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Specialist shift a waste of cash


Moving clinical nurse specialists to general duties will cost the NHS more in the long run than keeping them in their specialist roles, according to a report by major cancer organisations.

The report, published last week by the National Cancer Action Team and Macmillan Cancer Support, has the backing of chief nursing officer for England Dame Christine Beasley.

It says cancer specialist nurses “reduce inefficiency, drive innovation and improve quality”, and could save thousands of pounds in reduced admissions.

The document cites an analysis by Macmillan that showed focusing services on the cancer nurse specialist role cut cancer expenditure by 10 per cent.

Dame Christine said: “This publication reinforces my long held view that clinical nurse specialists can improve the safety, effectiveness, experience and productivity of care.”

Macmillan chief executive Ciaran Deváne said: “There is still evidence that CNSs are being diverted to general ward duties and admin. This is not a good use of their time or NHS resources.”


Readers' comments (7)

  • Perhaps the acute trusts will take notice of this. As palliative care CNSs in an acute trust there is an onus on us to prove the value of our role and shortsightedness in the fact that at present we do not generate an income to the trust, and therefore our value appears to be questioned. We are often the first health professionals to discuss discharge planning with patients approaching the end of their lives, we see documentation from teams stating patients need social services referral for a package of care, when they often actually need 24 hour nursing care which we can enable through Fast Tracking, often with the patient being discharged to the place of their choice within 24-48 hours of us first meeting with the patient. Our input frequently expediates symptom control and thus facilitates rapid discharge. Using CNSs to do general ward duties demodstrates a clear lack of understanding by the trust of the role of a CNS and is a waste of specialist resources.

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  • I work as a specialist nurse for Bowel Cancer Screening seeing patients who are on a 2 week wait pathway, we are already putting on extra clinics as we were breaching the 2 week rule. Therefore I am refusing to do shifts on wards as this will reduce my availability to see patients who potentially have cancers and may delay their diagnosis and treatment, needless to say managers think i'm just being difficult!

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  • Why imagine that all nurses are interchangeable pawns to be shuffled at will? There are obvious basic clinical skills we all share but being an expert ward nurse, in whatever field, is a specialism just as the more obvious, to management, specialist roles are. I would be insulted if management thought that my ward staff nurse or ward sister role was so easy that any old nurse could step into it. And when will they take notice of all the reports saying that specialist nurses ultimately save money - the present failings in commissioning and paying for services properly is the only reason they are seen as dispensible.

    A hospital is not just a factory for easy quick fixes for various conditions, some people are unwell in very complex and long term ways and need the type of acute care that can't be boxed and counted. The art as well as the science of nursing. You need us all!

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  • I am a member of a discharge team .Our Acute trust are constantly on red are minus beds each day ,mainly due to the recent closure of beds .Recently patients are breaching more and more we have no capacity ,or staff medical or nursing ,so of course the first people they pull onto the wards to staff them are the discharge team !! .Ditto to all the above comments

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  • I too am a CNS being expected to work on the ward one day a week which as my colleague's post has been empty since January is almost woefully worrying for me. I already work from 7am until I finish which can be up to 10pm at night just to get the basics of my job done. Doing a shift means that I just have to find time to do my own work outside the shift time, during lunch hours or during the shift if I am not busy helping others. As I am deemed not capable of looking after my patients in the HDU area and I am working through the competencies (fine, no problem as I am passing with flying colours and very quickly and it is a good update), I have to look after the 'minors' who do not have cancer. I have to find time to see my own patients. Interestingly, I get through the work for 6 less ill patients very quickly and still have time to do things for other people, answer the ward phone, discharge plan my complex patients and sneakily see some of my own patients and check on the 6 regularly! Now, I call that hard work. All our I had to remind CNS's have been recently ORDERED into uniform ("No arguments, if I say you do it, you do it", was the message we got), and I now spend my time on the wards either having to say, 'Sorry, I don't look after that person', (my bug bear on wards) if I am on another ward seeing an outlier, or have to spend time finding someone who can help as all the patients and relatives assume I am the ward sister/ manager. management that nothing was being done to fill it, I had to rewrite the job advert etc, etc, etc. I was contemplating early retirement but now it is a dead cert and then what a waste of all my experience. To refer to one of the respondents, the management style and nursing style now is NOWHERE near the efficiency of the 1970's when hospitals worked well with compassion and high standards from nurses and far less trained staff. Hospitals were run by managers with clear understanding of medical and nursing needs of sick patients and FAR less staff anyway. Yes, there was waste and things that were wrong, but nothing like the waste and inefficency of today.

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  • This is purely bad management and by doing your work out of hours you are supporting and encouraging this. While none of us want to walk away from a patient who needs our help - in the longer term this is detrimental to the patients and the NHS as a whole. You personally cannot physically and mentally keep this up and the Trust you work for is taking advantage of this. The Trust will probably pass quality assessments on the basis that x number of patients are seen etc when actually you are doing this in your own time. Your "voluntary work" will become normal practice. Do your best in the hours you are paid for and then leave. It is the Trusts responsibility to ensure an adequate service and fill the gaps appropriately - not yours. Also the Trust has a duty of care towards you - look at the Health and Safety website and contact your union rep

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