A130

What does CNS stand for?

Pauline Dineen

East Kent Health Foundation Trust, Kent, UK

Proposal

Early consideration suggested that there was not likely to be a tool available to carry out the task of quantifying the role of the CNS. A review was carried out for the purpose of analysing the service currently delivered and to identify areas that could be improved or developed by working in different ways. The service will subsequently be streamlined, role allocation explored and a possible service redesign to address the capacity issues which threaten to compromise target compliance. There could then be a decision made, based on accurate facts regarding the possible need for additional resources. This is the only evidenced work with the observations and recordings carried out by a third party so is of paramount importance and free from bias.

Process

Three days were spent shadowing 28 CNS to record activities that were carried out. Twenty main themes were identified and all tasks recorded on a timeline.

Aim

(1) To identify labour intensities and areas needing more support in light of the Cancer Reform Strategy.

(2) To identify variability between role/specialty and look for any possible standardisation.

(3) To identify tasks inappropriate for the CNS and reallocate thereby releasing more time to care.

Result

The timeline was transformed into a pie chart which evidenced that 33% of work carried out was not appropriate to the grade or role of the CNS.

Redevelopment will include:

(1) Increased teaching to achieve a greater level of nurse expertise

(2) Nurse led clinics

(3) Equity of care on outreach sites

(4) Increase in support groups/carer sessions

(5) Research and audit

(6) Drop in/patient initiated clinics

(7) Increased quality qualitative patient opinion sought

This was not a cost cutting exercise. There is nothing but gain to be achieved for the patient, and all relevant services, by a process redesign.