Centralising specialist cancer surgery services in England: survey of factors that matter to patients and carers and health professionals

Abstract

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.

The logistical management of tertiary urethral disease in the United Kingdom: Implications from an online audit of male reconstructive urethral surgery

“…15,16 Although there often seems to be resistance to the process of centralisation, 9 it appears that its acceptability to patients, particularly as far as the need to travel for both outpatient evaluation and inpatient care is concerned, is outweighed by the perceived clinical benefit. 17 –19 Therefore, the distance between tertiary or quartenary centres is not a major factor that inhibits the adoption of regional or supra-regional network structures.…”

Population-based study of the impact of surgical and adjuvant therapy at the same or a different institution on survival of patients with pancreatic adenocarcinoma

“…Investigations into patient preferences have revealed that patients with cancer are willing to travel to access specialized surgical care and improve their outcome. However, if there is no increased risk of complications or death, patients prefer to be cared for locally, closer to home, as this often allows for reduced patient‐incurred costs and increased social support from family and friends.…”

“…The study highlights the ability to obtain similar survival for patients by combining surgery for pancreatic adenocarcinoma in specialized centres with decentralized administration of adjuvant chemotherapy, closer to home. This is crucial information for designing patient‐centred and sustainable healthcare delivery strategies and networks of cancer care that support patients to be cared for close to their homes while being offered optimal cancer outcome, along with better social support, enhanced experience and reduced travelling and financial burdens , .…”

“…Whether policy‐mandated or happening naturally, regionalization of surgical care for pancreatic adenocarcinoma to high‐volume centres has become a reality in many healthcare systems. Although patients are willing to travel to high‐volume centres to seek improved outcomes, they also highly value care closer to home when comparable quality of care and outcomes can be provided . As a result, patients may receive surgery and adjuvant chemotherapy at different institutions.…”

The views of consultant dermatologists on creating centralized skin lesion units

“…This study therefore aimed to explore consultants’ views on perceived benefits of, and barriers to, implementing a centralized skin lesion unit, alongside potential settings, multidisciplinary team working and private sector involvement. These are factors of importance identified in research regarding centralization of other specialties . A qualitative research methodology was chosen in order to generate rich data and allow detailed explication of participants’ views.…”