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 instalment! For those of you who are a little late to the party I will be writing a regular blog in run up to ISCCN 2020, which will take place in London in March next year.
In this blog I will try and give you a flavour 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 firstname.lastname@example.org.
Mark will be a regular contributor in the leadup to the International Conference on Cancer Nursing (ICCN) 2020 in London, commencing March 1, 2020. 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.