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Clinical nurse specialist prescribing in a cancer centre supportive and palliative care team
  1. Sally Hall,
  2. Jo Thompson,
  3. Toni Phair and
  4. Andrew Neil Davies
  1. Department of Supportive and Palliative Care, Royal Surrey County Hospital, NHS Foundation Trust, Guildford, UK
  1. Correspondence to Ms Sally Hall, Supportive and Palliative Care, Royal Surrey County Hospital, NHS Foundation Trust, Guildford GU2 7XX, UK; sallyhall1{at}


Objective To provide insight into the prescribing practices of three independent nurse prescribers (INPs)/clinical nurse specialists (CNSs) working in a supportive and palliative care team (SPCT) in a district general hospital and a specialist tertiary cancer centre in the UK.

Methods A prospective review of all consultations and the prescribing activity arising from the consultations (and reasons for non-prescribing following a consultation) of 3 INPs/CNSs between 1 August 2018 and 31 October 2018.

Results Four hundred ninety-three consultations were undertaken on 186 individual patients. Two hundred forty-seven consultations representing 50% resulted in changes to a prescription, and 123 of those consultations representing 50% of prescriptions written resulted in the prescribing of an opioid for moderate-to-severe pain.

Conclusions This service evaluation demonstrates the potential for INPs in SPCTs to provide comprehensive symptom control while enabling CNSs to practice with a greater degree of autonomy leading to enhanced job satisfaction. On the basis of our experience, we would encourage all palliative care CNSs to undergo training to become INPs (if available).

  • symptoms and symptom management
  • pain
  • drug administration
  • service evaluation
  • cancer
  • hospital care

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  • Contributors SH conceived the service evaluation. SH, JT, TP were the INPs in the service evaluation. JT and AND analysed the data. SH drafted the initial manuscript, and all the authors reviewed and agreed with the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.