Changing the way people are supported after cancer treatment is a national priority to ensure they are helped to live well with and beyond the disease. At present, follow-up care is medically led, does not meet all people’s needs and has insufficient capacity to cope with increasing numbers of survivors. Implementing stratified follow up can improve after-care as it offers a personalised approach, promotes supported self-management and allocates more resources to those in greatest need.

This article proposes that, before implementation of stratified follow up, time is taken to embed the recovery package in mainstream after-care, thereby offering greater opportunities for support after cancer treatment. Practical considerations are discussed, informed by experience of running a pilot pathway for colorectal cancer survivors. To achieve this service redesign, a cultural shift is required by managers and commissioners to enable the necessary resource allocation.