Implementation and evaluation of a nurse-led clinic for men referred with suspected prostate cancer

Background: Cancer diagnostic delays remain a challenge. Advanced nurse-led clinics represent an innovative approach to improving pathway efficiency while delivering person-centred care. Aims: To evaluate barriers and facilitators in establishing a nurse-led clinic for urgent suspected prostate cancer referrals and assess the impact on patient experience and services. Methods: A hybrid effectiveness-implementation design and naturalistic case-study design. Data included routine data (pre-implementation, n =150; implementation, n =293), patient surveys ( n =162), patient interviews ( n =10), staff interviews ( n =12) and field notes. Data were analysed using thematic analysis, descriptive statistics and cost-consequence analysis. Findings: Collaboration between consultant and nurse facilitated service integration and multidisciplinary team engagement. Patients reported high satisfaction, valuing continuity of care and confidence in their nurse throughout the diagnostic pathway. The nurse-led clinic incurred lower costs than consultant-led clinics (£1049 vs £1417 per patient). Conclusion: Nurse-led clinics can improve diagnostic efficiency and deliver high-quality, person-centred care when underpinned by collaborative relationships between nurse and consultant, and with adequate administrative support.