All change: cancer services in transition

Area of Science:

• Oncology
• Health Services Research
• Palliative Care

Background:

• Radical changes in UK cancer services following the Calman-Hine Report and the NHS and Community Care Act 1990.
• Focus on the evolving landscape of hospice care within these reforms.
• Exploration of potential issues and dilemmas in providing supportive care for cancer patients and families.

Purpose of the Study:

• To explore potential issues and dilemmas in providing supportive care for cancer patients and their families within changing hospice care structures.
• To discuss the benefits and drawbacks of evolving organizational structures and ethos in cancer services.
• To facilitate debate on developments in hospice and cancer services.

Main Methods:

• Qualitative study drawing on interview data from the pilot phase of a larger research project.
• Interviews conducted with 29 professionals involved in cancer service provision in Lancaster and Kendal.
• Analysis of interview data to identify key themes and trigger reflections on service developments.

Main Results:

• Identified three key themes of concern: links between services, changing organizational factors, and increasing 'medical imperialism'.
• Discussed potential benefits and drawbacks associated with the changing ethos and organizational structures in hospice care.
• Presented reflections on developments in hospice and cancer services, informed by professional perspectives.

Conclusions:

• The paper offers a commentary on developments in the hospice sector rather than definitive conclusions.
• Highlights the need for ongoing discussion and debate regarding the psycho-social needs of cancer patients and their carers.
• Suggests that evolving service structures present both opportunities and challenges for supportive cancer care.