Forum focus: specialist nurses are needed now more than ever in cancer care

Politicians must see value of vital role

People with cancer may need someone with expert knowledge to help them ‘pick up the pieces’

Head and neck cancer nurse specialist with patient
Amanda Dear, Macmillan specialist head and neck cancer nurse at Freeman Hospital, Newcastle
Picture: Jim Varney

Recently, I had coffee with the consultant who employed me as the first specialist nurse in his gynaecology oncology team, and one of the first specialist nurses in a large teaching hospital.

He is now retired and, after our usual catch up, we got to reminiscing about our early days working together.

He had single-handedly spearheaded a campaign for a specialist nurse to work in his area of patient care. When the NHS weren’t forthcoming, he successfully sought the help of a local cancer charity, before negotiating funding from the local NHS.

I asked what drove him to campaign so hard for a specialist nurse when, at the time, it wasn’t the ‘norm’.

He said he recognised his patients needed someone to support them – someone who can help them to help 'pick up the pieces' when they received bad news or had been through major, life-changing surgery.

Patients report a better experience when supported by specialist nurses

He felt terrible when patients in these circumstances were left without anyone who had the expert knowledge and skills to help them.

Last year I made a presentation to an all party parliamentary group on the role of the specialist nurse for breast cancer patients.

Thankfully, there is no doubt about the value of this role. Patients who have a specialist nurse supporting them consistently report a better experience on their cancer pathways.

We went on to discuss how specialist nurses’ titles, roles, responsibilities and pay differs across the country. The initial concept for the role – of someone who can ‘pick up the pieces’ – has been interpreted in a variety of ways in an increasingly complex healthcare context.

Huge efforts are being made in the nursing community to improve this situation, however.

In 2017, for example, the RCN with the UK Oncology Nursing Society (UKONS) published the Career and Education Framework for Cancer Nursing.

There are too few NHS staff to meet the needs of people with cancer

This framework presents a common language for role titles, levels of practice and cancer-specific nursing outcomes across the UK, and emphasises the importance of providing information, demonstrating knowledge and communicating effectively.

The RCN has also campaigned tirelessly for safe staffing – having enough nursing staff with the right skills and knowledge, in the right place, at the right time.

Nowhere is the need for skilled staff felt more keenly than in cancer care, with Macmillan Cancer Support warning that there are too few NHS staff to meet the needs of growing numbers of people with cancer.

Macmillan stated that patients who call its helpline are often at ‘breaking point’, feeling they cannot ask questions of the overstretched doctors and nurses caring for them.

This must change, and managers and politicians must take notice.

In cancer care, we must not lose sight of why the specialist nurse role was created in the first place – to ensure there are staff with the time, knowledge and skills to listen to, discuss with, and answer questions from patients, many of whom would otherwise ring a charity helpline line when in crisis.

Further information

Nikki Morris, @nikki_a_morris, is chair of the RCN Cancer and Breast Care forum and chief executive officer of Age UK Camden

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