There are increasing numbers of people living with and beyond cancer. In high income countries more than half of those diagnosed with cancer will live more than 10 years, however, surviving cancer does not necessarily mean living well. An estimated one in four will be dealing with treatment related consequences and living with active "chronic cancer", in addition, two thirds of those with cancer will have at least one other condition e.g. hypertension, chronic heart disease, mental health issues or diabetes. Since 2007 there have been a range of national survivorship initiatives across the countries of the United Kingdom together with testing of initiatives, including risk stratified pathways of follow up care, a recovery package (holistic needs assessment, treatment summary, care plan and primary care review ) after completion of initial cancer treatment. There have been national patient experience and quality of life surveys leading to the development of metrics to be integrated into routine data collection and interventions to support work, physical exercise and manage severe treatment related consequences. This work has involved collaborative working between cancer registries, charities, Royal Colleges and private sector management consultancies as well as National Health Service bodies. Some of the successes and remaining challenges will be discussed.