What is it about?
Cancer services in the NHS are under huge pressure. More people are living with cancer and treatments are becoming more complex, but there are not enough doctors and nurses to meet the demand. This article looks at a new approach, using the ACCEND framework, which focuses on people’s skills and capabilities rather than just their job titles. By using this framework in two NHS trusts, tasks such as routine checks and treatment reviews were safely shared with advanced and enhanced practitioners, including nurses, pharmacists and other professionals. This freed up consultants to focus on the most complex cases. The study found that up to 30% of outpatient cancer care could be delivered by enhanced practitioners, and another 30% of systemic therapy clinics could be led by advanced practitioners. Patients reported high satisfaction with these clinics, and staff described better career development and clearer progression routes.
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Why is it important?
This work shows that the NHS can meet growing cancer care demands by rethinking how the workforce is organised. Instead of relying only on consultants, tasks can be safely shared with other trained professionals. This approach improves access for patients, reduces waiting times, and helps staff feel valued and supported. It also provides a sustainable, scalable model that can be used in other areas of healthcare, not just oncology. By focusing on skills and capabilities, the NHS can create a more flexible and resilient workforce, improve patient experience, and support staff wellbeing.
Perspectives
From our perspective as authors, this project demonstrates the power of redesigning services around people’s capabilities, not just their roles. We saw first-hand how involving nurses, pharmacists and advanced practitioners in new ways improved both patient care and staff satisfaction. It also showed us the importance of listening to staff concerns and supporting them through change. While challenges remain, especially around training and culture, this approach gives us real optimism for building a more sustainable NHS workforce for the future.
Joanna Lyle
The Mid-Yorkshire Teaching hospitals NHS Trust
Read the Original
This page is a summary of: Applying a capability-based approach to cancer workforce redesign: integrated career and educational development principles, British Journal of Healthcare Management, September 2025, Mark Allen Group,
DOI: 10.12968/bjhc.2024.0128.
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