# Patient navigation as a legal entitlement from the day of diagnosis

Source: https://onco.cc/ideas/idea-moon-navigation-as-a-right/  
OnCo record `idea-moon-navigation-as-a-right` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Every person told they have cancer gets a named navigator, by law, who helps them understand options, book appointments, find trials and deal with money and work.

## Summary

Navigation programmes (Harold Freeman model, Harlem) cut time-to-treatment and improve completion of therapy, and US Medicare began paying for Principal Illness Navigation in 2024. The proposal is to make navigation a statutory entitlement in every health system, funded per diagnosis, with a minimum service specification (first contact within 72 hours, written summary after each key consultation, a trial-eligibility check at each decision point) and public reporting of coverage.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Universal funded navigation reduces time from diagnosis to first treatment by at least 20% and raises trial enrolment and guideline-concordant care, with the largest gains in deprived and rural populations.
- Rationale: Fragmented care is the norm and the patients who fall through gaps are the ones with the least literacy and time. Navigation is one of the few interventions with consistent effects on timeliness and equity, and lay navigators are cheap relative to oncology drugs.
- Proposed test: Stepped-wedge rollout across one region or national payer: compare diagnosis-to-treatment interval, emergency admissions, trial enrolment and patient-reported understanding before and after entitlement; cost per quality-adjusted life-year against standard care.
- Maturity: being-tested-at-scale
- Actor: policy

## Sources

- Harold P. Freeman Patient Navigation Institute: https://www.hpfreemanpni.org/

## Connected records

- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Patients lack understanding, navigation and agency](https://onco.cc/bottlenecks/b-patient-voice/)

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