Unpicking the Threads: How Generalist and Specialist Nurses Work with Patients, Carers and Each Other in the Community to Support Cancer Survivors

Conducted by: Professor Nigel King (Project Leader), Jane Melvin, Dr Joanna Brooks and David Wilde, January 2009 - December 2011

Funding: Macmillan Cancer Support

Building on research conducted during a previous project carried out for Macmillan, this project aimed to examine the ways in which specialist and generalist nurses work with each other and other professionals, carers and patients to provide supportive care to cancer patients.

Previous findings suggested that aspects of the care and management of patients with long-term conditions could be applied to cancer patients, and also highlighted situations in which co-ordination and communication between specialist and generalist nurses can be problematic. Having established the importance of effective collaborative working between specialist and generalist nurses in terms of impact on patients and their families, this project further explored how models of care for patients with long-term conditions might inform the development of services for cancer patients.

The study used the Pictor qualitative interview technique to determine how specialist and generalist nurses understood each other’s roles and worked together in supporting patients with cancer and other long-term conditions. The project took place in one metropolitan borough in the North of England, characterised by higher than average mortality and morbidity rates and several areas of high deprivation; but also a very marked difference in socio-economic status between the most and least affluent wards.

The results of this project highlighted a need to consider collaborative working through the lens of relationships, including factors at team, organisational and societal levels as well as inter-personal relationships. These factors have a significant impact on how well professionals work together to support patients. Researchers found that organisational changes and policy initiatives often do not take into account the value of strong professional networks of relationships, disrupting them in ways that cannot be helpful for patient care and support.

A summary project report and also a video of Professor Nigel King discussing the project and findings are available.