Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit
Purpose: Health services across the world utilise advanced practice in cancer care. In the UK, lung cancer nurse specialists (LCNS) are recognised as key components of quality care in national guidelines, yet access to LCNS contact is unequal and some responsibilities are reportedly left undone. We...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2018
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| Online Access: | https://eprints.nottingham.ac.uk/53754/ |
| _version_ | 1848798984587444224 |
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| author | Stewart, Iain Leary, Alison Tod, Angela Borthwick, Diana Khakwani, Aamir Hubbard, Richard Beckett, Paul Tata, Laila |
| author_facet | Stewart, Iain Leary, Alison Tod, Angela Borthwick, Diana Khakwani, Aamir Hubbard, Richard Beckett, Paul Tata, Laila |
| author_sort | Stewart, Iain |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Purpose: Health services across the world utilise advanced practice in cancer care. In the UK, lung cancer nurse specialists (LCNS) are recognised as key components of quality care in national guidelines, yet access to LCNS contact is unequal and some responsibilities are reportedly left undone. We assess whether any variation in working practices of LCNS is attributable to factors of the lung cancer service at the hospital trust.
Method: Nationwide workload analysis of LCNS working practices in England, linked at trust level to patient data from the National Lung Cancer Audit. Chi-squared tests were performed to assess whether patient contact, workload, involvement in multidisciplinary teams (MDT), and provision of key interventions were related to 1) the trust's lung cancer service size, 2) LCNS caseload, 3) anti-cancer treatment facilities and 4) lung cancer patient survival.
Results: Unpaid overtime was substantial for over 60% of nurses and not associated with particular service factors assessed; lack of administrative support was associated with large caseloads and chemotherapy facilities. LCNS at trusts with no specialty were more likely to challenge all MDT members (80%) compared with those at surgical (53%) or chemotherapy (58%) trusts. The most frequent specialist nursing intervention to not be routinely offered was proactive case management.
Conclusion: Working practices of LCNS vary according to service factors, most frequently associated with trust anti-cancer treatment facilities. High workload pressures and limited ability to provide key interventions should be addressed across all services to ensure patients have access to recommended standards of care. |
| first_indexed | 2025-11-14T20:28:27Z |
| format | Article |
| id | nottingham-53754 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T20:28:27Z |
| publishDate | 2018 |
| publisher | Elsevier |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-537542019-08-09T04:30:14Z https://eprints.nottingham.ac.uk/53754/ Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit Stewart, Iain Leary, Alison Tod, Angela Borthwick, Diana Khakwani, Aamir Hubbard, Richard Beckett, Paul Tata, Laila Purpose: Health services across the world utilise advanced practice in cancer care. In the UK, lung cancer nurse specialists (LCNS) are recognised as key components of quality care in national guidelines, yet access to LCNS contact is unequal and some responsibilities are reportedly left undone. We assess whether any variation in working practices of LCNS is attributable to factors of the lung cancer service at the hospital trust. Method: Nationwide workload analysis of LCNS working practices in England, linked at trust level to patient data from the National Lung Cancer Audit. Chi-squared tests were performed to assess whether patient contact, workload, involvement in multidisciplinary teams (MDT), and provision of key interventions were related to 1) the trust's lung cancer service size, 2) LCNS caseload, 3) anti-cancer treatment facilities and 4) lung cancer patient survival. Results: Unpaid overtime was substantial for over 60% of nurses and not associated with particular service factors assessed; lack of administrative support was associated with large caseloads and chemotherapy facilities. LCNS at trusts with no specialty were more likely to challenge all MDT members (80%) compared with those at surgical (53%) or chemotherapy (58%) trusts. The most frequent specialist nursing intervention to not be routinely offered was proactive case management. Conclusion: Working practices of LCNS vary according to service factors, most frequently associated with trust anti-cancer treatment facilities. High workload pressures and limited ability to provide key interventions should be addressed across all services to ensure patients have access to recommended standards of care. Elsevier 2018-07-23 Article PeerReviewed application/pdf en cc_by_nc_nd https://eprints.nottingham.ac.uk/53754/1/20180727%20DCCLCNS%20-%20Manuscript%20EJON%20.pdf Stewart, Iain, Leary, Alison, Tod, Angela, Borthwick, Diana, Khakwani, Aamir, Hubbard, Richard, Beckett, Paul and Tata, Laila (2018) Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit. European Journal of Oncology Nursing . ISSN 1462-3889 (In Press) |
| spellingShingle | Stewart, Iain Leary, Alison Tod, Angela Borthwick, Diana Khakwani, Aamir Hubbard, Richard Beckett, Paul Tata, Laila Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit |
| title | Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit |
| title_full | Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit |
| title_fullStr | Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit |
| title_full_unstemmed | Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit |
| title_short | Barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit |
| title_sort | barriers to delivering advanced cancer nursing: a workload analysis of specialist nurse practice linked to the english national lung cancer audit |
| url | https://eprints.nottingham.ac.uk/53754/ |