LOCAL NHS TRUST PRACTICE

Local NHS Trust Practice



Local NHS Trust Practice

Introduction

The study reported here was instigated against a background of changing patterns of cancer services led by the United Kingdom Department of Health (DoH) . The Calman-Hine Report, now implemented as a National Service Framework, stressed the importance of providing effective, integrated, patient centred services and established a network of Cancer Centres and Units across the country. This was emphasised again more recently in the National Plan and National Cancer Plan (Prandoni, 2010).

Rational for the Change

The focus of this study was the review of the existing outpatient chemotherapy service and the feasibility, acceptability and cost-effectiveness of a home-based alternative which could bring in a positive change in NHS Trust. It was envisaged that the research would take place in two stages. Firstly, an interview approach would be adopted to examine the existing outpatient chemotherapy provision and to assess the feasibility of providing a home based chemotherapy service (Prandoni, 2010).

Literature Review

Literature searches were carried out using the following databases: Medline, CINAHL, CancerLit, the Cochrane Database Library and University of York NHS Centre for Reviews and Dissemination (CRD) database. Hand searching of additional 'grey' sources was also carried out (such as self-help literature). Initially, searches of Medline and CINAHL were conducted using the key words 'cost', 'treatment', 'outpatients', 'home-care', 'cancer' and 'economics'; these were then cross referenced. Searches of all the above databases subsequently included additional key words including 'chemotherapy', 'colorectal cancer', 'quality of life', 'patient satisfaction', 'economic evaluation', 'hospital at home' and 'organisational change'. (Bergqvist, 2010).

Changes in NHS Trust

The NHS is currently undergoing a period of intensive change - technological, social and economic - so there is a real need for all managers to facilitate this change within their organisations and the wider NHS environment. There is a variety of ...