The centralisation of specialist cancer surgical services across London Cancer and Greater Manchester Cancer, England, may significantly change how patients experience care. These centres are changing specialist surgical pathways for several cancers including prostate, bladder, kidney, and oesophago-gastric cancers, increasing the specialisation of centres and providing surgery in fewer hospitals. While there are potential benefits related to centralising services, changes of this kind are often controversial. The aim of this study was to identify factors related to the centralisation of specialist surgical services that are important to patients, carers and health care professionals.
This was a questionnaire-based study involving a convenience sample of patient and public involvement (PPI) and cancer health care professional (HCP) sub-groups in London and Greater Manchester (n = 186). Participants were asked to identify which of a list of factors potentially influenced by the centralisation of specialist cancer surgery were important to them and to rank these in order of importance. We ranked and shortlisted the most important factors.
We obtained 52 responses (28% response rate). The factors across both groups rated most important were: highly trained staff; likelihood and severity of complications; waiting time for cancer surgery; and access to staff members from various disciplines with specialised skills in cancer. These factors were also ranked as being important separately by the PPI and HCP sub-groups. There was considerable heterogeneity in the relative ordering of factors within sub-groups and overall.
This study examines and ranks factors important to patients and carers, and health care professionals in order to inform the implementation of centralisation of specialist cancer surgical services. The most important factors were similar in the two stakeholder sub-groups. Planners should consider the impact of reorganising services on these factors, and disseminate this information to patients, the public and health care professionals when deciding whether or not and how to centralise specialist cancer surgical services.
BMC cancer. 2018 Feb 27*** epublish ***
Mariya Melnychuk, Cecilia Vindrola-Padros, Michael Aitchison, Caroline S Clarke, Naomi J Fulop, Claire Levermore, Satish B Maddineni, Caroline M Moore, Muntzer M Mughal, Catherine Perry, Kathy Pritchard-Jones, Angus I G Ramsay, David Shackley, Jonathan Vickers, Stephen Morris
Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK., Department of Applied Health Research, University College London, Gower Street, London, WC1E 6BT, UK. ., Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, UK., Research Department of Primary Care & Population Health, Royal Free Campus, University College London, Rowland Hill St, London, NW3 2PF, UK., University College London Hospital NHS Foundation Trust, 47 Wimpole Street, London, W1G 8SE, UK., Departments of Urology, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK., Division of Surgical & Interventional Science, University College London, Gower Street, London, WC1E 6BT, UK., University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK., Alliance Manchester Business School, University of Manchester, Booth Street East, Manchester, M13 9SS, UK., UCLPartners Cancer Programme, 170 Tottenham Court Road, London, W1T 7HA, UK., Greater Manchester Cancer, A Block, Christie NHS Foundation Trust, 550 Wilmslow Rd, Manchester, M20 4BX, UK., Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.