{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:56:23Z","timestamp":1790618183446,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distress is a common, clinically significant response to cancer, yet specialist psycho\u2010oncology provision varies across the UK, and national service\u2010level data on staffing, access and activity are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To provide an updated picture of referral, access, workforce and activity of specialist psycho\u2010oncology services across the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional service survey distributed UK\u2010wide via professional networks used an 18\u2010item questionnaire capturing staffing, referrals, waiting times, activity and outcome measures for 2022\/2023. Activity was expressed per specialist whole\u2010time equivalent (WTE); reporting followed STROBE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010five psychology\u2010led NHS psycho\u2010oncology services participated, all in England and Scotland. All had Level 4 provision but only 40% had Level 3. Each WTE served a mean of 1530 new cancer diagnoses, saw 83 new patients and delivered 446 attended appointments (mean 7 sessions per patient). 8.4% of patients were referred for specialist support, below the \u223c25% estimated to need it. Eighty\u2010three percent of services judged their referrals to under\u2010represent need. Mean waits were 21\u00a0days (urgent) and 3.4\u00a0months (routine); services without a dedicated senior leadership post tended to wait longer (median routine 4 vs. 3\u00a0months; urgent 30 vs. 10\u00a0days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Specialist psycho\u2010oncology services in England and Scotland are understaffed, with long waits and inequitable access, even among psychology\u2010led services. Senior leadership may support shorter waits but must be matched by balanced staffing across Levels 3 and 4. Workforce investment, inclusive referral pathways, a cancer\u2010specific psychological wellbeing measure, and embedding specialist support where it is absent are needed to deliver equitable care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70613","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T09:25:58Z","timestamp":1789723558000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Referral and Activity in Specialist Psycho\u2010Oncology Services: A Survey of Provision in England and Scotland"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-3115-8778","authenticated-orcid":false,"given":"Anna","family":"Lagerdahl","sequence":"first","affiliation":[{"name":"Clinical Health Psychology Great Western Hospitals NHS Foundation Trust  Swindon UK"},{"name":"School of Psychology and Neuroscience University of Bristol  Bristol 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