cancer, clinical nurse specialist, continuity of care, key worker, nursing, patients



  1. Ling, Jonathan PhD, BA
  2. McCabe, Karen MPH, BSc
  3. Brent, Sue MA, RN
  4. Crosland, Ann PhD, BA, RN
  5. Brierley-Jones, Lyn PhD, BA


Purpose/Aims: The key worker role in cancer services was established in England to improve the continuity of care for patients. We examined how the role has been implemented by clinical nurse specialists and how both cancer patients and nursing staff viewed its effectiveness to inform debate about the transfer of patients between clinical nurse specialists during cancer care.


Design: This study was questionnaire based, with separate surveys developed for patients and staff.


Method: The questionnaires explored issues including implementation of the key worker role, modifications to it, and where the role was felt to have most impact. The questionnaires were completed by 101 staff members and 46 patients. The data were analyzed descriptively.


Results: Perspectives on the key worker role differed between nursing staff respondents and patient respondents. Overall, patient respondents were very positive, whereas staff respondents were less so. The following is a key difference related to patient handover: 71% of patient respondents wanted the same key worker throughout their treatment, but only 28% of staff respondents did. Staff respondents wanted more training to clarify the role.


Conclusion: Continuity of care through an assigned key worker was highly valued by patients. Successful implementation could be better achieved through improved communication with both nursing staff and allied health professions. Where possible, cancer patients should be assigned a dedicated key worker at initial diagnosis.