‘Critical lack of capacity’ in cancer services, warn CNSs | Nursing Times

Cancer nurses are among those raising the alarm about the current pressures facing oncology departments across the UK.

The UK Oncology Nursing Society (UKONS) has joined other cancer professional organisations in highlighting concerns about the “critical lack of capacity” to meet demand in oncology departments.

“It has a really big impact on our members if you’re not able to give the standard of care that you would like to”

Mark Foulkes

As a result, they have written a letter to health and social care secretary Steve Barclay warning that the situation was affecting patient access to timely care and innovative cancer treatments.

Speaking to Nursing Times today, UKONS president Mark Foulkes, who signed the letter, said more and more novel therapies were becoming available but there were not enough staff to deliver them.

“We don’t have the people to give them, to monitor them, to prescribe them – doctors, nurses, pharmacists, all specially trained, we don’t have the numbers to do that,” he said.

He said nurses were concerned that standards were being compromised due to the sheer level of demand, with staff under pressure to deliver “more care rather than good quality care”.

For example, he said increasing numbers of UKONS members were reporting a move in their workplaces for more junior staff to deliver chemotherapy and other anti-cancer therapies.

“There’s certain rules about who can give chemotherapy and that should be adequately qualified staff, we say, and we stand by that,” said Mr Foulkes, who is a Macmillan lead cancer nurse and nurse consultant in acute oncology.

“The Royal College of Nursing, ourselves and Macmillan all support that view, that you can’t just get anybody giving chemotherapy, it has to be people who’ve done specific training.”

Latest data shows that the NHS in England failed to meet any of its cancer waiting time targets in April 2023, with performance dropping for every target compared to the previous month.

During April, 77.7% of people were seen by a specialist within two weeks of an urgent suspected cancer referral – way below the 93% target and the seventh worst result on record.

Meanwhile, only 61% of people received their diagnosis and started their first treatment within two months of an urgent referral – the target is 85%.

As well as the patient impact, Mr Foulkes said the pressures were affecting access to training, development and support for nurses working in systemic anti-cancer therapy (SACT) services.

“If there is to be a meeting between cancer services and the government, it’s vital that nurses have a voice in that”

Mark Foulkes

In addition, the wellbeing and mental health of nurses and other health professionals working in cancer care was being affected.

“It has a really big impact on our members if you’re not able to give the standard of care that you would like to,” he said.

He added: “Working in oncology, in SACT units or chemotherapy units… it’s very hard, it’s demanding.

“There’s higher numbers of people coming through, there’s just increasing demand on that system, and we have trouble recruiting those specialist nurses.

“The stresses and strains of working every day in that sort of environment will take its toll on people’s mental health,” warned Mr Foulkes.

He said there was already work going on to encourage more nurses to specialise in cancer through a programme called Aspirant Cancer Career and Education Development (ACCEND).

However, Mr Foulkes said there needed to be more funding and focus from the government to address not only the workforce issues but the overall capacity difficulties facing SACT services.

While all NHS services were facing similar challenges, Mr Foulkes said the organisations behind the letter wanted the government to take note of the “specific issues” facing cancer care right now.

He also stressed that nurses needed to be involved in any discussions that take place to address these issues.

“If there is to be a meeting between cancer services and the government, it’s vital that nurses have a voice in that. It can’t be just doctors meeting.

“Because the people who actually deliver the care are nurses,” he said. “Nurses have to be involved.”

As well as UKONS, the letter to Mr Barclay was also signed by representatives from the Royal College of Radiologists, the British Oncology Pharmacy Association, and the Association of Cancer Physicians.

In response, a Department of Health and Social Care spokesperson said: “There are more doctors, nurses and staff working in the NHS than ever before with 50% more specialist cancer doctors treating patients now compared to 2010.

“The NHS is also seeing, treating and saving record numbers of people with cancer but we know there is more to do,” they said.

“That is why we are seeking views on our Major Conditions Strategy and the NHS will soon be publishing a long-term workforce plan setting out how it will recruit and retain even more staff.”

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