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Inject creativity to allay the impending workforce crisis in cancer care

As a growing proportion of cancer nurses approach retirement age, strategies are needed to recruit and retain more specialist nurses  

After years of pay freezes and increasing workloads, it is unsurprising that many specialist cancer nurses I speak to are looking forward to leaving the profession when they retire.

Macmillan’s recent Cancer Workforce Census in England found that the proportion of specialist cancer nurses aged 50 or over has increased over the last four years from 33% to 37%. We also face the prospect of a large proportion of those over 50 retiring over the next decade or so.

Invaluable experience

When they leave, they will take with them their specialist knowledge of cancer and years of invaluable experience out of the NHS. That’s why it is important to offer ways to keep this expertise in the health service and consider how we’re looking after the next generation of cancer nurses. We need strategies in place at a local level to make things like ‘retire and return’ schemes much more commonplace. Increased flexibility in working hours and opportunities for more practice development roles and succession planning are badly needed.

At the other end of the scale, we also have to address how we can improve the recruitment of the cancer nurses of tomorrow. It was a huge mistake for the government to scrap the nursing bursary and we have already seen the number of applications to study nursing in England fall through the floor.

Nursing leaders also need to consider how we avoid the career cul-de-sac that many clinical nurse specialists (CNSs) have experienced. The evolution of the nurse consultant was an opportunity to create better career progression. However, in recent years these posts appear to be disappearing due to an ill-prepared workforce, poor succession planning and cost reduction pressures in front-line services. 

If we are to recruit and retain a cancer workforce fit for the future it’s crucial we start properly investing in nurses and valuing those who are approaching retirement

Nursing must be an interesting and financially viable option for teenagers as a career if we are to recruit enough nurses to care for the growing number of people being diagnosed with cancer. It feels like nursing needs its own recruitment drive, similar to the government's attempt to boost the teaching profession with the camping slogan ‘Those who can, teach’.

Long-term workforce plan

But recruitment alone will not solve the problem – we need to work hard to improve the retention of specialist cancer nurses. With the NHS under intense pressure to deliver more for less, specialist nurses are being asked to help fill in the gaps and carry out general tasks on top of their existing workloads which is simply not acceptable. At Macmillan, we are concerned that with all the talk of a long-term plan for the NHS we are at risk of forgetting what needs to be done in the short-term. A commitment had been made for 2018-21 for everyone to have access to a CNS or support worker, and we are unclear how this will be achieved based on current budgets and plans.

If we are to recruit and retain a cancer workforce fit for the future it’s crucial we start properly investing in nurses and valuing those who are approaching retirement.

By failing to recruit and retain enough cancer nurses now, the NHS will not be able to provide safe, high-quality care for the cancer patients of tomorrow. The government and Health Education England need to set out an ambitious, long-term plan to tackle this and ensure that it is fully funded. Budgets may be tighter than ever, but this is not a problem the NHS can afford to have.


Karen Roberts is chief of nursing and allied healthcare professionals, Macmillan Cancer Support

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