<p>The Cancer Reform Strategy (Department of Health 2007) states that ‘commissioners and providers should ensure that the critical roles of clinical nurse specialists (CNSs) in information delivery, communication and co-ordination of care are supported’. Despite this, CNS roles are increasingly under threat. The British Association of Head and Neck Oncology Nurses conducted a short survey of CNSs in each region to understand better the actual and perceived threats to its members. The results showed that 31 per cent of respondents had been asked to work on the wards and 42 per cent had been asked to perform other managerial duties. The association recommends that strong consideration is given to maintaining and strengthening the CNS workforce.</p>