Good to be writing the third installment of my blog in the run-up to ICCN 2020 in London between 29 March and 1 April, 2020. The UK Oncology Nursing Society (UKONS) will be partnering with ISNCC in hosting the International Conference on Cancer Nursing.
As cancer nurses from across the world register for this great event, I thought I would give a flavor for what UK oncology nursing has been focusing on over the last few years. The area of practice I want to explore in this blog is the birth of Acute Oncology (AO) as a specialist area of practice in its own right and how AO services have developed since 2008.
“AO concentrates on the care of patients with a cancer diagnosis who are brought into hospitals via emergency services. AO services were developed as patients admitted with acute symptoms of their disease and/or side effects of cancer treatments did not always receive timely and appropriate emergency care. The duration of time that patients were in hospital was also longer than predicted if their condition had been treated more urgently.”
All hospitals under public ownership in the UK now have to provide an AO team – specialist cancer clinicians, generally a mix of doctors and specialist nurses, who review patients within 24-hours of referral and advice on their care. There are also national guidelines to advise staff working in emergency services and acute medicine about the management of patients admitted with acute symptoms of their disease and/or side effects. This has reduced treatment delays and improved patient outcomes.
In addition to the patient groups described above, the AO service also manages the care of patients who receive a new cancer diagnosis as a result of emergency admission. The overall survival in this cohort of patients is poorer than those diagnosed by referral from their general practitioner or cancer screening services. They tend to be older people, have more advanced disease and are more likely to have upper gastrointestinal or lung cancers. Any improvements AO services make to their management are likely to have a positive impact.
Led by Philippa Jones, the UK Oncology Nursing Society has developed guideline documents to support the development of AO services. The first of these was the ‘UKONS 24 hour Rapid Assessment Triage Tool’, which can be used by clinicians to assist in the assessment of patients who telephone with cancer-related issues. This allows appropriately trained nurses to advise them whether or not to attend hospital as an emergency. Another UKONS guideline is the ‘Acute Oncology Initial Management Guide’, which provides guidance on managing patients that are treated-for a cancer-related condition in emergency or AO services.
In an exciting development, I can reveal that ICCN 2020 conference delegates can register to attend the free UKONS Pre-Conference Program on 28 March 2020. This full-day session is entitled ‘Standardising Systemic Anti-Cancer Therapy and Acute Oncology’ and will focus on the standardization of cancer services, illustrating how guidelines including those for AO services have been implemented. Keep an eye on the ISNCC websitefor more details.
The ‘AO Initial Management Guidelines’ can be viewed by clicking here.
Goodbye until next month!
Mark is a regular contributor in the lead up to the International Conference on Cancer Nursing (ICCN 2020) in London, commencing 29 March – 1 April, 2020. #ICCN2020
Mark is a nurse consultant and Macmillan Lead Cancer Nurse at the Royal Berkshire Hospital in Reading, UK. He is UKONS Board Member and is very enthusiastic about improving cancer nurse education.
Mark Foulkes RGN, BSc (Hons), MSc (Nurse Consultant and Macmillan Lead Cancer Nurse – Royal Berkshire NHS Foundation Trust)
Hello from the UK! It’s good to be back with my next installment!
For those of you who are a little late to the party, I will be writing a regular blog in run up to ICCN 2020, which will take place in London in March next year.
In this blog, I will try and give you a flavor of what oncology nursing is like in the UK, what the current ‘hot topics’ are and the major challenges we face in the next few years.
“Specialist cancer nursing has been established in the UK for many years. The National Health Service (NHS) has supported the development of nursing specialities alongside increased medical specialisation. The role of the Clinical Nurse Specialist (CNS) in cancer care has been in existence since the 1970s, but was mandated in 2000 when the NHS released ‘cancer standards’ dictating that all multi-disciplinary teams working in cancer care had to have CNS as part of the core team of clinicians.”
More recently the National Cancer Patient Experience Survey, an annual survey of all hospitals caring for patients with cancer, has identified that the biggest factor in improving patient experience is accessibility to a CNS. Thus, specialist cancer nurses are generally valued and invested in within the UK. Currently the biggest challenge the UK faces is maintaining the numbers of cancer nurses in the face of lower numbers of nurses per head of population and an ageing workforce. A recent census indicated that 35% of cancer clinical nurse specialists will retire within the next 10 years.
Many UK oncology nurses have taken on extended roles, frequently in areas of practice traditionally reserved for doctors; these include prescribing (including systemic anti-cancer therapy (SACT)/ chemotherapy in some cases), medical assessment, running nurse-led or protocol-based clinics and communicating difficult news to patients. Shortages of experienced oncology nurses will impact patient care, particularly in the current situation where there is also a lack of oncologists in the UK.
