Cancer nursing on the line: Why we need urgent investment to end the workforce crisis
When the pandemic hit, an already short-staffed cancer workforce was depleted even further. A new report by Macmillan is now exposing the extent of the UK workforce crisis. Clare Woodford, Senior Policy Adviser at Macmillan, shares our charity's findings and what we are doing to end the crisis.
Everyone working in cancer care will be acutely aware of the long-standing workforce crisis that is engulfing our cancer services. Macmillan has been warning about increasing staffing gaps for many years. However, our charity's latest research exposes how the coronavirus pandemic has taken this crisis to a new level.
The incredible resilience of cancer professionals has been tested to the limit during the last 18 months as vital support services have been suspended and staff redeployed. Sadly, the cancer nursing shortage is limiting the support people with cancer are receiving, which leads to serious health consequences.
Now, for the first time, Macmillan’s new report 'Cancer nursing on the line' puts a figure on the number of extra nurses the Government needs to recruit – an extra 4,000 nurses across the UK by 2030 to meet the projected needs of people living with cancer.
Tackling the cancer workforce crisis
Alongside modelling the nursing workforce we will need by 2030, we have also costed the Government investment needed to train the 4000 required by people living with cancer in the UK – around £170 million. In England, we are asking for this Autumn’s Comprehensive Spending Review to invest in a new Cancer Nurse Fund, providing £124 million to train an extra 3,371 specialist cancer nurses by 2030.
And of course, we need to stem the flow of nurses leaving the profession and better support those currently in post. The strain of working flat out in such a pressured environment during the pandemic has taken its toll on professionals’ physical and mental health.
As well as vital wellbeing support, we have to address workload and ensure nurses can access fair pay and career progression opportunities. We know that before the pandemic 64% of cancer nurses could not access protected time for continuing professional development, with one in five having to use their annual leave and pay for courses out of their own pocket. And we need to boost the status of nursing careers, including by developing structured pathways from general adult nursing to specialist cancer nursing. This work has started but the pandemic has added a new urgency.
While Macmillan’s new modelling centres around specialist cancer nursing gaps, our Forgotten ‘C’ campaign highlights workforce shortages across a number of professionals delivering cancer care. The pandemic has added to this long-term challenge and we now face a full-blown care crisis. Macmillan is therefore calling for each nation to urgently deliver a fully funded, long-term workforce strategy.
Cancer patients missing vital support
Sadly, we are now seeing the impact of nursing pressures on access to personalised care for people living with cancer. Gabi, a specialist cancer nurse, describes the practical effect of shortages: ‘Our nursing staff are continually under pressure to provide the level of care they know their patients deserve. But with dwindling resources, including physical time and adequately staffed shifts, it is becoming increasingly difficult to do this’.
New Macmillan polling shows that 25% of people diagnosed with cancer in the UK in the past two years, including at least an estimated 75,000 people diagnosed since the start of the pandemic, missed out on specialist cancer nursing support. Among people recently diagnosed with cancer in the UK who did not receive enough support from a specialist cancer nurse during their diagnosis or treatment, almost half (44%) said this led to at least one of the following medical impacts:
- being unsure about which side-effects of treatment they should be looking out for
- ending up in A&E
- being unsure if they were taking their medication correctly.
People diagnosed in the past two years who lacked specialist nursing support were also significantly more likely to report serious mental health impacts related to their cancer diagnosis, such as being 52% more likely to report anxiety or depression.
Macmillan’s message is clear. We cannot keep piling the pressure on our specialist cancer nurses. If our Government is serious about building back better for cancer services, it must invest in cancer nurses and the wider workforce. People with cancer and our professionals deserve better.