As a gynaecological oncology Clinical Nurse Specialist (CNS), I see my role as sitting at the intersection of science, compassion and system leadership. Rather than an “added extra” to cancer services, the Cancer CNS role plays a pivotal role in the delivery of cancer care. 

The 2026 National Cancer Plan for England  highlights key priorities for cancer care delivery: tackling inequalities, expanding personalised care and driving innovation. These priorities align closely with the work of cancer Clinical Nurse Specialists like me, who have long championed the need for investment to turn them into a reality.  

Gynaecological cancer care – like cancer care in general, continues to be marked by unacceptable inequalities in patient outcomes. Factors such as where a patient lives, their cultural background, and her ability to navigate health systems should not influence her chances of survival, yet evidence continues to show that they do. 

CNS are well positioned to tackle this. Our relationships with patients give us insight into the social, cultural and practical barriers that shape engagement with care. 

Whether supporting patients from underserved communities, providing trauma-informed care or adapting how we discuss treatment and menopause across different cultural contexts, our work is grounded in trust. These conversations are not always easy, but they are transformative. When patients feel understood, they are more likely to participate actively in their care, improving both their experience and outcomes.

The National Cancer Plan’s emphasis on personalised care aligns naturally with the CNS role. Women’s cancers are deeply personal, and so is the care they require. As treatments become more complex, this need only grows. Advances in genomics and biomarker testing now guide highly tailored clinical decisions that were once based on more generalised approaches. 

This scientific progress is exciting. It offers the potential for more targeted and effective treatment, but it also introduces new layers of complexity for patients and health care providers to navigate. Training in genomics and advanced therapies is becoming increasingly essential to ensure that the nursing workforce has the capability to keep pace with the information they are expected to interpret.

For me, this has meant actively seeking opportunities to upskill practice, through working collaboratively with pharmaceutical partners and undertaking further study in genomics and genetic counselling. My role involves taking this knowledge and translating it into accessible, more informed care for my patients. 

Currently, I am establishing nurse-led virtual clinics to support patients during and after treatment. These clinics allow us to review symptoms, manage side effects and address concerns in a way that is flexible and accessible. They also create space for the holistic conversations and relational care that can be difficult to fit into traditional models but are increasingly being recognised as fundamental to the delivery of cancer care. 

Alongside this, I am working with digital teams to collate meaningful data so we can plan services more effectively and better understand patient needs and interactions with health care. This is innovation rooted in listening, using data not to replace patient voices, but to amplify them.

For this work to continue and grow however, the right investment and strong, visible leadership, are needed. We need appropriate CNS-to-patient ratios that truly acknowledge the complexities and demands unique to the cancer specialism. 

We also need job plans that align with the four pillars of advanced practice; not just clinical care, but leadership, education, and research as well. 

The Clinical Nurse Specialist role originated in the UK, and internationally we are recognised for leading the way in embedding it into practice. However, provision across our own system can vary, and expectations of the role often differ between patients, colleagues, and organisations. It’s understandable that this variation can sometimes create uncertainty or affect confidence for those working in CNS posts.

Workforce planning is too often short-term. If we are to fully realise the ambitions set out in The National Cancer Plan, we need bold, strategic reform. This means nationally agreed KPIs for CNS roles with tailored subsets for each speciality. It also means investing in structured education pathways such as the our Cancer Career Nursing Frameworks so that CNS have the skills, confidence and support needed to deliver advanced, modern cancer care.

We are seeing exciting opportunities for nurses to develop in areas beyond traditional clinical work, including service design, data insight and digital health. Supporting nurses to take up these roles, using data to improve care, contribute to research and help steer the ethical use of digital and AI tools is essential. Without this engagement, nursing risks being excluded from shaping the services of the future. When we embrace them, we can lead innovation that improves patient experience and system sustainability.

It is encouraging to see national policy setting a clearer, more ambitious direction for strengthening frontline cancer services. The challenge now is ensuring this vision is matched with the investment and leadership needed to bring together policy, applied health research, clinical evidence and workforce insight. Only by aligning all of these elements can we operationalise the recommendations effectively. As cancer CNS, we have a vital role to play in this, and in delivering a sustainable, future‑proof model of cancer care for our patients who need it.

Anouska’s reflections are about the recent NHS England Cancer Care Strategy, documents for across the UK can be found below

• Scotland’s 10 year vision to improve cancer survival and ensure equitable access to care. It was developed with people with lived experience and system partners. A three year delivery plan supporting the 10 year strategy, focusing on recovery, stabilisation, and redesign of services was also published.
• A national plan for Wales developed with stakeholders to improve outcomes and reduce inequalities. It guides Health Boards and Trusts across the whole cancer pathway and aligns with the 2021 Quality Statement for Cancer.
• Launched in March 2022, this 10 year strategy for Northern Ireland sets out a comprehensive programme to improve outcomes, stabilise services, and drive innovation.