Case Studies

Prior to accepting a post as the Lung Cancer Care Coordinator, I spent 10 years working as the Lung MDT coordinator and cancer tracker. During this role I developed a specialist interest in lung cancer and was increasingly missing the patient contact. I was therefore delighted when the Macmillan Lung Cancer Coordinator role was advertised and I was appointed.  

As one of the first Cancer Care Coordinators at the Trust, I was able to make the job my own and the role has certainly evolved into something quite different from when I started 7 years ago. 

Some of my roles now include: 

• Acting as a single point of contact for patients and carers: triaging enquiries, dealing with the ones that I know I can resolve within my capabilities and escalating to my CNS colleagues or to the consultants as required.
• Referring on to specialist services – for example, complementary therapy, dieticians, exercise programmes, welfare and benefits, clinical psychology, and also signposting to other resources and groups which could be of benefit.
• Chasing investigation reports in time for planned clinic appointments and requesting bloods prior to CTs.
• Maintaining a comprehensive spreadsheet, summarising where patients are on any given pathway. This helps with data collection for audits, which I have also been involved in.
• Running my own holistic needs assessment clinic.

However, my main role – and the one from which I get the most job satisfaction – is offering support and spending time with lung cancer patients and their families, providing support calls, ward visits and going to see patients whilst they have their chemotherapy treatments. I also support some patients in respiratory and oncology clinic appointments and have a weekly holistic needs assessment clinic. Over the coming year I will be the main point of contact for a defined cohort of patients as they undergo the investigative part of their lung cancer journey. This is something I’ve been working towards and am grateful to the nursing team for recognising my capabilities and helping me to continue to develop.

A unique part of my role over the last few years has been taking on some extra hours as lung cancer pathway navigator. This role has ensured earlier support for patients and faster cancer diagnosis by ensuring 2-week wait referrals are triaged promptly, relevant investigations are arranged, and patients informed efficiently.

I think anyone who works in this field does the job because they want to make a difference. People are going through probably the most difficult times of their lives, and anything I can do to make it more bearable, or that little bit easier for them and their families – whether that’s practically or emotionally – makes it all worthwhile. 

At times it can be really difficult. But I feel so lucky to work in such an incredible supportive team who value the role of the Coordinator and Navigator and can see the difference it makes, not only to the pathway but, most importantly, to the patient experience. I feel very passionate about advocating and supporting the development of this dynamic role nationally.  

I began my role as a Lung Cancer Navigator in October 2021 after many years working in musculoskeletal physiotherapy, and although daunting to make such a change in employment, it has been a very rewarding experience.

I work closely with the LCNSs in a small team in one of our District General Hospitals and help support the respiratory consultants, LCNSs and our patients. A big part of my role includes completing the patients’ holistic needs assessments, which provides an opportunity to discuss any queries or concerns they may have and working together to determine possible solutions and options of support. This may be through providing information leaflets, signposting or referral to NHS and external services such as benefit advisors, clinical psychologists, district nurses, social services and various charities to help with practical, physical and emotional issues. The holistic needs assessment tends to be done over the telephone due to capacity issues; however, we strive to accommodate face to face appointments as best able if a patient prefers this.

I support the LCNSs by dealing with telephone queries to the department, chasing investigation results, arranging appointments, attendances at the emergency department and day unit, and hospital transport as needed and assist with any requests within my scope of practice which allows the LCNSs to continue with their clinical duties and other calls that I may not have the qualifications or knowledge to resolve.

The majority of our patients are introduced to the LCNSs and myself through our Rapid Access Clinic at the point of suspicion and we help support throughout the pathway – through investigations, diagnosis, pre- and post-treatment and best supportive care. Some patients are diagnosed incidentally through an inpatient admittance, and we will keep in regular contact on the wards during this time which many patients have described finding beneficial.

Although a fairly new role, I believe the Lung Cancer Navigator/Coordinator post has proved to be an effective addition to the Lung Cancer Nursing Team for both staff and patients. I can be a point of contact for patients and family members, to offer a listening ear and support and to take on board some of the more time-consuming tasks the LCNSs would need to complete alongside their busy caseload and clinic commitments. The LCNSs are very supportive of my role, available for advice and direction, and fully encouraging of my role and any opportunities to develop my skills and understanding.

I am excited to be involved in the LCNUK Navigator framework programme and appreciate the opportunity to meet and work with such a team.  

I completed my Health and Social Care Foundation Degree Apprenticeship in 2019, which prepared me for a career as a qualified Assistant Practitioner. This apprenticeship built on my existing knowledge and skills within my role, combining work-based learning modules with specialist education. Upon completion, graduates are equipped to work autonomously and develop expertise specific to their clinical area.   

Currently, I work as an Assistant Practitioner within the Lung Cancer Nursing team. In this role I provide timely assessments for patients prior to a lung cancer diagnosis, deliver appropriate interventions and collaboratively plan care using the lung cancer pathway effectively. I am passionate about progressing my career within this specialty and strive to build strong rapport with patients, their families, visitors and MDT members. 

