The impact of head and neck cancer service guidance on surgical workload

Abstract

In 1995 the Calman–Hine report provided a policy framework for commissioning high-quality cancer services in England and Wales. 1 A comprehensive NHS cancer plan followed in 2000. 2 Both documents recommended that cancer care should be centralised around site-specific multidisciplinary teams. These reforms aimed to improve outcomes and reduce inequalities in NHS cancer care through service reconfiguration rather than the introduction of new health technologies. A body of evidence that high-workload 3 or specialist 4,5 teams had better outcomes than their low-workload or generalist peers supported the recommendations. In contrast, some studies produced inconclusive results 6 and not all health services adopted this site-specific approach. 7