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JOB DESCRIPTION
GENERAL INFORMATION
Title:
Macmillan Clinical Nurse Specialist in Thoracic Oncology
Grade:
BAND 7
Job Base:
Harefield Hospital
Responsible to:
Macmillan Lead Nurse for Cancer
Accountable to:
General Manager Respiratory Division
Disclosure & Barring Service (DBS) checks: enhanced with adult/child barred list
Job summary
1. The post holder will work with colleagues and the Lead Nurse for Cancer to deliver a
supportive nursing service for patients and their families undergoing treatment and
investigations for cancer conditions at Harefield Hospital.
2. The post holder will be a core member of the Harefield Cancer Multidisciplinary
Team, contributing expert nursing opinion. However, a key aspect of the role is
ensuring continuity for patients referred for specialist care, by liaison with referring
centres.
3. The post holder will be responsible for a caseload of patients and will act as “Key
Worker”. They will be responsible for proactive management of these patients,
providing a link while patients are at home and ensuring necessary onward referrals
are in place.
Key Working Relationships:
Internal
Lead Cancer Nurse
Trust cancer nursing team
Consultant thoracic surgeons
Consultant respiratory physicians
MDT Coordinators
Junior medical staff
Advanced Practitioners
Ward teams
Palliative & Supportive Care Team
Acute Pain Control Team
Complex Discharge Coordinators
Chaplaincy staff
Benefit Welfare Advisor
Psychology
Allied Health Professionals
External
Cancer Nurse Specialists in referring trusts
MDTs in referring trusts
Community palliative care teams
General Practitioners
Primary care nursing staff
Role Overview:
The Clinical Nurse Specialist will be expected to demonstrate a higher level of practice in
both his/her direct care of patients and in his/her ability to plan and develop services to
support cancer care. Through the key skills of leadership, innovation, mastery and clinical
expertise he/she will facilitate and deliver care which is patient centred, safe, and effective.
(Diagram 1) The CNS is a core member within the Multidisciplinary care team and through
demonstration of these higher level skills he/she will work collaboratively with clinicians and
service managers to promote, develop review and redesign services which are responsive
and relevant to patient’s needs.
Has power to act
Has authority
Has influence
Promotes a learning culture
Demonstrates leadership and innovation in work
contexts that are unpredictable and that require
solving problems involving many interacting factors
Sophisticated learning
skills
Develops new skills in
response to emerging
knowledge and
techniques
Advances professional
practice
Works across
professional
boundaries using
creative reasoning and
problem solving
Higher level clinical
/ technical /
research skills
Leadership
Innovation
Level
7
Roles
Breadth and depth
of knowledge
Mastery
Excellence
Development of others
Instigates and
manages change within
a complex environment
Experience
Vision
Innovates through
reflection in
practice
Deals with
complexity
Creative reasoning
Quality at the heart of practice
Actively integrates theory and practice
Demonstrates evidence based practice
Active continuing professional development
Striving to better previously established standards
Focus on ethical and moral dimensions
Scope of Practice:
Understanding the nature and the breadth of the cancer care pathway and the potential for
the CNS to influence care at key stages within this, is fundamental to appreciation of the role
of the CNS
The cancer care pathway is made up of a number of key phases to include diagnosis,
treatment, rehabilitation, monitoring / follow up, progressive disease and end of life. The
nature of each care pathway is individual and patients may present at different stages within
the pathway. The pathway is not linear and depending on the nature of their disease, people
may move from one part to the other and back again.
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The Recent Cancer Reform Strategy (2) has highlighted a need for improved focus of care
across the whole breadth of the cancer pathway and in particular at promotion of early
diagnosis as well as rehabilitation and survivorship. The National Cancer Survivorship
Initiative (NCSI) has identified a number of drivers for change to influence cancer
survivorship (3). Both Commissioners and health care providers are being supported to
undertake actions to review how routine follow up is delivered in an attempt to drive
improvements in cancer survivorship outcomes.
The Clinical Nurse Specialist will review the cancer patient pathway to determine the key
stages where he /she will have interventions to influence patient care. The CNS will
evidence the nature of assessment and care planning which takes place at these stages.
Particular attention is relevant to stages when the patient may be transferred between the
cancer unit and cancer centre. In addition to this key interventions may be required when a
patient transfers from secondary to primary care.
References
1. Excellence in Cancer Nursing: The Contribution of the Clinical Nurse Specialist
http://www.macmillan.org.uk/Documents/AboutUs/Commissioners/ExcellenceinCancerCaret
heContributionoftheClinicalNurseSpecialist.pdf
2. Improving Outcomes: A Strategy for Cancer January 2011
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/135516/dh_1
23394.pdf.pdf
3. Living With and Beyond Cancer: Taking Action to Improve Outcomes
https://www.gov.uk/government/publications/living-with-and-beyond-cancer-taking-action-toimprove-outcomes
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Main tasks and responsibilities
Communication
 To discuss treatment options for patients with cancer including surgery,
ablation therapy, chemotherapy, radiotherapy and palliative care with
sensitivity, knowledge and expertise enabling patients and families to make
informed choices.

