Re-organisation of oesophago-gastric cancer care in England: progress and remaining challenges

Author:

Palser Thomas R,Cromwell David A,Hardwick Richard H,Riley Stuart A,Greenaway Kimberley,Allum William,van der Meulen Jan HP

Abstract

Abstract Background Oesophago-gastric cancer services in England have been extensively reorganised since 2001 to deliver a centralised, specialist-led service. Our aim was to assess how well the National Health Service (NHS) in England met organisational standards for oesophago-gastric cancer care. Methods Questionnaires that asked about the provision of staging investigations, curative and palliative treatments and key personnel were sent in September 2007 to the lead clinician for oesophago-gastric cancer at all 30 cancer networks and 156 NHS acute trusts in England. Results Responses were received from all networks and 81% of NHS trusts. All networks provided essential staging investigations and a range of endoscopic palliative therapies. Only 16 of the 30 cancer networks discussed all patients at the specialist multi-disciplinary team meeting and 11 networks had not fully centralised curative surgery. There was also variation between NHS trusts in the integration of the palliative care team, the availability of nurse specialists and the use of dieticians to provide nutritional support. Conclusion There has been considerable progress in reforming oesophago-gastric cancer services but the process of reorganisation is still incomplete and regional differences in service provision exist that may lead to variation in patient outcomes.

Publisher

Springer Science and Business Media LLC

Subject

Health Policy

Reference25 articles.

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3. Office for National Statistics: Mortality Statistics: cause. Review of the Registrar General on deaths by cause, sex and age, in England and Wales, in 2005 (series DH2 No 32). 2006, London: Her Majesty's Stationary Office

4. Allum WH, Griffin SM, Watson A, Colin-Jones D: Guidelines for the management of oesophageal and gastric cancer. Gut. 2002, 50 (Suppl 5): v1-23.

5. Department of Health: Guidance on Commissioning Cancer Services: Improving Outcomes in Upper Gastro-Intestinal Cancers: The Manual. 2001, London: Department of Health

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