Macmillan Pan London Cancer CNS Development Lead (CDL) Pilot Project Overview

 

What is the CDL pilot project?

The CDL Pilot Project is a three year initiative being delivered by the four London Cancer Alliances in partnership with Macmillan Cancer Support and NHS England. It aims to strengthen the cancer nursing workforce across London by introducing the Cancer Clinical Nurse Specialist (CNS) Development Lead (CDL) role. 

Why This Pilot Matterswords of issues

  • London faces significant challenges in cancer nursing:
  • High vacancy rates (15% vs 12% nationally)
  • Low retention and morale
  • An aging workforce (37% over 50)
  • Limited awareness and exposure to cancer nursing in training
  • No nationally agrees career pathway until recently

The CDL role addresses these issues by mentoring new CNSs, promoting the profession, and embedding the ACCEND Framework- a national guide for cancer workforce capabilities. 

The pan- London project is being managed by the North Central London Cancer Alliance and pan- London resources and information can be found here

Key Aims of the CDL Pilot 
  • Expand and retain the cancer CNS workforce across London
  • Support new CNSs to become confident, autonomous professionals
  • Promote the CNS role and raise awareness
  • Operationalise the ACCEND programme locally
  • Foster nurse-led innovation and leadership
The CDL Role

CDLs are experienced cancer CNSs who: 

  • Mentor newly qualified CNSs using coaching, teaching, and reflective practice
  • Promote the CNS role locally and among internationally educated nurses
  • Conduct outreach to grow the pipeline of future CNSs
  • Localise the ACCEND framework to ensure CNSs develop the right skills

Delivery Model

Each of London's five integrated Care Systems (ICSs) hosts one CDL. Support is provided in two tiers: 

  • Enhanced Support: 1:1 mentoring for CNSs at the start of their CNS career
  • Universal Support: Group- based sessions and training for all CNSs

CNSs are selected for enhanced CDL support based on: 

  • Experience level (Band 6/7, <24 months in post)
  • Developmental needs
  • Working conditions )e.g., lone working, high turnover areas)
Project Timeline
  • Planning (Mar-Sept 2024): Research; pilot development; role definition; funding
  • Phase 1 (Sept 2023- June 2024): Stakeholder mapping, governance, CDL recruitment and induction; evaluation setup
  • Phase 2: (June 2024- Oct 2026): Delivery; toolkit and resource development; data collection; on-going comms and support
  • Phase 3 (Jan-Nov 2026): Evaluation; Legacy planning; potential rollout
Evaluation Approach
cdl evaluation

Led by MEL Research, the evaluation uses a Realist Evaluation framework to understand:

  • What works, for whom, and in what context
  • Impact on CNS development, retention, and patient care
  • Sustainability and scalability of the CDL role
Anticipated Benefits
  • Increased job satisfaction and competence among new CNSs
  • Improved recruitment and retention
  • Better delivery of personalised cancer care
  • A resilient ad skilled cancer nursing workforce
  • Potential national adaption of the CDL role

Governance

pan london evaluation approach

The CDL Pilot Governance structure provides strategic and operational support for the Macmillan Pan London Cancer CNS Development Lead Pilot, funded by Macmillan Cancer Support and NHSE Workforce, Training & Education (WT&E) Directorate. 

The groups offer governance and advisory functions, recommending priority changes when needed, ensuring objectives are met, and promoting the sharing of learning and best practices across pilot clusters. 

The group also supports the evaluation, adoption, and integration of the CDL function across London.