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Supporting breast cancer patients

More people than ever are being diagnosed with breast cancer, says Jacqueline Goodchild

More people than ever are being diagnosed with breast cancer and people are living longer with – or beyond – their cancer. Often experiencing consequences of their treatment that need very particular support.

People with cancer often report unmet physical, mental health, information and emotional support needs.

We know that for all cancer patients, having access to a specialist cancer nurse is the one most important factor in making sure that people feel treated as human beings, supported and engaged in their care, rather than just
as a set of symptoms. Yet one in 10 of all cancer patients are still not assigned a cancer nurse specialist.

The cancer workforce, including cancer nurse specialists, is under huge pressure and struggling to cope with current requirements for treatment and support. But as the number of people diagnosed with breast cancer increases, the number of clinical nurse specialists in breast cancer in England has only increased by 0.5 whole time equivalent since 2007.

With 41% of breast cancer nurses in England (whose age is known) reported to be over 50 years of age, there will be another challenge to face as more experienced nurses choose to retire and need to be replaced.

Achieving World Class Cancer Outcomes: A Strategy for England 2015-2020, published by the Independent Cancer Taskforce in July 2015, recognised that delivering a high-quality cancer service is only possible if the challenges facing the cancer workforce are addressed.

One of the Taskforce’s recommendations is to take a strategic approach to the current and future cancer workforce. We know that the issues of workforce capacity and skills cannot be considered in isolation, and that truly person-centred care cannot be achieved while health, social care and the third sector continue to plan separately.

Instead, we need to review the cancer workforce as a whole. We need to find sustainable ways to fill the current gaps and adopt a skill-mix approach to care, whereby a care team will contain different people with different skills depending on the person with cancer’s level and type of need. A working group, with cross-sector representation, would be the best way to deliver care that meets people’s needs, where and when they need it, by ensuring that everyone involved in providing care has the right skills, training and support.

If the NHS doesn’t tackle this challenge now, it is in danger of seriously letting people with cancer down.

Health Education England, NHS England, charities and other key bodies must work together to make sure there are sufficient numbers of appropriately trained staff, including cancer nurse specialists, to deliver effective and supportive care which meets patient needs, now and in the future.

Jacqueline Goodchild, workforce programme manager, Macmillan Cancer Support