{"id":2450,"date":"2022-12-18T19:03:24","date_gmt":"2022-12-18T19:03:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=2450"},"modified":"2022-12-18T19:03:24","modified_gmt":"2022-12-18T19:03:24","slug":"a-review-of-the-cancer-nursing-and-ahp-workforce-within-a-district-general-hospital","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2022\/12\/18\/a-review-of-the-cancer-nursing-and-ahp-workforce-within-a-district-general-hospital\/","title":{"rendered":"A review of the cancer nursing and AHP workforce within a district general hospital"},"content":{"rendered":"

Vicki Havercroft Dixon (@vjhavercroft), Lead Cancer Nurse \u2013 Hampshire Hospitals NHS Foundation Trust, Florence Nightingale Leadership Scholar 2021\/22 @FNightingaleF\"\"<\/a><\/p>\n

In May 2021 I was successful in starting the next part of my nursing leadership journey by commencing as a Florence Nightingale Foundation leadership scholar.\u00a0 Then in September 2021, after nearly 25 years at the same trust, the scholarship gave me the confidence to look outside my comfort zone and I started as the Lead Cancer Nurse at a district general hospital (DGH); a trust which had been part of a merger 10 years previously.<\/p>\n

Prior to my commencement in the lead nurse role, the trust had been plagued by inconsistent nursing and AHP leadership and management structures within cancer services. Cancer specialist roles such as the Clinical Nurse Specialist (CNS), Cancer Support Worker (CSW), and Cancer Specialist Allied Health Professionals (AHP) were not well understood or recognised.<\/p>\n

The Cancer Alliance (2019)<\/a> highlighted significant gaps in the cancer workforce, with Macmillan (2021)<\/a>echoing this and the negative impact on patient care (\u2018Cancer nursing on the line: why we need urgent investment across the UK\u2019). These unfavourable reports informed my first priority as lead cancer nurse, which was to undertake a cancer workforce review. Fortuitously, a trust wide workforce review had just begun, which I linked into. The addition of financial pressures at the trust meant that regardless of the workforce review recommendations, the focus had to be on finding creative and innovative solutions.<\/p>\n

Other than NICE guidance<\/a> for CNS and AHPs in the lung cancer pathway, there is no agreed workforce model to inform what an ideal CNS and AHP workforce should look like. Co-production with patients is the key to success. The local patient engagement group are a strong voice, working to support the trust in making positive changes.<\/p>\n

The most surprising finding from my workforce review, was that despite two acute hospitals merging 10 years earlier to form one trust, it did not function uniformly. Nursing, multidisciplinary teams (MDT) and medical teams remained quite separate with little or no cross cover. Cancer specialist AHPs were non-existent at one of the sites. This left little opportunity for innovative working and service development.<\/p>\n

Summary of findings:<\/em><\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Positives<\/em><\/strong><\/td>\nNegatives<\/em><\/strong><\/td>\n<\/tr>\n
Band 4s well supported<\/em><\/td>\nBand 7s not supported<\/em><\/td>\n<\/tr>\n
Band 6s supported<\/em><\/td>\nLittle or no collaboration between tumour site specific teams on the different hospital sites<\/em><\/td>\n<\/tr>\n
\u00a0<\/em><\/td>\nSignificant variations on how teams work, what is viewed as \u2018normal business\u2019 and what they see as extra and a burden on their time<\/em><\/td>\n<\/tr>\n
\u00a0<\/em><\/td>\nTeams that were managed by the Operational Services Managers (OSM) were less likely to have regular catch ups, meaningful appraisals, and a vision to move services forward<\/em><\/td>\n<\/tr>\n
\u00a0<\/em><\/td>\nLack of data around the nursing teams due to the current electronic IT system not being able to pull all the required data<\/em><\/td>\n<\/tr>\n
\u00a0<\/em><\/td>\nLack of job plans by some teams<\/em><\/td>\n<\/tr>\n
\u00a0<\/em><\/td>\nLack of cover during periods of sickness and annual leave<\/em><\/td>\n<\/tr>\n
\u00a0<\/em><\/td>\nLack of education around supporting patients\u2019 psychological needs<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/em><\/strong><\/p>\n

Summary of recommendations<\/em><\/strong><\/p>\n