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Call to boost CNS numbers to improve lung cancer diagnosis

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Hospital trusts will need to boost their specialist nurse numbers to enable the introduction of a raft of new high-quality molecular diagnostic tests for all lung cancer patients, a report has warned.

Lung cancer clinical specialist nurses (CNSs) should be increased to a level where no trust has less than two and the case load is no more than 80 new patients per year, according to the document.

“More needs to be done to ensure timely and rapid access diagnostic testing for lung cancer patients”

Mick Peake

This level of increase will ensure patient care is “fully integrated” and will allow the CNS to be a “critical point” of communication across the service, it stated.

The report, launched today by the UK Lung Cancer Coalition, said the NHS had been “slow to respond” to the rapid advances in molecular diagnostics.

New treatments for lung cancer based on molecular tests were emerging rapidly and leading to improvements in survival for many patients, noted the UKLCC.

However, it claimed that limitations in rapid access to high quality tests were denying some lung cancer patients access to the most accurate diagnosis and the best possible treatments.

The report highlighted the recent launch of seven NHS genomic testing labs across England and the government’s ambition to increase the proportion of early cancers diagnosed by 2028.

“It is often the case that band 7 nurses are performing administrative roles”

UKLCC report

But it said currently only 3% of pathology departments had enough staff, there was a wide variation in the quality of tissue samples received and significant delays in turning around test results.

Among its recommendations, the coalition called for a national, molecular diagnostics quality assurance programme and increases in funding to address the “critical workforce issues”.

A “strong workforce is central to an effective diagnostics process”, said the report, highlighting that every year more people were referred for diagnostic tests and services were “struggling to keep up”.

“The development of new therapies has meant that many patients are now living longer, which should be celebrated,” it said.

“This is, however, also having a direct impact on the workload of healthcare professionals, in particular, lung cancer CNSs,” noted the report.

“CNSs are having to look after patients who survive longer as well as taking on new cases,” it said. “CNSs can help to drastically improve the quality of life for people with cancer through assisting with decision-making, symptom management and emotional support.

It added: “They should have 80 new cases per CNS. However, it is often the case that band 7 nurses are performing administrative roles, just to move patients along the pathway – an ineffective use of their time and expertise which should be focussed on patient care.”

Dr Mike Peake

Dr Mike Peake

Mike Peake

Commenting on the report, Professor Mick Peake, clinical lead at UKLCC and a respiratory expert at the University of Leicester, said: “Molecular diagnostics is central to lung cancer diagnosis and treatment.

“If we are to deliver a world-class lung cancer service more needs to be done to ensure timely and rapid access diagnostic testing for lung cancer patients, wherever they live in the UK,” he said.

“The UKLCC is committed to doubling five-year lung cancer survival to 25% by 2025 – and universal and rapid access to high quality molecular diagnostics is a vital element in our ability to reach that target,” he added.

The report – titled Molecules matter: Turning the science of molecular diagnostics in lung cancer into a practical service for all patients – was launched today at the British Thoracic Oncology Group annual conference.

It is a companion to the previous UKLCC report Millimetres Matter: Implementing the National Optimal Lung Cancer Pathway, which was launched in November 2018, as previously reported by Nursing Times.

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Readers' comments (1)

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