I chose the apprenticeship route because it suited my family commitments, allowing me to continue working while completing my training. The course also gave me valuable exposure to various specialties related to lung cancer services, broadening my clinical understanding. 

Looking ahead, I aim to complete a top-up degree which will enhance my skills and knowledge, enabling me to advocate effectively for patients and promote patient-centred care, especially the significance of living with cancer. 

As an Assistant Practitioner I have a crucial role in educating patients about their conditions, empowering them to manage their health effectively both before and after a cancer diagnosis and treatment. I collaborate closely with district nurses, palliative care teams, physiotherapists and occupational therapists to ensure seamless coordinated care. By providing consistent timely support, I help patients regain independence, improve quality of life and reduce hospital admissions. 

Clinical Supervision in Cancer Care 
Clinical supervision is a vital process in cancer care, providing professional support, reflection and learning opportunities that enhance individual development and improve patient outcomes. It allows healthcare professionals to discuss challenging cases, address emotional stresses and integrate new skills from formal training into practice. Supervision also supports referral pathways to more specialised practitioners, fostering a collaborative team approach to cancer care. 

Cancer care is emotionally demanding, and supervision offers a safe space for healthcare professionals to process feelings of burnout, stress and vicarious trauma. This support is essential to building resilience and promoting self-care among those working in this field. 

I began my healthcare career as a Healthcare Assistant (HCA) in Oncology at Mount Vernon Hospital, where I spent five years supporting and caring for patients undergoing chemotherapy. This role required empathy, emotional resilience, and close attention to detail, as I worked with patients experiencing both the physical and emotional challenges of cancer treatment..   
Seeking to expand my knowledge and clinical skills, I moved to Harefield Hospital to work as an HCA on a cardiothoracic ward. This opportunity allowed me to gain valuable experience in caring for post-operative patients following cardiac and thoracic surgeries. My background in oncology proved particularly useful, as I was able to provide both clinical and emotional support to our lung cancer patients, drawing on my previous experience. 

Recognising my enthusiasm for learning and professional development, my manager encouraged me to apply for the Trainee Nursing Associate (TNA) programme. I was accepted into this NMC-approved two-year foundation degree, which combined academic study with practical, work-based experience. Through this programme, I gained exposure not only to adult nursing but also to paediatric and mental health care, which broadened my understanding of holistic patient care. 

During my time as a TNA, a Senior Macmillan Nurse observed the compassionate way I supported our lung cancer patients and encouraged me to apply for the newly established Macmillan Cancer Support Worker role. I was successful in the interview and transitioned into this position, with full support from my manager to continue and complete my Nurse Associate training. 

As this role was new to the Trust, I had the opportunity to help shape and develop it into something that truly benefited patients. With the backing of my manager, I led and contributed to several initiatives, including post-operative follow-ups, Enhanced Holistic Needs Assessments (eHNAs), support groups, bake sales, and audits. I also worked closely with inpatients and outpatients, created a contact list for patient signposting, and collaborated with other support workers and Clinical Nurse Specialists (CNS). In addition,  I completed numerous training courses to enhance my skills and understanding, all of which have contributed to my personal and professional development. 

After successfully completing my training and receiving my NMC PIN, my role transitioned to Macmillan Registered Nurse Associate. This qualification has enabled me to practise fully within my scope, take on greater responsibilities, and deliver a higher standard of care. It has also given me the confidence to offer meaningful emotional support to patients and their families during some of the most difficult moments of their lives. 

Looking ahead, my long-term goal is to become a Registered Nurse. Once funding is available, I intend to undertake the 18-month top-up programme to achieve this. I am deeply committed to continuing my development and providing the best possible care to patients, and I look forward to the opportunities and challenges that lie ahead. 

I was a Lung Cancer Care Co-ordinator for 4 years. A secondment opportunity arose for a Lung Cancer Navigator (at a Band 5 level), and I was successful at securing the role.

The role initially started under the performance Business Intelligence Unit (BIU) team. This has recently changed, and I am now managed in respiratory.

I initially meet the patient at the first faster diagnosis standard (FDS) appointment where the patient is made aware of a suspicious finding. From here, further investigations are booked and requested. A LCNS and I, support the patient through the diagnostics. I navigate the appointments with an aim to streamline this process, navigating barriers that would delay reaching a diagnosis.

I also oversee and provide guidance to a Cancer Care Co-ordinator, which is one of the reasons this role is graded to a band 5 level.

Another aspect of my role is I extract and analyse data on the performance of the pathway. From this, I identify delays and bottle necks, and I work with a wider team to implement new structure and changes to help support and improve targets in the pathway.

I am currently working on a standard operating procedure (SOP) to implement myself giving benign results to patients at the point of a non-suspicious CT, supporting the faster diagnosis targets.

I have supported the implementation of daily FDS clinics, shortening wait times and utilising clinic slots.

I triage and vet referrals for MDT submissions to ensure appropriate discussions. This helps to aid utilisation of slots and minimise delays for patient discussions. Streamlining the patient journey to improve outcomes and patient experience throughout.