England

• The Secretary of State for Health must ensure that the NHS has the sustainable nursing workforce required to deliver the care people living with cancer need.
•  NHS England, NHS Improvement and Health Education England must urgently deliver a costed cancer workforce plan. This must be based on realistic estimates of the workforce numbers that will be required to meet the needs of people living with cancer.
• The Chancellor must support this plan by providing the long-term investment needed in the next multi-year spending review.
• NHS England, NHS Improvement and Health Education England must act urgently to boost the supply and retention of the general adult nursing workforce. This is necessary to ensure all nurses have backfill for their clinical commitments to undertake CPD; and to ensure a pipeline for specialist nursing roles.
• Health Education England’s CPD budget should be restored, as a minimum, to its former highest level of £205m.

Northern Ireland 

In Northern Ireland, our cancer workforce is struggling. It needs adequate investment in the right places so that our health service can retain, develop and employ enough health care professionals with the right skill mix. This will ensure that as demand continues to increase, people living with cancer receive quality, person-centred care now and in the future.

The Department of Health should:

• Identify workforce as an immediate and long-term priority within the transformation agenda –

A planned, sustainable approach to workforce provides positive outcomes for patients. Vacancy levels and retention challenges are incurring exceptional costs which better workforce planning and more effectively targeted funding would negate.

•  Ensure that a costed cancer workforce plan is at the heart of the NI cancer strategy –

This should be based on realistic estimates of the workforce numbers required to meet the needs of people living with cancer, clear and supported professional development pathways for cancer workforce, and a person-centred, skill-mix approach to workforce planning.

Scotland

Macmillan believes that the NHS and social care system in Scotland simply does not have enough of a workforce to cope with the growing numbers and needs of people with cancer. We need:

• The Government to publish a fully-funded national health and social care workforce plan, including projections based on patient numbers, needs and complexity.
• A national approach to workforce development and deployment. We need to increase the available capacity to respond to people's needs and deploy differently, adding value to the workforce through volunteering and the third sector.
• Better data collection and integrated data, with analysis of the social care market and partnership working with the third sector.
• A fully-funded national approach to accelerate recruitment and retention strategies, including in remote areas.

Wales

To ensure we are in the best possible position to meet the demands of a growing and ever more complex cancer population, we need:

• The Welsh Government, NHS Wales and Health Education and Improvement Wales (HEIW) to apply the findings of the Macmillan Wales Cancer Workforce Census to their strategic workforce plans at an all-Wales level and within local health boards.
• The Welsh Government to emphasise the need for a stronger and more strategic focus on recruitment, retention and succession planning for cancer specialist nurses. There is wide ranging variation across specialist teams and evidence of workforce challenges on the horizon. For example, 74% of specialist cancer nurses working with breast cancer patients are aged 50 and above.
• HEIW - as a matter of priority - to commission research to understand what the future cancer care workforce and its skill mix will need to look like.
• The Welsh Government and HEIW to establish clear career pathways for specialist cancer nursing roles to support the delivery of high quality person-centred care. Doing so will provide clarity, support and the retention of clinical expertise. It will also help prevent de-skilling and encourage generalist nurses to move into this specialist area; and,
• The Welsh Government to scope the feasibility of partnership research with Macmillan Cancer Support to combine the Wales Cancer Patient Experience survey results with the data and findings of the Macmillan Wales Cancer Workforce Census. By doing so we may better understand reasons for and the close relationship between a skilled specialist cancer nurse workforce and a high quality cancer patient experience.