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Specialist adult cancer

Specialist adult cancer nurses in EnglandA census of the specialist adult cancer nursing workforce in the UK, 20141. Introduction1.1 BackgroundThe specialist adult cancer nursingcensus was originally designed to mapthe specialist adult cancer nursingpopulation by cancer type and localityin order to inform commissioningintentions and workforce planning.The first two censuses in 2007 2 and 2008 3were developed and led by the cancernetwork nurse director and colleagues,before they handed over management tothe National Cancer Action Team (NCAT)and Mouchel Management ConsultingLimited, who led on the 2010 4 and 2011 5censuses respectively. Further iterationsexpanded data collection to include roletitle, banding and geography. In 2014,Macmillan Cancer Support commissionedthe census working with MouchelManagement Consulting (supported bythe Centre for Workforce Intelligence).The 2014 census of specialist adult cancernurse workforce has leant on the significantexperience and expertise provided by thecontinued involvement of three seniorcancer nurses and healthcare scientists/professional colleagues: Professor AlisonLeary and Paul Trevatt, who had developedthe original census, and Steve Candler.It is the first UK-wide census, however, totake account of the significant differencesin policy and delivery of cancer care inthe Celtic nations, the data has beenpresented in separate reports and shouldbe interpreted in light of the relevantnational context.The census took place at a time ofsignificant financial constraint acrossthe UK. In addition, changes in the NHSin England have resulted in a numberof mergers of hospital trusts and areconfiguration of the cancer networksinto larger Strategic Clinical Networks(SCNs), which in turn have presentedchallenges in identifying appropriatecontacts, supporting communicationsand validating responses.It may be useful to read this document inconjunction with other resources such as:• Excellence in cancer care: Thecontribution of the Clinical NurseSpecialist. NCAT, 2010 6 .• Clinical nurse specialists in cancer:Provision, proportion and performance.NCAT 2010 4 and 2011 5 .• Advanced level nursing: A positionstatement. Department of Health, 2010 7 .• Manual of cancer services. Departmentof Health, 2004 8 .• NHS cancer commissioning toolkit.National Cancer Intelligence Network 9 .• One-to-one support for cancer patients.A report prepared for the Departmentof Health by Frontier Economics,December 2010 10 .• Coordinated cancer care: betterfor patients, more efficient. NHSConfederation briefing, 2010 11 .While this document does offer informationregarding the ratio of specialist adult cancernurses to incidence of cancer and two-yearprevalence in the SCNs in England, thisdoes not represent guidance on appropriatecaseload. It merely demonstrates varianceof provision of these posts by geographicallocation and tumour type.This document aims to strengthen theargument for maintaining and expandingthe provision of specialist nurse expertisein England in order to ensure that thegrowing number of people living withcancer receive a good patient experience.6

Specialist adult cancer nurses in EnglandA census of the specialist adult cancer nursing workforce in the UK, 20141.2 MethodsThis census was primarily based on theapproach adopted for previous censuses,in particular the work undertaken byNCAT in the most recent census 5 .Given the significant changes in the NHSin England, the emphasis was on ensuringa robust but focused data set.Data was collected over an eight-weekperiod between April and June 2014.However, the workforce numbers collectedwere a snapshot of the population on theday of the census, 24 April 2014. The datawas primarily collected using a bespokespreadsheet with drop-down menus.Areas of enquiry were informed by theprevious four censuses.Areas of practice are broadly based onthe NICE Improving Outcomes Guidancedefinitions 12 . Consistent with 2011, theareas of practice include ‘acute oncologyservices’ (AOS), as it was recommendedin the 2009 NCAG report Chemotherapyservices in England: Ensuring quality andsafety that all hospitals with emergencydepartments should establish this service 13 .As in previous years, there was the facilityto record a post as being supported by thecharity Macmillan Cancer Support. All postsare recorded as whole time equivalents(WTE) in adult cancer care where 1 WTE isequivalent to a 37.5 hour week.Additional information was collected onthe age and gender of post holders andon vacant posts. Data was also collectedon posts that reported supporting ‘cancerof unknown primary’.Spreadsheets were returned from leadcancer nurses in hospital trusts. Somefurther checking and completion wasundertaken to ensure complete recordswere provided where possible. NHS TrustLead Cancer Nurses and Directors ofNursing were involved as appropriate tocollate the relevant data.Data was returned electronically fromtrusts to Mouchel for analysis. One monthwas given for data to be returned, with afurther extension to enable appropriatedissemination and support for returns.Collection was completed by 13 June 2014.Census process:• Project team and Mouchel agreedcensus tool design and data fields• Spreadsheet and instructions forcompletion were sent out to lead cancernurses or equivalent in each trust orhospital across the UK• Data entry completed at trust level• Completed spreadsheets returnedto Mouchel• Records checked with respondentsfor completeness and accuracy asappropriate• Analysis by Mouchel and project team• Data tables produced for review andkey findings identified• Report7

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