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Becoming a Macmillan Clinical Nurse Specialist

Some 2.5 million Brits are currently living with cancer – a figure which is expected to nearly double by 2030, thanks to improvements in treatment and an ageing population. Each year, more than 335,000 people are diagnosed with cancer in the UK. Supporting them through initial diagnosis, and ensuring they don’t have to face cancer alone, are 4,000 Macmillan Clinical Nurse Specialists (CNS). If you’re interested in becoming one of them, here’s what you need to know.

What the role involves

Macmillan nurses support cancer patients and their families, ensuring that each person achieves the highest quality of life from the time they are diagnosed, through treatment, whatever the outcome.

As clinical experts in nursing practice, they may specialise in caring for a particular group of people, such as children; a particular type of cancer, such as breast cancer; the type of problem, such as lymphoedema; or type of care, such as palliative care.

Working in hospitals and in the community, they provide emotional and psychological support and expert information and advice on managing symptoms, pain control, cancer treatments and side effects, as well as offering assistance with financial matters.

Unlike Marie Curie Nurses, Macmillan nurses do not provide “hands-on” care. Instead, their role is to assess an individual’s psychological and physical needs, and the needs of their families, and then coordinate a team of people to provide that care.

‘As more and more people are diagnosed with cancer, and many are living longer with the disease, cancer is becoming a far more complex illness,’ says Jacqueline Goodchild, Macmillan Workforce Programme Manager.

‘Macmillan knows that clinical nurse specialists are a key part of multi-disciplinary teams, providing technical expertise and practical support, and facilitating communication between care settings and professionals. Research shows that having access to one of these cancer nurses is a key factor in positive outcomes.’

How are they funded?

The charity funds the salary cost and some of the training of Macmillan nurses for the first three years in return for a trust or hospice continuing their funding after that time. This method, known as pump-priming, means that the charity has a prominent and permanent place in cancer services.

A third of all specialist cancer nurses working in the UK are Macmillan nurses. Once in the role, Macmillan nurses continue to undertake specialist courses, for example, in chemotherapy, palliative, paediatric or breast cancer care.

Jacqueline adds: ‘Forty years after Macmillan first established cancer CNS roles, we remain strongly committed to increasing the numbers of these posts so that everyone has access to the specialist support they need and we are re-establishing a development programme that will support nurses wishing to establish themselves as specialists in cancer care.’

Qualifications and experience you need

To become a Macmillan CNS, you must have a first-level nurse registration, plus at least five year’s post-registration clinical nurse experience, two of which must have been in cancer, palliative care or a specialty area. You also need a specialist qualification in cancer, palliative care or a clinically related nursing subject, or evidence of an intention to work towards one.

Ideally, you will also have spent time working in community care, be able to demonstrate high-level assessment and care-planning skills or have experience of working in an autonomous role.

Macmillan CNSs are employed directly through their partner organisations, which are advertised on the NHS Jobs website, as well as in health-related media and journals.

Macmillan have a core job description and person specification, which outline the skills, knowledge and behaviours and minimum requirements for all new Macmillan CNS nursing jobs. You can read them here: Band 6 CNS job description [PDF] and Band 7 CNS job description [PDF]. Employers may request specific requirements in addition to those outlined.

A personal perspective

Diane Evanson, a Rarer Tumours Macmillan Clinical Nurse Specialist at the Shrewsbury and Telford NHS Hospital Trust, decided to enter the role after a positive personal experience.

‘It was a Macmillan nurse who cared for my grandparents, her caring, open and honest attitude, that inspired me to enter the role, and has stayed with me ever since,’ she says.

‘My previous job was in acute oncology, which involved managing patient cancer treatment complications. This was a busy role which didn’t have the capacity to give on-going support. In contrast, my Macmillan role enables me to support my patients through their diagnosis and treatment.’

When it came to securing her role, Diane says the main challenge was getting enough experience in her field and persuading Macmillan that she was the right person for the job.

‘Their expectations are high and getting here has taken many years of study and hands-on experience, but it has been worth it. This role I do now is my perfect job, and if it hadn’t been for Macmillan’s insight it would not have come about.

‘Macmillan are supportive to their professionals, they are about embracing the knowledge already gained from previous experience and then giving so many opportunities for us to grow more, providing courses, peer support and an ear to listen to new ideas. Their approach is very much “bring your skills and knowledge and we will enhance them.”’

If you’re interested in following in Diane’s footsteps, her advice is to read and understand Macmillan’s strategy and values and show how they would benefit your practice.

‘Becoming a Macmillan CNS has been one of the highlights of my career. It takes hard work and commitment, but the rewards are there. There is nothing like providing on-going support to a cancer patient and their family, and knowing that you have made a real difference to their lives.’

Find out more    

2015 is a significant year because it marks 40 years since Macmillan built, equipped and opened its first unit and funded the first Macmillan nurse team. To find out more about 40 years of Macmillan professionals visit:

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