Quality statement 3: Lung cancer clinical nurse specialist

Quality statement

Adults with suspected or confirmed lung cancer have access to a named lung cancer clinical nurse specialist. [2012, updated 2019]

Rationale

Lung cancer clinical nurse specialists can provide specialist guidance and support at all stages of care and treatment for adults with lung cancer and their family and carers. They can act as the key worker, coordinating care between secondary and primary care and providing continuity. Having a named clinical nurse specialist will ensure that adults with lung cancer can access advice and support whenever they need it, helping to improve their quality of life and health outcomes.

Quality measures

Structure

a) Evidence of the availability of clinical nurse specialists who specialise in the care and support of adults with lung cancer.

Data source: Local data collection, for example, workforce plans or staff rotas. Clinical advice to cancer alliances for the commissioning of the whole lung cancer pathway (Lung Cancer Clinical Expert Group, 2017) recommends 1 whole-time equivalent nurse for an annual caseload of 80 new patients.

b) Evidence of local arrangements to ensure that adults with lung cancer know how to contact the lung cancer clinical nurse specialist between hospital visits.

Data source: Local data collection, for example, service protocols and information on how to contact a clinical nurse specialist.

Process

a) Proportion of adults with lung cancer who had a lung cancer clinical nurse specialist present at diagnosis.

Numerator – the number in the denominator who had a lung cancer clinical nurse specialist present at diagnosis.

Denominator – the number of adults with lung cancer.

Data source: Royal College of Physicians National Lung Cancer Audit uses data from National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset on people who had a lung cancer clinical nurse specialist present for diagnosis.

b) Proportion of adults with lung cancer who have had assessment by a lung cancer clinical nurse specialist.

Numerator – the number in the denominator who have had assessment by a lung cancer clinical nurse specialist.

Denominator – the number of adults with lung cancer.

Data source: Royal College of Physicians National Lung Cancer Audit uses data from National Cancer Registration and Analysis Service Cancer Outcomes and Services Dataset on people assessed by a lung cancer clinical nurse specialist.

c) Proportion of adults with lung cancer who were given the name of a lung cancer clinical nurse specialist who would support them.

Numerator – the number in the denominator who were given the name of a lung cancer clinical nurse specialist who would support them.

Denominator – the number of adults with lung cancer.

Data source: Local data collection, for example, audit of patient records. Quality Health National Cancer Patient Experience Survey includes data on people with lung cancer who were given the name of a clinical nurse specialist who would support them through their treatment.

Outcome

a) Proportion of adults with lung cancer who are satisfied with the support provided by a lung cancer clinical nurse specialist.

Numerator – the number in the denominator who are satisfied with the support provided by a lung cancer clinical nurse specialist.

Denominator – the number of adults with lung cancer.

Data source: Local data collection, for example, a survey of adults with lung cancer. Quality Health National Cancer Patient Experience Survey includes data on ease of contacting a clinical nurse specialist for people with lung cancer receiving hospital treatment.

b) Health-related quality of life for adults with lung cancer.

Data source: Local data collection, for example, a survey of adults with lung cancer or their families and carers including patient-reported outcome measure.

What the quality statement means for different audiences

Service providers (such as secondary and tertiary care) ensure that lung cancer clinical nurse specialists are available to support adults with suspected or confirmed lung cancer throughout their care. Providers ensure that processes are in place for adults with lung cancer to be supported by a lung cancer clinical nurse specialist at diagnosis and for them to have regular assessments with a lung cancer clinical nurse specialist at key points in their care.

Healthcare professionals (such as members of the lung cancer multidisciplinary team) ensure that adults with suspected or confirmed lung cancer know how to contact a lung cancer clinical nurse specialist between hospital visits. Healthcare professionals share information with the lung cancer clinical nurse specialist to allow them to coordinate care for adults with lung cancer. Lung cancer clinical nurse specialists provide support and information to adults with lung cancer and carry out assessments at key points of care.

Commissioners (clinical commissioning groups) commission services with enough clinical nurse specialists with expertise in lung cancer to support all adults with lung cancer throughout all stages of care.

Adults with lung cancer can contact a clinical nurse specialist (a nurse experienced in treating lung cancer) for information, advice and support throughout their care.

Source guidance

Lung cancer: diagnosis and management (2019) NICE guideline NG122, recommendations 1.2.2, 1.3.33 and 1.6.3.

Definitions of terms used in this quality statement

Suspected lung cancer

Adults with symptoms and signs of lung cancer who are referred for investigation.

[Expert opinion]

Lung cancer clinical nurse specialist

This can include surgical or oncology lung cancer clinical nurse specialists as well as palliative care clinical nurse specialists, depending on the stage of care.

[Expert opinion]

Equality and diversity considerations

Lung cancer clinical nurse specialists should ensure that people are provided with information that they can easily read and understand themselves, or with support, so that they can communicate effectively with health and care services. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally appropriate. People should have access to an interpreter or advocate if needed. For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.