For years, educating and training nurses to administer systemic anti-cancer therapy (SACT) has been fraught with challenges. Some challenges have arisen from the limited capacity to supervise and assess SACT practice and, at times, nonexistent or limited funding; others have arisen from the rather ad hoc and inconsistent way SACT education and training has been provided.
But as well as challenges there are opportunities. SACT education and training moved on from the days of ‘on the job’ opportunistic learning (the ‘see one, do one, teach one’ concept) with the introduction of the now-extinct ENB N59 course and publication of the Royal College of Nursing's guidelines on the administration of chemotherapy in 1998.
In 2007, when working as a senior lecturer in cancer care, I was fortunate to work with the local cancer network lead chemotherapy nurses to review the university's accredited chemotherapy course that I ran. I was acutely aware that regionally standardised SACT education and training was not provided throughout the UK. Some regions had a local university-accredited course, others had well-established in-house courses that had competence assessment, and some regions had little formal, regular education in place, although they worked to national standards at the time, recommended in the Manual for Cancer Services: Chemotherapy measures (National Cancer Action Team, 2004).
When I joined the UK Oncology Nursing Society (UKONS) Board in 2016, I was party to discussions about developing a national SACT Competency Passport. The Wales Cancer Clinical Network had developed and implemented standardised chemotherapy competencies for Wales, so there was a precedent for national standards.
At the same time, the London Lead Cancer Nurses and Pan London SACT Nurses Group aimed to develop a Pan-London SACT Competence Passport. Catherine Oakley, Chemotherapy Nurse Consultant at Guy's and St Thomas' NHS Foundation Trust, and the immediate past President of UKONS, led the development of a national SACT Competency Passport that was initially piloted and implemented across London.
With start-up funding from CapitalNurse, the UKONS SACT Competency Passport was launched in September 2017 (Oakley et al, 2018). UKONS has developed a model answer guide, which is issued to designated SACT sign-off assessors in SACT provider organisations. To date, nearly two-thirds of the SACT providers in the UK have requested this guide. In addition, Passport documentation has been made available on the UKONS website (https://www.ukons.org/); UKONS has promoted the Passport and funded a series of Train the Trainer events around the UK.
A Learning Outcomes Framework aligned to the Passport was published by the UKONS SACT Competency Passport Steering Group (Lavender and Oakley, 2019). With the support of CapitalNurse and North London Partners in Health and Care, the group has worked with the Electronic Staff Record (ESR) Specialist Interest Group to gain approval for the UKONS SACT Passport Learning Outcomes Framework to be adopted as a suite of national SACT competencies, available to all NHS trusts.
This means that completion of the Passport can be recorded on to ESR, and in so doing provide a nationwide digitally portable record of achievement of SACT competence. The Passport and Learning Outcomes Framework can also be used by educators to develop SACT courses.
The UKONS SACT Competency Passport Steering Group evaluates and reviews the Passport and is working on additional sections/versions for different areas of SACT practice, as well as developing online learning resources.
Given the wide consultation and collaboration involved in this project to date, I sincerely hope that the UKONS SACT Competency Passport, Learning Outcomes Framework and ESR Competencies are embraced by all SACT nurses across the UK.