To ensure appropriate written information is available for patients and their families.

To ensure the needs of patients are met for whom English is not their first
language, or who have other communication difficulties, by the use of
interpreters and/or information in other languages or formats.

Maintain and promote effective communication with all members of the multidisciplinary team and other wards/departments

To help facilitate users’ views being heard through various means, implementing
change where appropriate and including the users’ view to influence that change
Patient care (both direct and indirect)
 To develop and maintain a caseload of patients and act as the nominated “Key
Worker” from diagnosis, or during the thoracic pathway.

To ensure that people affected by cancer are aware that they are interacting with a
senior healthcare professional and have access to the range of cancer resources and
services available to them (financial, information, support etc).

To ensure robust handover processes are in place between Key Workers when care
is transferred between organisations.

To be responsible for ensuring patients are aware of how to contact the Key Worker
and this relationship is recorded in the medical records.

To work as part of the multidisciplinary team, recognising the value of this way of
working and contributing to the process involved in team decision-making.

To provide expert nursing advice, education and support to patients with actual or
suspected cancer and their families, throughout the course of their illness from prediagnosis onwards.

To assess, plan, implement and evaluate programmes of care in collaboration
with ward staff, actively seeking evidence based practice that will support
clinical outcomes as appropriate.

To undertake expert assessment of physical, psychological, social, emotional
and spiritual issues at key points in the pathway using a Holistic Needs
Assessment tool and develop appropriate management plans and advice.

To sustain a high quality service with the surgical and respiratory teams, liaising with
the wider multidisciplinary team within the Trust, as well as oncology teams, referring
hospitals, and primary care teams involved in the patient’s care to ensure coordinated care is provided.

To work alongside the Multidisciplinary Team Co-ordinator to facilitate the patient
journey.
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
To attend and participate in the cancer Multidisciplinary Team Meetings

To act as the patient’s advocate, respecting privacy, confidentiality and cultural
diversity and promote this approach to care in other members of staff.

To have a high profile within clinical areas and work in partnership with nursing
and other multidisciplinary staff to ensure that care, treatment and service
needs are met, ensuring a standard approach to the delivery of excellent
nursing and supportive care.

To take a lead role in promoting a healthy lifestyle for patients and their
families, in line with national strategy requirements.
Managerial
 To be an authorised signatory on the cancer budget when required.

Where appropriate, take responsibility for the ordering and maintenance of stocks
required in order to deliver effective care to cancer patients and their families.

To attend the regular advanced Practitioner and CNS Team Meetings

To actively engage with the cancer management team, the RM Partners forums and
other partners as appropriate to continuously raise the profile of cancer nursing and
promote patient centred services for patients affected by cancer.

To help maximise the potential of all team members

To attend and play a major role in corporate groups as a representative of the
Advanced Nursing Team for Cancer Care

To represent the Trust at regional and national conferences and on working groups
as appropriate
Information management
 To maintain accurate records of the clinical service, including maintenance of Nurse
Specialist records, in accordance with Trust record keeping guidelines.

To ensure activity data are collected on Nurse Specialist workload concerning
referrals, contacts and day-to-day activity

To actively contribute to the cancer nursing team Annual Report

To undertake training for electronic information systems in place

To have an active email account and use this as one of the methods of
communicating with patients, families, and other professional staff

To work to ensure the opportunities afforded by the use of Trust intranet and internet
are maximised in order to promote and facilitate the service to staff, users and the
general public
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Research and service development
 To work alongside the Lead Nurse to ensure a continued strategic development of
the cancer service is maintained.

To ensure all team members and users have a real voice in the development of the
cancer care services within the Trust.

