The demand placed on health systems in Europe will continue to rise as the population ages and more people are diagnosed with long-term or life-limiting conditions. Cancer is a major disease burden that contributes to an upward pressure on all relevant health systems.
Whereas mobility of health professionals may enhance health systems’ ability to respond to new challenges, it may also present a complicating factor in a situation when heterogeneous requirements and qualifications exist across countries.
In order to ensure high quality care to patients, the modern oncology workforce must cultivate flexibility and innovation.
Multi-disciplinary team working - where each discipline has an instrumental but complementary role - is a principal driver of optimal patient outcomes in cancer.
Moreover, specialisation is increasingly called for to ensure the best possible expertise underpinning cancer care delivery.
Nurses make a central contribution to all cancer patients and should be integral to effective multidisciplinary team working. Despite its important added value in terms of patient outcomes, however, specialised cancer nursing lacks uniform regulation, or recognition1, across Europe.
One consequence of this lack of regulation is that different definitions of cancer nurse are currently used, based on a variety of factors or their combination including the nurses’ role (or the scope of the role), purpose, location of care delivery, type or severity of cancer, and educational preparation. Patient representatives2
highlighted the need for clarity when defining a cancer nurse, stating that “there are many names for them, and the different academic degrees are very confusing for patients”.
The following definition can be formulated based on available literature (ESNO 2015, CANO 2016):
- Specialist cancer nurse: On an international level, specialist cancer nurses are expected to be educated to a degree level (or higher), have a formal training in cancer, and to care for cancer patients as a specialised population, and this across different cancer types and the entire cancer care continuum.
In addition, advanced cancer nurses can be distinguished as those educated at a post-graduate level and considered as expert in, at least, one aspect of cancer care.
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Due to the variability in the education type and tasks performed by nurses working with cancer patients across countries, the term ‘specialised or specialist cancer nurse’ in this paper encompasses the variety of titles that may be used - with the understanding that there is a need to recognise the heterogeneous landscape across Europe. Cancer nursing can thus be understood as a baseline definition that includes the more specific roles and responsibilities that exist therein.
The project Recognising European Cancer Nursing (RECaN)
- led by the European Oncology Nursing Society (EONS) and supported by ECCO – The European CanCer Organisation, aims to consolidate evidence to clarify and effectively position the contribution of specialised cancer nursing as an essential supportive function during the cancer journey for the benefit of all patients, as well as European health systems.
 It is considered for the purposes of the paper that recognition implies that a profession is regulated in a particular country in relation to the definition in Article 1 (a) Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualifications, amended by Directive 2013/55/EU
 ECCO Patient Advisory Committee (PAC)