Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England
Background: Lung cancer nurse specialists (LCNS) are integral to the multidisciplinary clinical team, providing personalised physical and psycho-social interventions, and care management for people with lung cancer. The National Institute of Health and Care Excellence (NICE) recommend that all patie...
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| Format: | Article |
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Elsevier
2016
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| Online Access: | https://eprints.nottingham.ac.uk/38655/ http://dx.doi.org/10.1016/j.lungcan.2016.03.011 |
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| author | Khakwani, Aamir Hubbard, Richard B. Beckett, Paul Borthwick, Diana Tod, Angela Leary, Alison White, John Tata, Laila J. |
| author_facet | Khakwani, Aamir Hubbard, Richard B. Beckett, Paul Borthwick, Diana Tod, Angela Leary, Alison White, John Tata, Laila J. |
| author_sort | Khakwani, Aamir |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Lung cancer nurse specialists (LCNS) are integral to the multidisciplinary clinical team, providing personalised physical and psycho-social interventions, and care management for people with lung cancer. The National Institute of Health and Care Excellence (NICE) recommend that all patients have access to a LCNS. We conducted a national study assessing whether there is variation in access to and timing of LCNS assessment.
Methods: The National Cancer Action Team’s LCNS workforce census in England was linked with patient and hospital Trust data from the English National Lung Cancer Audit. Multivariate logistic regression was used to assess features associated with LCNS assessment.
Results: 128,124 lung cancer patients were seen from 2007 to 2011. LCNS assessment confirmation was ‘yes’ in 62%, ‘no’ in 6% and ‘missing’ in 32%. Where (in clinic versus ward) and when (before versus after diagnosis) patients were assessed by a LCNS also varied. Older patients with poor performance status, early cancer stage, and comorbidities were less likely to be assessed; there was no difference with sex or socioeconomic group. Patients receiving any anti-cancer treatment were more likely to be assessed. Assessment was lower in Trusts with high annual patient numbers (odds ratio = 0.58, 95% confidence interval 0.37–0.91) and where LCNS caseload > 250 (0.69, 0.41–1.16, although not statistically significant), but increased where workload was conducted mostly by band 8 nurses (2.22, 1.22–4.02).
Conclusion: LCNS assessment varied by patient and Trust features, which may indicate unmet need for some patients. The current workforce needs to expand as well as retain experienced LCNSs. |
| first_indexed | 2025-11-14T19:35:38Z |
| format | Article |
| id | nottingham-38655 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:35:38Z |
| publishDate | 2016 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-386552020-05-04T17:40:28Z https://eprints.nottingham.ac.uk/38655/ Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England Khakwani, Aamir Hubbard, Richard B. Beckett, Paul Borthwick, Diana Tod, Angela Leary, Alison White, John Tata, Laila J. Background: Lung cancer nurse specialists (LCNS) are integral to the multidisciplinary clinical team, providing personalised physical and psycho-social interventions, and care management for people with lung cancer. The National Institute of Health and Care Excellence (NICE) recommend that all patients have access to a LCNS. We conducted a national study assessing whether there is variation in access to and timing of LCNS assessment. Methods: The National Cancer Action Team’s LCNS workforce census in England was linked with patient and hospital Trust data from the English National Lung Cancer Audit. Multivariate logistic regression was used to assess features associated with LCNS assessment. Results: 128,124 lung cancer patients were seen from 2007 to 2011. LCNS assessment confirmation was ‘yes’ in 62%, ‘no’ in 6% and ‘missing’ in 32%. Where (in clinic versus ward) and when (before versus after diagnosis) patients were assessed by a LCNS also varied. Older patients with poor performance status, early cancer stage, and comorbidities were less likely to be assessed; there was no difference with sex or socioeconomic group. Patients receiving any anti-cancer treatment were more likely to be assessed. Assessment was lower in Trusts with high annual patient numbers (odds ratio = 0.58, 95% confidence interval 0.37–0.91) and where LCNS caseload > 250 (0.69, 0.41–1.16, although not statistically significant), but increased where workload was conducted mostly by band 8 nurses (2.22, 1.22–4.02). Conclusion: LCNS assessment varied by patient and Trust features, which may indicate unmet need for some patients. The current workforce needs to expand as well as retain experienced LCNSs. Elsevier 2016-03-26 Article PeerReviewed Khakwani, Aamir, Hubbard, Richard B., Beckett, Paul, Borthwick, Diana, Tod, Angela, Leary, Alison, White, John and Tata, Laila J. (2016) Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England. Lung Cancer, 96 . pp. 33-40. ISSN 0169-5002 Lung neoplasm; Non-small cell lung cancer; Small-cell lung cancer; Nurses; Health services http://www.sciencedirect.com/science/article/pii/S0169500216302574 http://dx.doi.org/10.1016/j.lungcan.2016.03.011 http://dx.doi.org/10.1016/j.lungcan.2016.03.011 |
| spellingShingle | Lung neoplasm; Non-small cell lung cancer; Small-cell lung cancer; Nurses; Health services Khakwani, Aamir Hubbard, Richard B. Beckett, Paul Borthwick, Diana Tod, Angela Leary, Alison White, John Tata, Laila J. Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England |
| title | Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England |
| title_full | Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England |
| title_fullStr | Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England |
| title_full_unstemmed | Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England |
| title_short | Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across England |
| title_sort | which patients are assessed by lung cancer nurse specialists? a national lung cancer audit study of over 128,000 patients across england |
| topic | Lung neoplasm; Non-small cell lung cancer; Small-cell lung cancer; Nurses; Health services |
| url | https://eprints.nottingham.ac.uk/38655/ https://eprints.nottingham.ac.uk/38655/ https://eprints.nottingham.ac.uk/38655/ http://dx.doi.org/10.1016/j.lungcan.2016.03.011 |