To participate in preparation and planning for the National Cancer Peer Review
process

To contribute to ensuring compliance to Trust policies and procedures amongst the
multi-disciplinary team.

To contribute to the development of new nursing practice and roles.

To contribute to the developments of guidelines and protocols at a local level.

To set, monitor and review standards on a regular basis to ensure practice and care
is evidence based and in line with local and national policy.

To provide and demonstrate sound clinical expertise and develop support
mechanisms for sharing good practice, encouraging and directing innovation in ongoing nursing development.

To demonstrate a commitment to advancing nursing/clinical practice in research and
implementing evidence based practice.

To identify opportunities for nursing research within own speciality and work with
team members to facilitate objectives.

To take part in the audit of the current service ensuring appropriate action for service
improvement is undertaken when indicated.

Influence others to base their practice on evidence.

Demonstrate research critical appraisal skills.
Professional
 To maintain effective registration with the NMC

To abide by the Trust’s core behaviours for staff and all other Trust policies including
standing financial instructions, research governance, clinical governance, patient and
public involvement, codes and practices, and health and safety policies

To act as a role model for advanced nursing practice within the Trust.

To develop and maintain clinical skills and knowledge in cancer care in order
to achieve evidence based best practice and promote this in others.

To be involved in the training of nursing staff and Allied Health Professionals
by providing teaching for ward-based education programmes and other inhouse initiatives and on courses developed by the CNS team.

Participate in the Trust’s appraisal and personal development plan schemes
meeting with the Lead Nurse regularly for one-to-one support and at least
annually to discuss personal and professional development.
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
To identify and be responsible for own professional and managerial development in
liaison with the Lead Nurse for Cancer, attending courses, meetings and conferences
in order to achieve this.

To act as a resource to more junior staff members to help identify and meet their own
goals for professional development

