Clinical nurse specialists (CNSs) are clinical experts in nursing practice within a speciality area. The speciality may be focused on a population, such as young people; the type of problem, such as lymphoedema; a particular type of cancer, such as lung cancer; or the type of care, such as palliative.

Hospices were early innovators of the extended role and certainly one of the first areas to use the title ‘Clinical Nurse Specialist’ (CNS). Although the title CNS had been used as far back as the 1940s, the first community-based specialist practice palliative care nurse roles were set up at St Christopher’s in the late 1960s. Ten years later, Macmillan Cancer Care developed many roles for expert nurses and are now well known for their branding of the ‘Macmillan Nurse’ (Hansford, 2013).