Practice and community nurses will need a range of new skills to help deliver a major government strategy to improve the care of cancer patients and survivors.
The National Cancer Survivorship Initiative, published today by the Department of Health, says that follow up arrangements are not meeting the needs of cancer survivors in England and that primary care will need to play a greater part in delivering care to people living with cancer.
The strategy identifies five “shifts” the NHS needs to make in the approach to the care and support of cancer survivors, including a move towards more personalised care planning and support for self-management (see below).
Adopting these changes in clinical practice will require primary care nurses to “develop existing and new skills”, including holistic needs assessment skills, telehealth skills and the expertise to support patients to self-manage care.
Health minister Ann Keen said: “Key primary care staff, such as practice nurses, district nurses and specialist nurses will be required to develop their skills so that they can meet the holistic needs of people with cancer,” she said.
The initiative’s supported self-management workstream project manager Lynn Batehup said practice and community nurses will be able to transfer some of the knowledge and skills they already have, such as those used to support patients with long term conditions “but there will be a need for elements of the nursingworkforce to develop new skills”.
“A central element of a new follow up arrangement for breast cancer patients [piloted at Good Hope Hospital in Birmingham] is a telephone based support service. This is very different to face-to-face care and will require upskilling for nurses,” she said. “Cancer treatments can have many different side effects and specialist nurses may also require extra training in managing the consequences of cancer treatment,” she added.
However, the Foundation of Nursing Studies chief executive Theresa Shaw warned that undertaking more training could make practice and community nurses feel “overburdened”.
“Taking on a new task does not always mean learning a new skill. This has to be made clearer to nurses so that they don’t feel under more pressure,” she said.
“It has also been increasingly noted that much of the training and personal development undertaken by nurses is being done in their own time, and being paid for out of their own pocket. At a time when the NHS is being asked to make tremendous savings, the question of where the funding will come from for any extra training has to be addressed.”
The Cancer Survivorship Initiative’s five “shifts” in approaches to care
- A cultural shift in the approach to care and support for people affected by cancer – to a greater focus on recovery, health and well being after cancer treatment
- A shift away from a “one size fits all” approach towards a more personal approach of assessment, information provision and personalised care planning.
- A shift away from a clinically-led approach to follow-up care towards support for self-management.
- A shift from a single model of clinical follow up to tailored support that enables early recognition of and preparation for the consequences of treatment as well as early recognition of signs and symptoms of further disease.
- A shift from an emphasis on measuring clinical activity to a new emphasis on measuring experience and outcomes for cancer survivors through PROMS.