Specialist nurse shortage negatively affecting prostate cancer care

According to Prostate Cancer UK, there is a currently a shortfall of more than 300 specialist urology nurses meaning many men do not have access to the expert care and advice they provide.

“We’re calling on NHS providers across the UK to develop a clear strategy”

Heather Blake

The charity has warned that the problem is set to get worse, as the number of men affected by prostate cancer continues to increase.

“We know that men with prostate cancer who have access to a clinical nurse specialist have a better patient experience,” said Heather Blake, director of support and influencing at Prostate Cancer UK.

“But currently there are only six CNSs specialising in urology for every thousand people diagnosed with urological cancer in England,” she said.

“Many men with prostate cancer miss out on this critical support while living with the often life-changing side effects of their diagnosis and treatment,” she noted.

An estimated 400,000 men are currently living with prostate cancer in the UK, with the number set to rise.

The charity had estimated that around 800 urology nurses are needed across England to ensure every man receives the best care.

However, the latest Macmillan specialist cancer nurse survey in 2017 found there were only 463 urology CNS posts in England – meaning a shortfall of more than 300.

“Most specialist cancer nurses who care for prostate cancer patients specialise in urology”

Helen Johnson

Prostate Cancer UK has also estimated that nearly 1,000 specialist nurses will be needed in just under 10 years’ time to cope with increased demand.

In addition, the charity has pointed to “shocking” regional variations in men’s access to nursing support.

The latest National Cancer Patient Experience Survey found 90% of men who took part had been given the name of their clinical nurse specialist.

However, results varied across trusts in England, with only 60% of men in one area being given the name of their specialist nurse.

While 84% of men said it was easy to contact their specialist nurse, this also varied from trust to trust dropping to just 56% at one organisation.

Prostate Cancer UK said the shortage of specialist nurses was having an impact on urology nurse caseloads and working conditions.

“Nurses tell us that they face high caseloads, and this is made worse by a lack of administrative support which prevents them being able to give each patient the dedicated support he needs. This must change,” said Ms Blake.

She said NHS organisations needed to look at “innovative ways to free up nurses’ time and enable them to do the jobs they are trained to do”.

“That’s why we’re calling on NHS providers across the UK to develop a clear strategy that addresses these CNS workforce issues and for the government to provide the money needed to make it happen,” she added.

“There are simply not enough clinical nurse specialists caring for prostate cancer patients”

Clare Waymont

Clinical nurse specialists told Nursing Times that a key issue was the fact urology nurses tended not focus on prostate cancer alone.

“Most specialist cancer nurses who care for prostate cancer patients specialise in urology, rather than prostate cancer specifically,” explained CNS Helen Johnson.

“This means they also have to care for patients with other urological issues like bladder, testicular and kidney cancer, as well as patients with benign problems like prostatitis or incontinence,” she said.

As a result, she said “the urology nursing workforce has always been stretched beyond capacity compared to other specialties”.

While there has been an expansion in urology medical teams to cope with increasing demand, Ms Johnson said this had not been backed up with extra nursing support.

Meanwhile, she highlighted that many urology nurses were set to retire within the next five to 10 years.

“Unfortunately, hospital trusts don’t seem to have a plan in place to replace these individuals or grow the teams they already have,” said Ms Johnson.

Fellow CNS Clare Waymont agreed more work needed to be done to boost numbers.

“The clinical nurse specialist plays a vital role in the management and delivery of high quality, patient focused care, but there are simply not enough clinical nurse specialists caring for prostate cancer patients, particularly in comparison to other cancers,” she said.

She added: “We are heading towards a further depletion in the workforce with large numbers of clinical nurse specialists due to retire. We need to ensure succession planning and offer a structured education and development programme for future urological specialist nurses.”