The Cancer Clinical Nurse Specialist (CNS) plays a key role in a patient’s cancer care journey – supporting them through diagnosis, treatment and the provision of psychological support and specialist care. Cancer CNSs also facilitate service improvements and implement strategic changes in personalised cancer care and living with and beyond cancer. Specialist cancer nurses improve outcomes, support patients, reduce treatment costs, increase efficiency, drive innovation, and provide valuable information for service improvement as well as enable multidisciplinary care.   

Across London there is a shortage of CNSs and a rising demand for care. There are around 375,000 new cancer cases in the UK every year – around 1,000 cases every day (CRUK, 2016-2018). Currently, there are not enough junior nurses considering this career pathway.  

A report by the London Lead Cancer Nurses Forum in 2021  identified challenges facing the cancer nursing workforce in the capital.  North Central London Cancer Alliance has been commissioned by Health Education England (HEE) to deliver a programme of work across London to address this issue. The focus is on strengthening the supply  ‘pipeline’ of nurses who could become senior CNSs in future years.   

This project has been developed in close collaboration with London lead cancer nurses, with Health Education England and with CNSs, academics and workforce leads from Cancer Alliances across England. The project has identified misperceptions or lack of awareness of the CNS role among nurses as a factor influencing the shortage.  There is also low awareness of the career development or progression pathway for this area of nursing.  

Working with the London Lead Cancer Nurses, the project team has undertaken an extensive programme of engagement and research, and has developed transformative actions to support CNS development:

  • A London-specific communications campaign aimed at addressing misconceptions about cancer CNS roles, promoting the roles, and increasing awareness of routes into cancer CNS roles.
  • A pilot of a new nursing leadership role, aimed at supporting aspirant and new CNSs, in each Integrated Care Board (ICB) in London. This pilot has received a high level of support and guidance from Cancer Nursing Leadership in London, HEE and input from Cancer CNSs across the capital.

Pilot objectives

The project will pilot a new role – the Cancer CNS Development Lead (CDL) – that supports the development of new cancer clinical nurse specialists (CNSs).

This new clinical role has been designed by London lead cancer nurses to address difficulties filling CNS roles with suitable applicants, and to mitigate the impact of high numbers of experienced CNSs retiring and being replaced by relatively less experienced nurses who need a higher level of support in order to reach full professional autonomy.  

The pilot will run for two years, with the following objectives:   

  • Increasing the number of suitable applicants applying for CNS roles in London   
  • Faster professional development of new CNSs, mitigating the impact of the upcoming retirement of large numbers of experienced CNSs   
  • Improving retention of CNSs   
  • Providing hands-on support to new CNSs, supporting their transition to becoming skilled and knowledgeable autonomous professionals. Providing outreach to other nurses, to encourage transition to CNS roles.  

The Cancer CNS Development Lead

The proposed CDL roles will be held by experienced cancer CNSs who will work across a cluster of hospital trusts, with two key areas of focus:    

  • Supporting between 10 and 18 newly appointed CNSs per postholder to develop as autonomous professionals. This will be through teaching, observational, coaching and reflective techniques as well as signposting towards other resources, based on an evidence-based capability framework (likely to be the ACCEND framework). Developmental CNSs will receive between 12-18 months’ support from the CDL. 
  • Being a Cancer CNS champion and a point of contact for aspiring Cancer CNSs. The CDL will actively promoting the Cancer CNS role, through, for example, career events, webinars and shadowing days. The programme recognises the lack of internationally educated CNSs and the CDL will promote the Cancer CNS role among this group of nurses.   

Celebrating National Cancer CNS Day 2023

On National Cancer CNS Day (26 April 2023) we celebrate the incredible work of our cancer CNSs. Cancer nurses make a big difference to patients’ lives across London. They go above and beyond to deliver specialist care every day. Please watch and share our film which recognises their work.

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