To establish a network with multi-professional colleagues within the Trust and across
London, other referring Trusts and nationally.
Other duties
To undertake any other duties commensurate with the grade as requested.
This job description is intended as a basic guide to the scope and responsibilities of
the post and is not exhaustive. It will be subject to regular review and amendment as
necessary in consultation with the post holder.
ADDITIONAL INFORMATION
Trust mission
To be the leading national and international centre for the diagnosis, treatment and care of
patients with heart and lung disease, creating and disseminating knowledge through
research and education
Confidentiality
During the course of your employment you may have access to, see or hear information of a
confidential nature and you are required not to disclose such information, particularly that
relating to patients and staff.
In order to comply with the Data Protection Act 1998 you must not at any time use personal
data held by the Trust for any unauthorised purpose or disclose such as data to a third party.
You must not make any disclosure to any unauthorised person or use any confidential
information relating to the business affairs of the Trust, unless expressly authorised to do so
by the Trust.
Health & Safety
Smoking
It is the policy of Royal Brompton & Harefield NHS Foundation Trust that all people who work
for the Trust or, while on its premises, obtain treatment or visit the Trust in any capacity, do
so without exposure to tobacco smoke, and so smoking of cigarettes and E-cigarettes is not
allowed anywhere on any Trust premises.
The Trust aims to provide appropriate support, in partnership with local Occupational Health
and Community Services, to ensure that Trust staff and patients can access practical help
and support in their attempts to stop smoking.
This policy is based on clear evidence that, in addition to the health risks taken by smokers
themselves, others who breathe in exhaled tobacco smoke (passive smokers) have
increased risk of disease.
NHS Estates have notified all NHS agencies that E-Cigarettes and the charging there of are
not permitted within any Trust property (including accommodation).
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Diversity
You are at all times required to carry out your responsibilities with due regard to the Trust’s
Diversity policy and to ensure that colleagues or staff that you manage receive equal
treatment throughout their employment with the Trust.
Risk management
All staff have a responsibility to report all clinical and non-clinical accidents or incidents
promptly and, when requested, to co-operate with any investigation undertaken.
Conflict of interests
You may not without the consent of the Trust engage in any outside employment. In
accordance with the Trust’s Conflict of Interest policy, you must declare to your manager all
private interests which could potentially result in personal gain as a consequence of your
employment in the Trust. Interests that might appear to be in conflict should also be
declared to your manager.
In addition, the NHS Code of Conduct and Standards of Business Conduct for NHS Staff
(HSG 93/5) requires you to declare all situations where you or a close relative or associate
has a controlling interest in a business (such as a private company, public organisation or
other NHS voluntary organisation) or in any activity which may compete for any NHS
contracts to supply goods or services to the Trust. You must therefore register such interests
with the Trust, either on appointment or subsequently whenever such interests are gained.
You should not engage in such interests without the written consent of the Trust, which will
not be unreasonably
withheld. It is your responsibility to ensure that you are not placed in a position that may give
rise to a conflict between your private interest and your NHS duties.
CODE OF CONDUCT FOR PROFESSIONALLY QUALIFIED STAFF GROUPS
All staff are required to work in accordance with their professional group’s code of conduct
(e.g. NMC, GMC, DoH Code of Conduct for Senior Managers).
Disclosure & Barring Service checks (where relevant)
If the post has been identified as being an 'eligible position’ under the Rehabilitation of
Offenders Act 1974 (Exceptions) Order 1975 or, in some cases, the Police Act 1997, it meets
the eligibility criteria for a disclosure to be requested through the Disclosure and Barring
Service (DBS). Where a DBS check is indicated above applicants who receive a conditional
offer of employment will need to complete a satisfactory DBS check prior to the appointment
being confirmed.
With the exception of Basic disclosure certificates which only contain information about spent
convictions, all other DBS level checks will disclose both spent and unspent convictions,
cautions (including reprimands and final warnings) which are not 'protected' as defined by the
Rehabilitation of Offenders Act 1974 (Exceptions Order) 1975 (as amended). Enhanced
disclosures may also include other relevant police information where this is deemed relevant
to the position you are applying for.
A criminal record will not necessarily bar you from appointment - that will depend on the
nature of the position for which you are applying and the particular circumstances of the
incident(s).
You are obliged to inform the Trust if at any time in the course of your employment you are
the subject of a police investigation, or are convicted of a criminal offence.
You must also inform the Trust immediately if at any time during your employment you are
the subject of an investigation by the Independent Safeguarding Authority or are Barred from
either its Children’s Barred List or Adults’ Barred List. Failure to comply with these
requirements may result in disciplinary action. You will be committing a criminal offence if
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you seek to undertake or undertake any Regulated activity while Barred by the Independent
Safeguarding Authority from either its Children’s Barred List or Adults’ Barred List.
Core behaviours for all Trust staff
All staff will:
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Act with honesty and integrity at all times
Demonstrate respect for others and value diversity
Focus on the patient and internal and external customer at all times
Make an active contribution to developing the service
Learn from and share experience and knowledge
Keep others informed of issues of importance and relevance
Consciously review mistakes and successes to improve performance
Act as ambassadors for their directorate and the Trust
Be aware of the impact of their own behaviour on others
Be discreet and aware of issues requiring confidentiality
In addition, all managers and supervisors will:
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Value and recognise the ideas and contributions of all team members
Coach individuals and teams to perform to the best of their ability
Delegate work to develop individuals in their roles and realise their potential
Give ongoing feedback on performance, and effectively manage poor performance
Provide support and guidance to all team members
Encourage their team to achieve work/personal life balance
Actively listen to comments/challenges and respond constructively
Lead by example, setting high standards
Ensure that there are sufficient resources for their team and rebalance priorities
accordingly
Provide a safe working environment
Infection and Prevention Control
All Trust staff will:

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Act as a role model and champion for the highest standards of all aspects of infection
prevention and control and implementation of all Infection Prevention and Control
Trust policies and guidelines.
Demonstrate respect for the roles and endeavours of others, in implementing good
standards of hand hygiene.
Value and recognise the ideas and contributions of colleagues in their endeavours to
reduce the incidence of healthcare associated infection.
The Royal Brompton & Harefield NHS Foundation Trust is a non-smoking Trust.
Nurses working within the Royal Brompton & Harefield NHS Foundation Trust are
expected to abide by the essentials of nursing care (6 C's)
 Competence: to continually develop nursing knowledge and skills
 Care: to always provide the highest quality care to all patients
 Compassion: to treat people with kindness and respect at all times
 Commitment: to always strive to do the best for patients
 Communication: to be open and transparent with patients and colleagues at all times
 Courage: to always speak out if it is in the patients best interest
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Confirmed as accurate by post holder:………………………………………………
Date:…………………………………………………………………………………………..
Confirmed as accurate by manager:………………………………………………….
Date:…………………………………………………………………………………………..
Date: December 2016 (Matthew Johnson Macmillan Lead Cancer Nurse)
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