Delivering integrated care systems and patient choice for cancer
Research type
Research Study
Full title
Delivering integrated care systems and patient choice for specialist cancer treatments in the NHS: impact on access, equity and outcomes of care.
IRAS ID
282367
Contact name
Ajay Aggarwal
Contact email
Sponsor organisation
London School of Hygiene and Tropical Medicine
Duration of Study in the UK
5 years, 0 months, 1 days
Research summary
The NHS is centralising cancer services to fewer centres, by closing smaller
specialist cancer units or limiting the treatments they offer, in order to improve patient outcomes and use limited resources more effectively. It is expected that networking between referring hospitals and specialist cancer centres will guarantee access to evidence-based treatments. However, these models of care delivery have been associated with difficulties in access to treatment for cancer patients, which has had a worsening effect on their health outcomes. In addition, variation in the quality of treatment persists across specialist NHS cancer centres.This 5-year project will examine from the perspective of patients, hospitals and policymakers how best to organise specialist cancer services to improve the quality of treatment delivered and ensure that the most vulnerable patients groups are able to access good quality care. It will aim to:
1. Understand the patient and hospital factors which influence where patients with different cancers receive their treatment.
2. Investigate the impact of centralisation of cancer services on access and
outcomes from specialist cancer treatments
3. Investigate how closures of cancer treatment services might be undertaken in a way that improves patient outcomes and minimises the burden of travel for the sickest, elderly and most socially deprived patient groups.The study will use patient information collected by NHS hospitals and approaches to the analysis of information from the fields of geography and economics. It will include all patients diagnosed and treated for breast, bowel, prostate and oesophageal cancer in the English NHS between 2013 and 2019 (approximately 1 million patients). These cancers have been chosen as they present different challenges in defining how best to organise services as they vary in their presentation and treatments. Patient and public involvement (PPI) has informed the scope, objectives and design of the study.
REC name
Wales REC 7
REC reference
20/WA/0161
Date of REC Opinion
26 May 2020
REC opinion
Favourable Opinion