Applying a capability-based approach to cancer workforce redesign: integrated career and educational development principles

Oncology services in the UK are facing unprecedented challenges, including an ageing population, increasing service demand and shortages of medical and non-medical staff. The aspirant cancer career and education development (ACCEND) programme was developed by Health Education England, with a framework that aimed to provide a capability-based, mixed professional registration approach to the cancer care workforce. The goal of this programme was to encourage a wider workforce to support oncology services and patients. This article explores how the integration of the ACCEND framework can address workforce challenges in oncology services, particularly within systemic anti-cancer therapy, acute oncology, outpatient care and helpline services. The implementation of this framework in two NHS trusts is examined, focusing on workforce redesign and patient outcomes. This showed that the frameworks resulted in a more structured approach to outpatient care, with 30% of care being managed by enhanced practitioners, including non-medical registered professionals such as advanced pharmacists and advanced clinical practitioners. These advanced practitioners also lead 30% of systemic anti-cancer therapy clinics and manage acute oncology cases. This workforce redesign has implications for service efficiency, patient experience and staff satisfaction, by offering a sustainable and scalable model for workforce redesign in oncology services and enhancing professional development opportunities.