Urgent action is needed to address the unprecedented challenges facing the cancer workforce in England, especially specialist nurses, a leading charity has warned.
Macmillan Cancer Support has today published a report warning that NHS workforce shortages mean there are not enough cancer clinicians to address the needs of a growing number of patients.
“There is a very real risk that the situation will unravel”
The report – titled Thinking Differently – also states that those who are in post face increasing and more complex caseloads, with the result that they are unable to make full use of their skills.
The report highlighted previous estimates from Macmillan that there was currently a gap of 3,400 clinical nurse specialists across the UK.
But it warned that the deficit could increase to 7,000 posts by 2030, if the workforce did not grow and trends in cancer numbers continued.
While good patient experience is strongly associated with access to a clinical nurse specialist, one in 10 patients in England do not have access to one, added the report.
Meanwhile, the charity’s own nurse specialists had reported a rise in colleagues leaving the profession and a growing tendency not to replace their posts, or to replace them on temporary contracts.
“Doing nothing is no longer an option”
Some had reported to the charity that their time is ‘increasingly stretched’ and that it is taken up by ‘doing non-specialist tasks’, particularly as more of their time is taken up with admin.
One remarked that “I need to be able to target my specialist skills, and not at the photocopier”, stated the report.
It highlighted that a third of nurses were due to retire in the next 10 years, and that the charity feared that pressures will mean these were not replaced.
Increased stress and low morale among professionals could have a knock-on effect and prevent the cancer workforce from providing a seamless, co-ordinated experience for patients, it warned.
Macmillan Cancer Support said it was calling on Health Education England to hold a “thorough review” of the cancer workforce.
The charity said HEE works and other national bodies, such as NHS England and the Department of Health, needed to develop a clear, long-term plan, as recommended in the national cancer strategy.
It recommended five solutions to address workforce issues, including improving career pathways to specialist cancer roles and enhancing the skills, confidence, and communication of existing staff.
Cancer specialist nurses face ‘unsustainable pressure’
Dr Rosie Loftus, joint chief medical officer at Macmillan Cancer Support, said: “NHS professionals are telling us that the pressure upon them has never been greater.
“This is impacting hugely on their capacity to deliver the care they believe their patients need,” she said. “Doing nothing is no longer an option – the NHS simply will not be able to provide people living with cancer with safe and effective healthcare if we don’t see action now.
“While Macmillan has an important role to play in developing and supporting the future cancer workforce, we cannot achieve transformational change alone,” she said. “It is only by coming up with a workable and thorough plan that we can drive the necessary change across the country.”
Dr Fran Woodard, executive director of policy and impact at Macmillan, added: “If the workforce issues aren’t addressed urgently by Health Education England and the Department of Health, there is a very real risk that the situation will unravel and we won’t provide the right standard of care for future generations of people with cancer.”
Rob Smith, director of strategy and planning at Health Education England, said: “HEE is developing a workforce strategy that responds to the recommendations of the cancer taskforce review; this also reflects the challenges being identified by Cancer Alliances who are delivering the cancer transformation programme.
“This approach is essential in order that any solutions to workforce challenges are sustainable and that patients get the right care at the right time in the right place,” he said.
“HEE is also working in partnership with Macmillan on aspects of the strategy, initially to provide access to education opportunities for nurses and others to develop their skills and knowledge in supporting patients with cancer and their families,” he added.