Cancer nurses have been influential in the UK in maintaining patient safety, particularly around the delivery of SACT and supporting patients when they become unwell as a result of treatment or extending disease. This activity has taken place by consensus of, and guidance from, the UK Oncology Nursing Society (UKONS) with the development of a telephone triage tool for assessing patients over the telephone when they report side effects or symptoms of cancer of its treatment. This tool is now used throughout the UK and internationally. The tool can be viewed here.
UKONS have also worked to develop the ‘SACT Competency Passport’, which standardises the training and assessment of oncology nurses in administering SACT. This tool is the first to be included on the national electronic record database for nurses, meaning that the nurse has a digital record of SACT competence and can move between hospitals without repeating training. The passport can be viewed here.
I hope this has given you a flavour of cancer nursing in the UK. If you want to contact me to discuss the content of this blog please feel to do so at mark.foulkes@royalberkshire.nhs.uk.
Mark is a regular contributor in the lead up to the International Conference on Cancer Nursing (ICCN 2020) in London, commencing 29 March – 1 April, 2020. #ICCN2020
Mark is a nurse consultant and Macmillan Lead Cancer Nurse at the Royal Berkshire Hospital in Reading, UK. He is UKONS Board Member and is very enthusiastic about improving cancer nurse education.
Mark Foulkes RGN, BSc (Hons), MSc (Nurse Consultant and Macmillan Lead Cancer Nurse – Royal Berkshire NHS Foundation Trust)
Greetings to cancer nurses across the world! It is such a pleasure to have the opportunity to chat to you via this new blog. I will be writing regularly as we move towards the International Conference on Cancer Nursing (ICCN 2020) in London.
Perhaps an introduction is in order? My name is Mark Foulkes and I am a Nurse Consultant and the Macmillan Lead Cancer Nurse at the Royal Berkshire Hospital in Reading. In practice this means I work in a Cancer Centre (providing radiotherapy and chemotherapy) in a large town around 30 miles west of London. I work in our Acute Oncology team assessing and caring for patients who are brought into hospital either with side-effects of cancer treatment, cancer-related symptoms or those who have been diagnosed with a new cancer following a hospital admission. I am also a Board Member for the UK Oncology Nursing Society (UKONS), where I lead for cancer nurse education.
“UKONS are working in partnership with the ISNCC to bring you this conference and we are thrilled that London has been chosen to host the event. It is particularly apt that London is the venue in 2020, as next year marks the 200th anniversary of the birth of Florence Nightingale and the WHO ‘Year of the Nurse’. London is a sort of ‘homecoming’ for the ICCN as the conference was founded by Robert Tiffany in London in 1984. So other than this ‘alignment of stars’ and a superb conference line-up (details will follow in the next few weeks and months) what can London offer cancer nurses in terms of connections with our history and the history of medicine?”
Let’s start with Florence Nightingale herself. Regarded as the inventor of modern nursing, Nightingale set up the first school of nursing at St Thomas’s Hospital in London in 1860 following her return from the Crimean War and her belief that good sanitation and cleanliness would save patients lives. The Florence Nightingale School of Nursing is now part of Kings College Hospital, but the original buildings can still be seen at The Florence Nightingale Museumat St. Thomas’ Hospital, where the Guy’s and St.Thomas’ NHS Foundation Trust still award the Nightingale badge to nurses who complete nurse education and training at the hospital.
Another famous nurse who built her reputation in the Crimean War was Mary Seacole. Mary Seacole was a British-Jamaican woman who has been honoured as the greatest black Briton. She was based in London for much of her life and died in Paddington in London in 1881. She is buried at St. Mary’s Catholic Cemetery (part of Kensal Rise Cemetery) in North West London and the Mary Seacole Statue can be viewed at St Thomas’s Hospital.
Another London site that might be of interest to the ICCN 2020 delegates, and indeed to nurses in general, is one of the oldest operating theatres in the world. Housed in the attic of the early eighteenth-century church of the old St Thomas’ Hospital. This atmospheric museum offers a unique insight into the history of medicine and surgery. The timber building was once used to dry and store herbs for patients’ medicines but, in 1822, an operating theatre was added. The theatre predates such luxuries as anaesthetics and antiseptics, and it is the oldest surviving surgical theatre in Europe. Finally, no ‘nursing tour’ of London would be complete without a visit to the Royal College of Nursing’s Library and Heritage Centre, which has exhibitions integrating stories from nurses themselves and items from their unique collection.
I hope this has given you a taste of the nursing history that London has to offer, and I hope you can attend the ICCN 2020. I will return in a few weeks with another blog focusing on cancer nursing in the UK and the role of the UK Oncology Nursing society (UKONS). You can register for ICCN 2020 in Londo here.
Mark is a regular contributor in the lead up to the International Conference on Cancer Nursing (ICCN 2020) in London, commencing 29 March – 1 April, 2020. #ICCN2020
Mark is a nurse consultant and Macmillan Lead Cancer Nurse at the Royal Berkshire Hospital in Reading, UK. He is UKONS Board Member and is very enthusiastic about improving cancer nurse education.
