Background

Patient experience is a widely used measure of care quality in cancer. Clinical nurse specialists (CNS) are now involved in many aspects of cancer care. This study examined whether being given the name of a CNS is associated with different experiences reported by patients across the cancer care pathway.

Method

Using the linked National Cancer Patient Experience Survey (CPES) and the Cancer Registry Dataset in England (2010-14), we identified 100,885 colorectal, lung, breast and prostate cancer patients who responded to CPES between 2010-14. We compared experiences of four key aspects of cancer care among patients who reported being given a CNS name with those who did not, adjusting for age, sex, socioeconomic deprivation, ethnicity, route to diagnosis, and disease stage at diagnosis.

Results

Across all cancer types, patients who reported being given the name of a CNS reported better experiences of being involved in treatment decisions, perceived that their care was more co-ordinated, that they were treated with more respect and dignity, and overall reported  more positive care experience compared with those who did not.  Experience of  being involved in treatment decisions was the aspect of care most strongly associated with  being given a CNS name (colorectal: adjusted OR 2.69, 95% CI: 2.45 – 2.96; lung: adjusted OR 2.41, 95% CI: 2.07 - 2.78; breast: adjusted OR 2.68, 95% CI: 2.47 - 2.92; prostate: adjusted OR 2.11, 95% CI: 1.92 - 2.32).

Conclusion

Being given the name of a CNS is associated with patients reporting better experiences across several core aspects of cancer care. These findings provide new evidence of the vital contribution CNS make to cancer care, and strongly suggest their input and support should be available to all patients after the diagnosis.

Impact statement

This study suggests that CNS care is playing a direct role in improving patients’ experiences and that removing this care will diminish cancer service delivery.