National Cancer Plan highlights East Midlands Breast Pain Pathway and makes recommendations that support the use of FaHRAS-Online
Health Innovation East Midlands (HIEM) have highlighted the role of innovation in the East Midlands, including The East Midlands Breast Pain Pathway (EMBPP) and FaHRAS-Online, within the National Cancer Plan.
The East Midlands Breast Pain Pathway (EMBPP) is a regional approach to managing breast pain within the community and is recommended by NHS England within the National Cancer Plan through its inclusion as a case study as an exemplar in best practice. The pathway has been adopted beyond the East Midlands and is being implemented widely throughout the NHS.
As noted by Health Innovation East Midlands (HIEM) in their recently published article, FaHRAS-Online is also an East Midlands innovation and is being used by sites operating Community Breast Pain Clinics to fulfil the risk assessment component of the East Midlands Breast Pain Pathway. This was first championed by HIEM in 2015 and has gone on to receive backing from the Small Business Research Initiative, and was part of the EMBPP collaboration shortlisted for the Health Service Journal Award for Primary and Community Care Innovation of the Year.
The National Cancer Plan was released in February 2026 and sets out a framework to achieve major systematic changes in order that 3 out of 4 people diagnosed with cancer survive for 5 years or more by 2035. As part of these recommendations, explicit mandates were given to support community breast pain clinics, harnessing digital innovation to make better use of diagnostic capacity (Action 4, p14) and
‘the deployment of decision support software…to reduce low value referrals’.
(Action 1, p13)
FaHRAS-Online falls squarely abreast of these recommendations and can be used to support the development of new breast pain services, alongside existing business-as-usual operations, in a way that is compliant with the national approach. The software provides actionable recommendations, based on national guidance and validated, independent risk models. This provides mutual reassurance to both patient and provider and ensures only appropriate referrals are made to reduce pressure on downstream diagnostic capacity. Through effective management within the community, utilising digital tools to aid decision making regarding specialist referral, diagnostic capacity and specialist resources can be saved. As part of the EMBPP National Audit it was found that around 1 in 3 of these patients had a cancer-affected family member. It was also identified that as many as 2 in 3 of patients would have gone on to receive a mammogram and 1 in 4 would receive an ultrasound were they seen as before within Breast Cancer Diagnostic Centres (BCDCs). This highlights the role of decision support within the setting, ensuring that appropriate referral of those with a significant family history risk component was made to avoid unnecessary diagnostic testing.
When incorporated within Community Breast Pain Clinics the use of the software also neatly aligns with the three shifts required by NHS England in order to transform healthcare delivery:
- From Hospital to Community
- From Analogue to Digital
- From Sickness to Prevention
By providing community based clinics, patients are seen in an appropriate environment, outside of pressured, anxiety-inducing cancer clinics, freeing up specialist resources. The use of the FaHRAS-Online software helps support the shift towards digitisation, gathering family history information digitally directly from the patient, with a record of objective risk assessment that provides mutual security for both patient and provider. This also supports a shift towards prevention through the identification of patients at risk of developing cancer within the community at the earliest possible stage (i.e. before it even has a chance to develop) which helps drive cancer outcomes.
To see the HIEM news article, please visit: