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Nursing at heart of drive to speed up cancer diagnosis

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Nurses will be at the centre of a government drive to diagnose more cancer patients more quickly, due to be announced by the prime minister tomorrow.

In his speech to the Labour party conference tomorrow, Gordon Brown will pledge to provide all patients with the results of diagnostic tests within one week of visiting their GP or consultant by 2014.

As an interim measure, he will guarantee that within three years the time for the tests will be brought down to two weeks.

The announcement will form part of an initiative to save the lives of up to 10,000 cancer patients each year, which will be led by cancer tsar Mike Richards.

National clinical director for cancer Professor Richards told Nursing Times the pledge would result in “new and additional roles for nurses”, who will play a crucial part in carrying out many of the tests. Examples include endoscopies, flexible sigmoidoscopies and ultrasounds.

The investment in diagnostic services will see “increasing opportunities for nurse practitioners” in this area, Mr Richards said. Funding will be made available to train nurses to perform these roles.

“We already have nurse endoscopists and we need more. There is no reason why these tasks can’t be performed by nurses.

“Nurses can also be trained to deliver ultrasound scans, and there will also be roles for nurses in raising awareness of symptoms.”

The prime minister will announce that some capital funding, which for the last decade has been largely directed towards improving hospital buildings, will in future be spent on the diagnostics equipment needed in GP surgeries, polyclinics and community hospitals to fulfil the pledge. This will include MRI and CT scanners and ultrasound machines.

“The whole aim of this is to be able to diagnose cancer earlier,” Professor Richards said. “Research shows that if we can bring the cancer survival rates up to the best in Europe, we will save around 10,000 lives a year.”

He said the sort of patients that the diagnostics are intended to benefit are those who do not fulfil the criteria for an urgent two-week referral to a specialist, but about whom a doctor has concerns.

Examples included a woman presenting with abdominal pain and loss of appetite, which could be irritable bowel syndrome or could be ovarian cancer, or a patient with rectal bleeding but who was below the age where cancer was common.

“If they had direct access to endoscopy services, it might be 3 to 5 per cent of those do have cancer and we want to pick them up as quickly as possible.”

Mr Brown will say that the diagnostics will initially be targeted at lung, colorectal and ovarian cancers, with a commitment to extend the tests to all cancers within five years.

Buckinghamshire Hospitals NHS Trust’s lead breast cancer nurse Dawn Symonds warned the target could put a lot of pressure on nurses and pathology departments.

“The gold standard in cancer care is triple assessment – clinical examination, ultra sound and pathology. It is also recommended that any results are discussed at a multidisciplinary team meeting,” she said.

“It could be a huge challenge to do all these things safely [within a week], and if patient expectations are raised to this level it will put increasing pressure on specialist nurses,” she added.

Dawn Symonds stressed that the diagnostics would have to be done by specialist nurses, for example those running outreach clinics. “Nurses can be trained how to perform ultrasound scans, but you need to have the knowledge to be able to interpret them,” she said.

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Readers' comments (3)

  • While I appreciate the extended role of nursing we have a shortage of experienced nurses at the moment and there will be a huge exodus of retiring nurses in the near future that will cause a further shortfall. As a clinical nurse specialist myself, I do not wish to become a task orientated nurse, (i.e. doing ultrasounds etc.) This was the nursing model that existed in many places, when I trained (although where I trained was one of the pilots for a new and extremely good modular system that did away with this.) Nurses are there to care and support patients and although I agree with nurse gastrostomy, colonoscopy and cystoscopy, I am not sure we can afford to denude our badly needed clinical nursing staff in this way. Find more nurses to employ, we can think about it but please, please think of our patients still needing care in hospital and the community. For follow-up of cancer patients, I think extending the role of clinical nurse specialists to include clinical examination would be an excellent idea as CNS's see patients for psychosocial and lifelstyle issues post treatment so could also include this in the holistic care.

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  • I am a Bowel Cancer Screening nurse and I see my +ve FOB patients within 2 weeks, they then have a colonoscopy within 2 weeks, it then often takes up to 2 weeks to get biopsy results (and that is with our department putting funding into the pathology dept.) For anyone to think this could all be done in one week is pie in the sky. Also rushing patients through this process can cause extreme anxiety as they become convinced that you know something youre not telling them!

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  • so will anyone start to certify qualifications as opposed to attendance, even with the usual trainings? i can't help but find that'll increase efficiancy levels greatly.

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