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Organising UK cancer nursing services: a review

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VOL: 98, ISSUE: 42, PAGE NO: 35

Alison Richardson, PhD, MSc, BN, RN, PGDE, RNT, is professor of cancer and palliative nursing care, Florence Nightingale School of Nursing and Midwifery, King's College London

Morven Miller, MSc, BA, RGN, is research assistant, School of Nursing and Midwifery, University of Glasgow;Helen Potter, MSc, RGN, is lead cancer nurse, Macmillan Brook Cancer Unit, Queen Elizabeth Hospital NHS Trust, London

Cancer services in the UK have been reorganised since the publication of the Calman-Hine report (Department of Health, 1995) and the national cancer plan (DoH, 2000a). This programme of reform presented significant challenges for cancer nursing and cancer nurses. These were summarised in The Nursing Contribution to Cancer Care (DoH, 2000b), which also provided a strategic plan for the development of cancer nursing services.

Cancer services in the UK have been reorganised since the publication of the Calman-Hine report (Department of Health, 1995) and the national cancer plan (DoH, 2000a). This programme of reform presented significant challenges for cancer nursing and cancer nurses. These were summarised in The Nursing Contribution to Cancer Care (DoH, 2000b), which also provided a strategic plan for the development of cancer nursing services.

Our survey of all known lead cancer nurses in England provides descriptive information on the critical issues facing the profession in an effort to support the development and organisation of cancer nursing services. The lead nurses were sent a questionnaire on:

- Leadership, management and coordination;

- The structure and role of nursing services;

- Workforce planning and training;

- Educational initiatives in development and evaluation.

The findings highlighted the significant evolution that cancer nursing in the UK has undergone in response to nursing's professional agenda and specific cancer-related policy initiatives. For example, 81% of lead cancer nurses provided evidence of how they were working towards achieving the standards set out in the Manual of Cancer Services Assessment Standards (DoH, 2000c).

New roles have developed and greater attention has been given to multidisciplinary working, including improved communication between the providers of primary and secondary care. This is maintained through formal and informal communication, collaborative patient care initiatives, joint education programmes and management/strategic links.

Eighty per cent of the lead nurses carried out an audit in their area and 54 topics were identified. Forty-two per cent of the lead nurses had a written strategy for cancer nursing services, while 92% of those without a formal strategy were either in the process of writing one or planned to write one.

Workforce planning - in terms of numbers of staff and the need for professional development - is a priority, as is collaboration with educational consortia and providers. Gaps in the specialist workforce should be addressed through consideration of the role and functions of different types of nurses in cancer care.

The study highlighted diversity in clinical nurse specialists' roles, such as the areas in which they work and the need for greater understanding about the size of their caseloads. The potential role of generic nurses in cancer care needs to be addressed, including the best ways to meet their training needs. Network lead cancer nurses need to set common goals to achieve agreed standards for cancer nursing.

The evidence presented by lead cancer nurses shows that cancer nursing has accepted the challenges of changing practice and new government legislation. The aim is to ensure that patients with cancer receive a quality service.

- For the full article see: Richardson, A. et al (2002)Organising cancer nursing services in the UK: a review of current practice. NTResearch; 7: 4, 288-296.

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