussex Academic Health Science Network (KSS AHSN) for their invaluable contribution to conducting this insightful case study. Their expertise and support have been instrumental in capturing the transformative impact of Enhanced Supportive Care (ESC) and the collaborative efforts with Piota, providing valuable insights for the advancement of healthcare practices and patient support.

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