Excellence in cancer research nursing: Celebrating innovation during tough times

It continues to be a tough time for clinical research and the healthcare and research professionals involved in the delivery of clinical studies as they struggle to recover to pre-pandemic levels. The Royal College of Nursing’s annual Nursing Awards is a chance to recognise nurses who work tirelessly to deliver high-quality clinical cancer research and, ultimately, improve the care and outcomes of people affected by cancer.

“Research nurses are critical to the successful running of clinical studies and to helping patients access novel cancer treatments and care,” says Anne Croudass, lead research nurse at Cancer Research UK. “Their role is often a dual one, balancing the need to support patients throughout their clinical trial journey, from recruitment to follow up, and managing the day-to-day delivery of the study. This means research nurses are in an ideal position to spot opportunities to streamline and improve the delivery of increasingly complex cancer trials and the experience of patients on them.” 

We spoke to Jo Hargroves, the winner of this year’s Excellence in Cancer Research Nursing Award, and the category’s shortlisted finalists, to hear about what they do – and what it means to them.

Winner – Jo Hargroves, CRUK senior research nurse at University College London Hospitals NHS Foundation Trust

Jo created a course to provide staff new to clinical research with a thorough grounding and education in the fundamentals and complexities of clinical cancer studies.

Cancer clinical research is a complex area to work in, and everyone new to it – regardless of background – faces a steep learning curve. Wanting to share the skills and expertise of my team, I designed the Cancer Research Professionals course to give those new to clinical research practical tools to deliver high-quality patient care in a research setting.

It’s essential that a research course covers fundamentals such as data management, quality and regulation and informed consent. This course includes interactive tools, case studies, role-play scenarios. Interviews with patients emphasise how to deliver better care and understand the meaning and impact of our interactions on patient experience. All attendees have said the course will enhance their career as a cancer research professional and nurses new to the unit have since reported a greater awareness of data management, and I hope this will enhance the quality and speed of trial data. I am so proud of the course and what it’s achieved so far, and the plan is to expand it to be nationwide. I look forward to reaching more people and showing them what a rewarding, exciting and worthwhile speciality cancer clinical research is.

I have been working in cancer clinical research for over 20 years and love the variety that this speciality offers – no two days are ever the same. I am proud to be a research nurse and work alongside a fantastic team of research nurses, trial practitioners, data managers and trial assistants at UCLH. It is so rewarding to give patients the opportunity to participate in clinical trials and see the advances that these trials have had for patients. Trial protocols are getting ever more complex in cancer research and research nurse and trial practitioner roles are essential in supporting patients and delivering high quality clinical research.

Finalist – Vivienne Wilson, Edinburgh Cancer Centre

Vivienne led the development and set up of a nurse-led patient trials advocate service – the first of its kind in the UK – increasing patient awareness of, and access to, clinical cancer trials.

We set up and delivered the Patient Trials Advocate service to give patients in our breast cancer clinic the opportunity to discuss clinical trials and link them up with suitable studies. We advise them about trials during one-to-one consultations, help them search for trials using national databases, and support patients to discuss the options with their clinician.

The bespoke service in partnership with charity Make 2nds Count has raised patient awareness and understanding of the potential benefits of taking part in a cancer clinical trial, and many have said they feel better informed and less fearful about being referred. Several patients have subsequently gone into a trial as a direct result of this service.

The project has grown, and we’ve now recruited two more nurses and recently expanded the service to cover the whole of the UK. It’s been a great opportunity to use my research nursing experience and apply the specialist skills that I’ve developed to make this service such a success.

I’m very proud to be a cancer research nurse. It’s varied, exciting, challenging, life changing and extremely rewarding. I’m extremely proud to play an important role in the delivery of new cancer  treatments within a clinical trial, whilst contributing to the development and introduction of new and improved cancer treatments for the future.

