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Major challenges threaten future of cancer nursing, in depth study reveals

Macmillan Cancer Support today (Monday 30 April) reveals the findings of its census of specialist cancer nurses and support workers, the first in depth investigation into the cancer nursing and support workforce in England since 2014.

Macmillan Cancer Support’s census shows:

  • The number of new cases per specialist cancer nurse is dramatically different across the country
  • A greater proportion of specialist cancer nurses being paid in lower pay bands than in 2014
  • Higher vacancy rates in specialist cancer nurse and cancer support worker roles than the UK average for health and social work
  • The proportion of specialist cancer nurses aged over 50 has increased

The Census reveals a startlingly broad variation in the number of new patients diagnosed each year per specialist cancer nurse, in some areas and some specialisms as many as three times others.

Examples of this variation by specialism include:

  • The number of new cancer diagnoses each year per urology nurse varies from 87 to 251 by area.
  • The ratio of new cancer diagnoses per breast cancer nurse each year varies by area from 56 to 145.
  • Numbers of new lung cancer cases each year per specialist nurse vary from 62 to 203 by area

Macmillan warns that such wide variation may mean that patients may not be getting access to badly-needed specialist care.

The in-depth study, which gives the most accurate picture of the cancer nursing workforce in England to date, suggests further worrying trends. While the workforce as a whole has grown, a greater proportion of specialist nurses are now employed in lower pay bands than in 2014, when Macmillan last conducted a census of the workforce.

Macmillan warns that a trend of highly trained specialists taking on increasingly complex caseloads for lower pay may be exacerbating recruitment and retention problems in the cancer nursing workforce.

The census looked at four roles: specialist cancer nurses, chemotherapy specialist nurses, specialist palliative care nurses who focus on cancer and cancer support workers. It found vacancy rates higher than the UK rate for health and social work across all four roles, with as many as one in seven chemotherapy nurse positions being unfilled in some parts of England.

The study also found that the proportion of specialist cancer nurses aged 50 or over has increased since the last census in 2014, which Macmillan says highlights the importance of making sure plans are in place to make the workforce sustainable in the long term.

Dr Karen Roberts, chief nursing officer at Macmillan Cancer Support, said:
“Having the expertise and support of a specialist nurse from the point of diagnosis has a huge bearing on whether or not a cancer 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.

“Nurses working in cancer care tell us that their increasingly complex and pressured workload is beginning to affect the quality of care patients receive. It is no surprise that hospitals are struggling to recruit to these roles, given this unprecedented pressure.”

Dr Fran Woodard, executive director of policy at Macmillan Cancer Support said:

“While the cancer workforce has grown, it has done so over a number of years without adequate long-term planning or direction.  Macmillan has undertaken this work to highlight the strain this puts on those working in cancer care and to ensure that action is taken.  This situation will become more acute as the number of people being diagnosed with cancer continues to grow.

“We welcome the progress Health Education England is making on the cancer workforce strategy. However, this census highlights the urgent need for this essential part of the NHS workforce to be properly equipped to cope with the increasingly complex challenge that cancer poses in the years to come, and it is therefore vital that the Department of Health and Social Care ensures that the cancer workforce strategy is appropriately funded”.

To read the full report click here

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