Quality statement 3: Clinical nurse specialist
Quality statement
Adults with renal cell carcinoma (RCC) have access to a clinical nurse specialist.
Rationale
Clinical nurse specialists can provide specialist guidance and support for adults with RCC, and their families and carers, from diagnosis and throughout management, follow-up or palliative care. They can act as the key worker, coordinating communication and care between secondary and primary care and providing continuity. Having a clinical nurse specialist will ensure that adults with RCC can access information, advice and support whenever they need it, helping to improve their quality of life and health outcomes.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
a) Proportion of adults newly diagnosed with RCC seen by a clinical nurse specialist.
Numerator – the number in the denominator seen by a clinical nurse specialist.
Denominator – the number of adults with a new diagnosis of RCC.
Data source: The National Kidney Cancer Audit - National Cancer Audit Collaborating Centre's Quarterly Report performance indicator dashboard presents data on the percentage of people diagnosed with kidney cancer that were seen by a clinical nurse specialist.
b) Proportion of adults with RCC who are given contact details of a clinical nurse specialist who will support them.
Numerator – the number in the denominator who are given the details of a clinical nurse specialist who will support them.
Denominator – the number of adults with RCC.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from patient records or audits of clinic letters. The National Cancer Patient Experience Survey includes a question on whether people (aged 16 and over) had a main contact within the care team, such as a clinical nurse specialist, who would support them through their treatment. Survey data for renal cancer (cancer type) are presented on the interactive dashboard at national and various sub-national levels.
Outcome
Proportion of adults with RCC who are satisfied with the support provided by a clinical nurse specialist.
Numerator – the number in the denominator who are satisfied with the support provided by a clinical nurse specialist.
Denominator – the number of adults with RCC.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from a survey of adults with RCC. The National Cancer Patient Experience Survey includes a question on how helpful people (aged 16 and over) found the advice received from their main contact in the care team overall. Survey data for renal cancer (cancer type) are presented on the interactive dashboard at national and various sub-national levels.
What the quality statement means for different audiences
Service providers (such as secondary and tertiary care services) ensure that clinical nurse specialists are available to support adults with RCC from diagnosis and throughout management, follow-up or palliative care.
Healthcare professionals (clinical nurse specialists) are a point of contact and a source of information, advice and support for adults with RCC and their families and carers.
Commissioners ensure that services have enough clinical nurse specialists with training and experience in kidney cancer to support all adults with RCC, from diagnosis and throughout management, follow-up or palliative care.
Adults with RCC can contact a clinical nurse specialist (a nurse experienced in treating and supporting adults with kidney cancer) for information, advice and support throughout their care.
Source guidance
Kidney cancer: diagnosis and management. NICE guideline NG256 (2026), recommendations 1.1.3 and 1.1.4
Definitions of terms used in this quality statement
Access
Being able to contact and use the services provided by a clinical nurse specialist. These services include:
-
providing information, advice and support, from diagnosis and throughout management, follow-up or palliative care
-
signposting to voluntary or community emotional support services, or referral to NHS psychological health support services, if and when appropriate
-
smoking cessation support
-
opportunities for involvement in clinical trials and other types of research.
The clinical nurse specialist may do risk factor assessments, holistic needs assessments and personalised care and support planning. [NICE's guideline on kidney cancer, recommendations 1.1.2 to 1.1.4 and 1.1.6 to 1.1.8]
Clinical nurse specialist
A clinical nurse with training and experience in supporting adults with kidney cancer. This can include surgical or oncology clinical nurse specialists and palliative care clinical nurse specialists, depending on the stage of care. They attend multidisciplinary team meetings, act as a link between the urology and oncology teams, and liaise between primary and secondary care, supporting communication and care coordination. [NICE's guideline on kidney cancer, recommendation 1.1.4, and expert opinion]