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P-280 Clinical nurse specialists in development- growing your own
  1. Christine Goodwin,
  2. Sharon Hudson and
  3. Lisa Kennedy
  1. Birmingham St Mary’s Hospice, Birmingham, UK


Background Birmingham St Mary’s Hospice Community Team is a large urban Community Palliative Care Service in Birmingham. The Clinical Nurse Specialist Team are Band 7 Nurses and have responsibility for caseload management, clinical effectiveness and leadership. They support a 24 hour on call service and delivery of the hospice education programme. In recent years recruitment to these roles has been difficult. This aligns with the national picture of a current shortfall of 10% in the nursing workforce.

The hospice specifies at least degree level education, two years’ experience at Band 7 in palliative care or relevant specialty and postgraduate education in palliative care as core to the role. The role is changing; with a need to understand palliative care beyond cancer, to work within a changing health landscape and to have advanced practice skills such as NMP. In recruitment, we were seeing nurses with the right values base and with some relevant experience but without the experience or qualifications to fulfil the role.

Method The hospice developed a Band 6 to 7 Competency Programme based broadly on the Macmillan Competency Framework (2) for Nurses but tailored to a broad palliative care approach.

  • Six month programme of mentored support, education and experiential learning

  • Sage & Thyme Certification

  • European Certificate in Palliative Care

  • Competency Programme and Reflection; Expert practice, leadership and consultancy, education and clinical effectiveness. This can then be utilised for re–validation.


  • Nine nurses recruited to the programme over five years

  • From a broad range of backgrounds including ITU, district nursing and internally. This has enabled a positive approach to integration with primary and secondary care and supported positive cultural change

  • Eight have completed and were successful in transition to Band 7, seven are still in post.

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