Nurse Practitioner, United Kingdom

I currently work on triage in a cancer services unit. Over the last five years I have seen drastic changes within our service.

Our service covers both haematology and oncology patients, with approximately 350  patients on active treatment. When I joined the triage service, we were based within the chemotherapy unit. Both haematology and oncology consultants were in nearby clinics with experienced oncologists covering the triage service. Consultant secretaries were also just across the corridor. Our triage service consisted of four staff and a shift lead.

The triage unit is open between 08:00 to 19:00 Monday to Friday, with a 24hr helpline service.

Two years ago, during the pandemic, the triage service was moved to a Same Day Emergency Care Unit. The doctors that covered triage left and were replaced with two doctors who had no experience in oncology. Our hours were extended, and our patient capacity trebled. Only two members of the nursing staff are now on shift at any one time with no admin clerks assigned. This means that all phone calls and admin work are covered by those two staff as well as clinical duties. Our shift lead left about a year ago with still no replacement in sight.

Last year, it came to a crisis point as staff members were taking on extra hours to cover annual leave. This in turn resulted in staff absences because of illnesses from burnout.

We often work fifteen-hour days. There is no night staff and often no beds for those patients who require admission.

Oncology consultants are continuing to leave and are not replaced. This means longer waiting times for patients trying to schedule an appointment. Secretaries are also leaving which leads to more and more inappropriate telephone calls to the triage service.

With many more patients being diagnosed with cancer, more recurrences as a result of late diagnoses during the pandemic, GPs still not seeing many patients face-to-face, no new staff being recruited and growing staff shortages... our National Cancer Service workforce is indeed in a crisis.