Finalist – Margot Creighton, Belfast Health & Social Care Trust

Margot was shortlisted for her leadership of the multi-centre, randomised DIAdIC study examining psychoeducational interventions for people with advanced cancer and their caregivers.  

The DIAdIC project is a holistic study that aims to improve the quality of life of patients with advanced cancer and their caregivers. It recognises that the effects of cancer go beyond the patient, and caregivers have a key role and need support too. The project assesses a nurse-delivered and a web-based psychoeducational intervention for both the patient and caregiver, aimed at improving emotional functioning and self-efficacy.

As the only research nurse on the DIAdIC study in Belfast, I facilitate discussion around sensitive topics such as advanced care planning, which can be challenging and emotional to think about. I ensure everything is taken at the pace of the patient and caregiver so they are empowered to speak to extended family about their thoughts and wishes. The intervention also aims to deal with uncertainty and facilitates learning new ways of coping with an advanced cancer diagnosis. Highlighting the value of early intervention and acknowledging the important role of the caregiver, the project encourages the caregiver to seek timely healthcare advice for their symptoms too.

This novel international project will provide new insights into how best to support people with advanced cancer and their caregivers, thus it has the potential to make a very significant difference.

Undertaking research with people who have a diagnosis of advanced cancer and their caregivers is both a challenge and a privilege. I am humbled working with the families participating in the DIAdIC study, as without them none of this would be possible. The opportunity to raise the profile of the project and highlight the vital role of the research nurse in a nurse-led intervention has been invaluable.

Finalist – The Hope Cancer Trials Centre research nurse team, University Hospitals of Leicester NHS Trust

The team took the lead in expanding the facility’s capacity and increasing its clinical trial portfolio.

The Hope Cancer Trials Centre is a dedicated cancer research studies delivery hub in Leicester, supported by the Experimental Cancer Medicine Centres (ECMC) network. We can have around 100 different trials open, and recruiting patients, at any one time. When the centre reached capacity, we launched an expansion project to increase our clinical trials area and study portfolios. This involved redesigning the centre’s layout and resources, ensuring they continued to meet the needs of the service and patients, as well as adapting our practices during the pandemic.

The expansion project has allowed us to offer greater access to life-changing treatment by increasing our capacity to treat patients. It has also enabled us to focus on developing expertise in bio-specifics and new generations of targeted treatments. What’s more we’ve streamlined the patient pathway, meaning better patient experience and care.

We’re delighted to be shortlisted for this award – as research nurses we want to raise awareness and understanding of our role and impact on patient care and outcomes. Our hands on role often means we’re in a position to spot solutions to the challenges posed by the increasing complexity of cancer trials and their delivery. We also want to increase opportunities for patients to access cancer clinical trials and embed a research culture promoting clinical trials to the wider nursing community, other health professionals and patients.

Finalist – Oncology research delivery team, Royal Free Hospital London

The team spotted an opportunity to streamline the pathway for clinical trial participants on long-term follow up.

Some trials involve up to ten years’ follow up, even after a patient is discharged and their cancer is in remission, and this can often mean patients are lost to trials – something which has unfortunately been exacerbated by the pandemic.

The demand for appointments in our breast medical oncology clinic has increased dramatically over the last year due to the increasing prevalence of late presentation and advanced cancer diagnoses following the COVID-19 pandemic. This highlighted the need for efficient appointment scheduling and effective follow-up management for lower risk patients, including clinical trial participants on long-term follow up.

Working closely with a multidisciplinary team, we set up a patient referral pathway using a research nurse-led telephone follow-up clinic to help free up consultant clinic appointments for more acute and urgent cases. Since April this year, over 50 patients have been referred to the clinic.

Feedback has been overwhelmingly positive, and patients reported the telephone format was convenient and eliminated the need for travel to hospital or waiting in crowded areas. Other benefits include a reduction in follow-up appointments in the breast medical oncology clinic, greater autonomy and job satisfaction for research nurse and cost saving to the NHS in moving appointments from consultant to nurse-led.