21 February 2017
Urgent action needed to address the unprecedented challenges facing the cancer workforce in England
Macmillan Cancer Support has published a report calling for stronger leadership to address challenges facing the cancer workforce in the NHS.
Thinking Differently warns that workforce shortages across the NHS mean that there are not enough cancer professionals to address the needs of a growing cancer population. Macmillan also reports that cancer professionals who are in post face increasing and more complex caseloads, with the result that they are unable to make full use of their skills.
The report warns that:
- Previous analysis by Macmillan estimated that there was a gap of 3,400 Clinical Nurse Specialists across the UK1. We have estimated there could be a deficit of 7000 posts by 20302, if the workforce doesn’t grow and trends in cancer numbers continue
- While good patient experience is strongly associated with access to a Clinical Nurse Specialist3, one in 10 patients in England do not have access to one4
- Macmillan Clinical Nurse Specialists have reported a rise in colleagues leaving the profession and a growing tendency not to replace these roles, or to replace them on temporary contracts
- Macmillan professionals have reported to the charity that their time is ‘increasingly stretched’ and that it is taken up by ‘doing non-specialist tasks’, particularly as more of their time is taken up with admin. One remarked that ‘I need to be able to target my specialist skills, and not at the photocopier.’
- A third of nurses are due to retire in the next 10 years, and Macmillan fears that pressures will mean these are not replaced5
Macmillan Cancer Support fears that increased stress and low morale among professionals could have a knock-on effect and prevent the cancer workforce from providing a seamless, coordinated experience for patients. Macmillan warns that without a sustainable cancer workforce, the NHS will not be able to deliver high-quality care to everyone living with cancer in the future.
Macmillan Cancer Support urges Health Education England (HEE) to consider a more ambitious approach, starting with holding a thorough review of the cancer workforce. The charity warns that unless HEE works with other national bodies, such as NHS England and the Department of Health, to develop a clear long-term plan – as recommended in the Cancer Strategy – the situation could deteriorate rapidly.
While the national vision should set a framework for the cancer workforce, Macmillan recognises that there is no ‘one-size fits all’ solution. Local bodies and organisations, including Cancer Alliances, will have a significant role to play in making sure this national vision works. The charity’s report recommends five solutions, which it believes are necessary to address workforce issues, including improving career pathways to specialist cancer roles, as well as enhancing the skills, confidence, and communication of existing staff.
Dr Rosie Loftus, Joint Chief Medical Officer at Macmillan Cancer Support, said:
“NHS professionals are telling us that the pressure upon them has never been greater. This is impacting hugely on their capacity to deliver the care they believe their patients need. Doing nothing is no longer an option – the NHS simply will not be able to provide people living with cancer with safe and effective healthcare if we don’t see action now.
“While Macmillan has an important role to play in developing and supporting the future cancer workforce, we cannot achieve transformational change alone. It is only by coming up with a workable and thorough plan that we can drive the necessary change across the country, so that doctors, nurses and other professionals can face the future with confidence.”
Dr Fran Woodard, Executive Director of Policy and Impact at Macmillan Cancer Support, said:
“The NHS needs a workforce with the right skills to meet the future challenges of a cancer population that is growing in both size and complexity. It is important that professionals are able to provide the highest quality care to patients and it is vital that these challenges are addressed now to enable them to make best use of their specialist skills.
“If the workforce issues aren’t addressed urgently by Health Education England and the Department of Health, there is a very real risk that the situation will unravel and we won’t provide the right standard of care for future generations of people with cancer.”
To read Thinking Differently, click here.
For further information, please contact:
Patrick Pringle, Senior Media & PR Officer
020 7840 4891 (out of hours 07801 307068)
Notes to Editors:
About Macmillan Cancer Support
When you have cancer, you don’t just worry about what will happen to your body, you worry about what will happen to your life. Whether it’s concerns about who you can talk to, planning for the extra costs or what to do about work, at Macmillan we understand how a cancer diagnosis can take over everything.
That’s why we’re here. We provide support that helps people take back control of their lives. But right now, we can’t reach everyone who needs us. We need your help to make sure that people affected by cancer get the support they need to face the toughest fight of their life. No one should face cancer alone, and with your support no one will.
To get involved, call 0300 1000 200 today. And please remember, we’re here for you too. If you’d like support, information or just to chat, call us free on 0808 808 00 00 (Monday to Friday, 9am–8pm) or visit macmillan.org.uk
1.Macmillan Cancer Support (2014) Working Together – Challenges, Opportunities and Priorities for the UK’s Cancer Workforce http://www.macmillan.org.uk/_images/ workforcediscussiondoc_tcm9-295356. pdf Internal Macmillan analysis based on Frontier Economics.
2.Macmillan Cancer Support (2014) Working Together – Challenges, Opportunities and Priorities for the UK’s Cancer Workforce http://www.macmillan.org.uk/_images/ workforcediscussiondoc_tcm9-295356. pdf Internal Macmillan analysis based on Frontier Economics.
One to one support for cancer patients: A report prepared for DH. December 2010 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216683/dh_122521. pdf
Number of nurses required is calculated based on assumptions around the appropriate size of caseloads (caseloads vary by speciality). Numbers projected forward to 2030. Includes Lung, breast, urology, upper gastrointestinal, gynaecological, lower gastrointestinal, haematology, head & neck, brain & central nervous system and skin.
Macmillan Cancer Support (2014) Working Together – Challenges, Opportunities and Priorities for the UK’s Cancer Workforce http://www.macmillan.org. uk/_images/workforcediscussiondoc_tcm9- 295356.pdf
3. Macmillan Cancer Support (2014) Working Together – Challenges, Opportunities and Priorities for the UK’s Cancer Workforce http://www.macmillan.org.uk/_images/ workforcediscussiondoc_tcm9-295356.pdf
4. Cancer Patient Experience Survey (2013) https://www.quality-health.co.uk/resources/ surveys/national-cancer-experiencesurvey/2013-national-cancer-patientexerience-survey
5. Marangozov R, Williams M, Buchan J, July 2016, Institute for Employment Studies, The labour market for nurses in the UK and its relationship to the demand for, and supply of, international nurses in the NHS http://www.employment-studies.co.uk/ resource/labour-market-nurses-uk-andits-relationship-demand-and-supplyinternational-nurses-nhs