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Cancer survey highlights importance of specialist nurses for patients

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More than a third of cancer patients felt there were not enough nurses on duty to care for them in hospital, according to the latest national survey, which also highlights the importance of providing specialist nurses.

The survey of more than 110,000 cancer patients suggests services have improved over the last four years, however, it reveals ongoing concern about nursing staff levels.

Just 62% of patients said there were always or nearly always enough nurses on duty on their hospital ward. Twenty-nine per cent said there were sometimes enough nurses, while 10% said there were rarely or never enough nurses on duty.

“The survey shows the importance of having a clinical nurse specialist to support patients”

Catherine Wood

The proportion of patients who said there were enough nurses had increased slightly, from 61% in 2013. However, there was no real change in patients’ views of staffing levels since the first survey in 2010.

The 2014 survey found variations in patients’ experiences of adequate staffing depending on the type of cancer they were being treated for.

Just 56% of those with colorectal or gastrointestinal cancer and 57% with upper gastrointestinal cancer said there were enough nurses on the ward, but that went up to 66% for breast cancer and 76% for skin cancer.

The survey also found wide variation in how well individual trusts were doing on nurse staffing levels, with results ranging from 44% to 89% of cancer patients reporting sufficient staffing.

In addition, the results for the 2014 survey indicate a worrying reduction in the quality of support and care from GPs and practice nurses – the single biggest drop in national scores from 2010 to 2014.

In 2014, just two thirds of patients (66%) reported GPs and practice nurses had done everything they could to support them during their treatment for cancer, down from 69% in 2010.

“The results showed that the factor with the strongest association with high patient scores in the survey was always the presence of a clinical nurse specialist”

Cancer survey report

However, there were also plenty of encouraging results, with more patients than ever (89%) reporting they had been given the name of a clinical nurse specialist (CNS) – up from 88% the previous year and 84% in 2010.

Ninety-one per cent said their CNS “definitely” listened carefully to them when they last spoke and that they got understandable answers to questions all or most of the time.

A key finding overall was the importance that patients placed on having access to a specialist nurse.

“At all cancers level, and for each of the 13 tumour groups, the results showed that the factor with the strongest association with high patient scores in the survey was always the presence of a clinical nurse specialist,” said the report on the survey results.

Eighty-four per cent of patients said they were always treated with dignity and respect by staff, up from 82% in 2010.

The survey also suggested improvements in care and communication by ward nurses. More than three quarters of cancer patients (76%) said they got understandable answers from ward nurses in 2014, up from 73% in 2010.

The proportion of patients who said they have confidence and trust in ward nurses increased from 66% in 2010 to 71% in 2014.

Sean Duffy, NHS England’s national clinical director for cancer, said he was pleased with the results, but acknowledged there was room for improvement.

NHS England

Sean Duffy

“We know cancer services are under pressure and as the NHS sees more patients earlier, we need to ensure waiting times are kept down and that in the areas where patients are telling us we need to do better swift action is taken,” he said.

A new “buddying” programme is to be launched this autumn, which will see highly-rated cancer trusts paired up with those keen to make improvements in a bid to tackle variations in patients’ experiences and drive up standards.

The scheme will involve up to 12 trusts and will involve managers and clinical staff, including directors of nursing and cancer lead nurses.

Commenting on the survey results, Catherine Wood, senior involvement officer at Breakthrough Breast Cancer, said the survey showed the “importance” of having a clinical nurse specialist to support patients.

Breakthrough Breast Cancer

Catherine Wood

“Their energy and commitment to patients is one of the factors that make breast cancer care such a leader in positive patient experience,” she said.

“However, as with many aspects of the NHS, they are increasingly under pressure and more work needs to be done to ensure that they are supported and can continue to provide the care they work so hard to give their patients,” she added.

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