The paediatric oncology community nurse specialist: the influence of employment location and funders on models of practice

A specialist nursing service has evolved in recent years, to care for children with cancer or leukaemia and their families, and co-ordinate care in the community. These paediatric oncology community nurse specialists (POCNS) are mostly based at regional children's cancer treatment centres, although some are based within paediatric units of district general hospitals. In addition to the National Health Service (NHS), a major source of funding has been provided from a range of charities. This paper examines the impact that the employment location (regional or district) and funding sources have on the process, practice and structure of nursing within the speciality. All 43 POCNSs were interviewed from 28 different hospitals across the United Kingdom and Eire. Thirty-one were based at regional treatment centres, whilst 12 were from district general hospitals. Funding was provided by: the NHS (9); Cancer and Leukaemia in Childhood (CLIC) (10); Cancer Relief Macmillan Fund (5); and other charities (19). Major differences were found according to the location of POCNSs, i.e. the regional model and the district model, and according to funders, i.e. the Macmillan model, the CLIC model and the 'other funders' model. This research suggests that both funding source and location of POCNSs have implications for nursing practice.