Specialist cancer nurse roles are being downbanded, says Macmillan

Rise in complex caseloads and downbanding of cancer nurse roles may hit recruitment and retention, charity warns

Specialist cancer nurses are handling a greater number of complex cases but being paid less, report reveals.

Macmillan's latest report reveals a huge variation in caseloads for specialist cancer
nurses across England. Picture: SPL

A rise in complex caseloads and in the proportion of specialist cancer nurses on lower pay bands risks exacerbating existing recruitment and retention difficulties, Macmillan Cancer Support has warned.

The charity's latest census of specialist cancer nurses and support workers in England found that 28% of specialist cancer nurses are on band 5 or 6, which is 5% more than at the time of the previous census in 2014. The majority (61%) are band 7.

Exacerbating existing problems

Macmillan Cancer Support executive director of policy Fran Woodard said: ‘This census appears to reveal a worrying trend of specialist cancer nurse roles being employed on lower pay bands since our last census in 2014.

‘We are concerned that this could mean highly trained specialists are taking on more complex caseloads, and that this is not being recognised in terms of the pay they receive.

‘If this is the case, it could risk exacerbating well established problems with recruitment and retention in the nursing workforce.’

The charity’s 2017 report From the Frontline: Workforce Pressures in the NHS showed cancer nurses are handling an increasing number of cases of greater complexity, as people live longer.

But its latest report reveals huge variation in individual caseloads for nurses, depending on type of cancer and region in England. Findings include:

  • There were 62 newly diagnosed patients with lung cancer per each cancer nurse in Greater Manchester, compared with 203 per nurse in Kent and Medway.
  • For urological cancer, the variation ranged from 87 patients per nurse in North Central and North East London to 251 in Kent and Medway.

‘Cancer nurses are being run ragged’

Macmillan’s chief nursing officer
Karen Roberts

Macmillan’s chief nursing officer Karen Roberts said: ‘Having the expertise and support of a specialist nurse from the point of diagnosis has a huge bearing on whether or not a patient has a positive experience of the care they receive. 

‘We are concerned that cancer nurses are being run ragged, and that some patients may not be receiving the level of specialist care they need.’

Vacancy rates for cancer nursing remain higher than the 3.2% UK average for health and social care roles. For specialist cancer nurse roles the rate is 4.3%, while for chemotherapy nurse roles it is 6.3% and specialist palliative nurse roles in cancer care 4.8%.

RCN research and innovation manager Ann McMahon said it is no exaggeration to say a shortage of specialist nurses puts patients’ lives at risk by delaying treatment.

‘The blame for this rests solely with the government,’ she said. ‘Poor workforce planning and brutal cuts to training budgets have left specialist services struggling to recruit skilled nurses. Patients deserve better than this, and ministers must look again at the recruitment, training and retention of specialist nursing staff.’

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