A training framework for multi-professional advanced level practice in non-surgical oncology: The journey through development and consultation to consensus

Abstract

Introduction

The Non-Surgical Oncology (NSO) workforce, like many healthcare specialities, faces critical personnel shortages. With a 21 % deficit in consultant oncologists anticipated by 2028, alongside vacancies in key roles such as therapeutic radiographers. To address these challenges, innovative workforce strategies are necessary, including the diversification of skills and the creation of advanced career pathways for healthcare professionals such as nurses, pharmacists, and allied health professionals. Advanced Clinical Practitioners (ACPs) and Advanced Practitioners (APs) have emerged as pivotal in bridging workforce gaps; however, their training lacks standardisation.

Methods

This study utilised a multiphase design to gain consultation and consensus on the suitability of a newly developed NSO training framework adapted from the Royal College of Radiologists and Royal College of Physicians' joint curricula. Applying a modified Delphi approach, seen to be beneficial in curriculum design, and considering the diversity of professions and roles across the speciality, was used to develop an online survey which was distributed across the NSO healthcare sector. The survey aimed to gain consensus on the framework's alignment with clinical and educational needs and identify barriers to its implementation.

Results

On reviewing the NSO training framework, the majority of the panel members (n = 46/51; 90.2 %) felt the capabilities appropriately mapped to the 2017 MPF.⁷ When asked about the clarity of the overall introduction and the introduction to the CiPs an overall positive response rate was noted (n = 50/51; 98 %). There was a slightly lower level of consensus around the clarity of the generic and core oncology CiPs, and slightly less agreement in the speciality-specific capabilities. Following the first survey (round one), the responses were reviewed, and it was identified that overall, in eight out of ten of the questions agreement between panel members had exceeded the level of agreement established by the researchers. As a result, the decision was made to cease the surveys and analyse the results in full as a single round.

Conclusion

Addressing the projected workforce shortages in oncologists and other key non-surgical oncology roles, this study contributes a framework adapted from established curricula, ensuring an equitable and high-standard educational pathway for trainees. The multi-phase process revealed consensus for the framework's alignment with clinical and educational standards, particularly its focus on capabilities in practice (CiPs), though highlighted inconsistencies in supervision and assessment.

Implications for practice

The NSO framework is essential for ensuring equitable training, improving workforce retention, and enhancing patient care outcomes.