The prostate cancer specialist nursing workforce is facing a bleak and uncertain future if urgent action is not taken, according to new research commissioned by Prostate Cancer UK and undertaken with support from the British Association of Urological Nurses (BAUN).
In a survey of just under 300 specialist nurses working with men affected by prostate cancer, conducted for Prostate Cancer UK by Plymouth University, London South Bank University and Mouchel, almost half (49%) reported that they were approaching retirement or intending to leave nursing within the next ten years. But with no clear plans for training a new workforce and prostate cancer predicted to become the most common cancer overall by 2030, patients face a future without the experience and expertise these nurses offer.
The crisis looms against a range of existing challenges which are already putting the current workforce under extreme pressure. Insufficient, variable specialist nursing provision and sometimes huge caseloads, plus a lack of administrative support, are already leading to some core elements of care, such as holistic needs assessments, being missed.*
Owen Sharp, Chief Executive of Prostate Cancer UK said:
“We know that men with prostate cancer who have access to a Clinical Nurse Specialist report better experiences of care. They often tell us that the support they receive from specialist nurses is crucial in helping them to overcome a wide range of issues including life changing side effects. The support these nurses provide is undeniably vital but our report shows a stark future where this treasure house of experience and expertise is lost and not replenished.
“Nurses are telling us that they are over-stretched beyond belief, they feel undervalued and they simply don’t have time to give every patient the dedicated support and care he needs. Couple this with the fact that a significant chunk of the workforce is soon retiring – as incidence rates for prostate cancer are expected to rise - and the picture becomes even bleaker.”
The report also reveals that while many nurses have an appetite for further career development, they find their path blocked. Obstacles to their education include limited funding, heavy workloads, and lack of study leave. Restricted opportunities for progression into leadership roles emerge as another key concern, as well as there being too few development posts for the next generation of specialist cancer nurses.
Philippa Aslet, President of BAUN during the study said; “With prostate cancer on course to become the most common cancer by 2030, there is an ever growing need for more prostate cancer specialist nurses.
“However the current workforce is under tremendous pressure and as a result of incredibly high workloads, we’re seeing some essential aspects of care drop off in many centres. If we’re going to retain our existing nurses, they need more support and there is a clear need for increased investment into the workforce.
“It’s great to see a real ambition amongst nurses for further development but again workload or lack of funding means that these opportunities currently aren’t available to them. We’d like to see this change.”
Professor Alison Leary from London South Bank University, one of the authors of the report, commented; “Findings suggest that care for the needs of men diagnosed with prostate cancer could be put in jeopardy as a result of an over-stretched, under-valued and diminishing nursing staff. Urgent attention needs to be given to strategic workforce planning to develop expertise and ensure that the workforce is a sustainable one. The development of new opportunities for both entry level nurses to entice new talent, and leadership positions to retain existing talent will be key in this.”
The report suggested a wide variation in the provision of specialist nursing for men with prostate cancer, with a number of nurses reporting frozen or vacant posts across the UK.
Owen Sharp continued; “Every man diagnosed with prostate cancer, no matter where they live, should have access to a nurse with specialist knowledge and training in prostate cancer care. But for this to happen, we need prompt, decisive action.
“We are calling on Chief Nursing Officers and local providers across the UK to take a long hard look at their urology nursing workforce. There’s still time to avert this crisis if they act now - put new incentives in place to retain the excellent workforce that currently exists, enable them to do the jobs they are trained to do, and get a training programme up and running so new nurses start to come through.”
Prostate Cancer UK provides a range of support and information for healthcare professionals working with men affected by prostate disease and is funding some short term nursing roles in order to test out new pathways of care with the generous support of the Movember Foundation and Royal Mail. For further information or to find out about Prostate Cancer UK’s movement for men, Men United, visit www.prostatecanceruk.org/health-professionals.
Notes to Editors:
About the report
This survey of the specialist nursing workforce caring for men with prostate cancer was completed across the four countries of the UK during June and July 2014. In total 302 specialist nurses working with men affected by prostate cancer completed the survey and data from 285 was used in the analysis. This is the biggest whole population survey of this workforce in recent years.
The most common job title was Clinical Nurse Specialist (185) and the most common band was Agenda for Change band seven (174). However in Scotland 50% of the respondents stated that they were paid on band six. Over half the group (158) had worked in prostate cancer care for more than 10 years. Few (48) had come into specialist posts from a specific specialist nurse development role.
According to the 2014 National Cancer Patient’s Experience Survey men with prostate cancer who have access to a Clinical Nurse Specialist report better experiences of care.
• The workforce is ageing: The workforce is ageing and nurses caring for patients with prostate cancer are no exception. 49% (140) of nurses declared that they are eligible for retirement or intending to leave the profession within the next 10 years.
• Insufficient and variable prostate cancer nursing provision: The majority of posts were full time (189), however the range of time spent working with prostate cancer patients was variable. Only 23 posts spent 100% of their time caring for men with prostate cancer. 35 nurses spent less than 30% of their time caring for men with prostate cancer, offering some specific services such as continence or erectile dysfunction services, or because no uro-oncology post was available
• High case loads: 52 nurses (18%) had a caseload of greater than 600. The most common response was those with a caseload of 600 plus.
• Lack of administrative support: About 65% of respondents said they had no administrative support per week or support for clinic letters only. Of these responses, about 86% declared that they work unpaid overtime with about 36% declaring that they work at least four hours overtime per week.
• Lack of development posts for next generation workforce: Only 48 of 285 nurses (17%) stated they came in to specialist nursing through a development role.
About Men United and Prostate Cancer UK:
• Men United is Prostate Cancer UK’s movement for everyone who believes that men are worth fighting for, to help us beat prostate cancer and keep friendships alive. Over 200,000 people engaged with Men United in 2014.
• Search Men United, or visit prostatecanceruk.org/menunited
• Prostate Cancer UK works to get men in all areas of the country the early detection, effective diagnosis and better treatments that will beat this disease.
• Prostate cancer is the most common cancer in men. More than 10,000 men die every year from this male-only disease, and 300,000 men are living with prostate cancer in the UK.
• Anyone with concerns about prostate cancer can contact Prostate Cancer UK's Specialist Nurses in confidence on 0800 074 8383 or via the online Live chat, instant messaging service: www.prostatecanceruk.org. The Specialist Nurse phone service is free to landlines and open from 9am to 6pm Monday to Friday with late opening until 8pm on Wednesdays.