On 15 March we will see the second National Cancer Clinical Nurse Specialist (CNS) awareness day. Created by the Greater Manchester Cancer Alliance, this day is now embedded into our working year. It is an opportunity to showcase the specialist cancer nursing workforce and the services they deliver. With 30% of our specialist cancer nursing workforce due to retire in the next 10 years, the CNS workforce needs to increase by 100% in the next 7 years, to meet patient demand (Macmillan Cancer Support, 2021). Last year's event managed to engage with 12 million people across social media platforms, with all 21 cancer alliances involved in publicising the day. It was hugely successful and highlighted the valuable role of the cancer CNS.
Ford (2022) discussed the role of the CNS and how vital it is to improving services, treatment and care. The CNS role in the UK has largely evolved into an advanced practice role in order to meet the needs of patients and their families (Leary, 2021). However, the CNS role is often misunderstood and undervalued in many healthcare services, possibly because the overall effect of the role cannot be defined by single tasks, but rather represents a number of complex interactions. This ambiguity in role definition has led to CNSs being regularly reviewed within their organisations and being asked to ‘prove their worth’ is not an uncommon phrase heard by colleagues across the UK. Given growing evidence that nurse specialist roles and having a named CNS are associated with better outcomes for cancer patients (Stewart et al, 2021; Alessy et al, 2022), it seems unnecessary to have to continually prove this contribution.
It may be that the benefit of having a named point of contact at one of the most difficult times in a person's life cannot be easily described. The experience of being told they have cancer stays with a person and can have an effect on how willing they are to report problems at a later date, yet the subtle nature of some interactions can be difficult to define. Having an advocate to help navigate treatment decisions that could have lifelong effects are invaluable to patients, so why do managers not value this in the same way? It may be that immediate savings are prioritised over potential future monetary benefits to the NHS. In a complex healthcare system, it is difficult to prove the economic benefits of nursing roles, but not impossible.
Do managers and commissioners of services really understand the CNS's role if they are asking CNSs to justify their place in an organisation? Why do we need to further define the CNS role? There are various competency frameworks available for use that have overlapping elements such as advanced communication and assessment skills – do these not answer the question? The UK Oncology Nursing Society (UKONS) aims to discuss this further at their Twitter event on 15 March entitled, ‘Specialist vs Generalist – what is the future of the nursing workforce?’
A key emerging theme among specialist nursing teams is a lack of recognition in terms of their impact and skill. Given that the role has developed into an advanced practice role to meet the complex needs of patients and their families, the achievements of this group should be celebrated. UKONS has recently met with other national specialist nursing organisations to develop a statement highlighting the value of the CNS across specialties. This position statement will aim to provide further evidence and clarity of the CNS role to ensure the impact and skills of CNSs are recognised and valued.