Evidence map›Paper›PMID 32508182›Full record

ArticleJournal of health services research & policy2021

Implementing major system change in specialist cancer surgery: The role of provider networks.

Cecilia Vindrola-Padros, Angus Ig Ramsay, Catherine Perry, Sarah Darley, Victoria J Wood, Caroline S Clarke, John Hines, Claire Levermore, Mariya Melnychuk, Caroline M Moore and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of health services research & policy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Cecilia Vindrola-PadrosSenior Research Fellow, Department of Applied Health Research, University College London, London, UK.ORCID 0000-0001-7859-1646
Angus Ig RamsaySenior Research Fellow, Department of Applied Health Research, University College London, London, UK.
Catherine PerryApplied Research Collaboration Greater Manchester, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK.
Sarah DarleyResearch Associate, Alliance Manchester Business School, University of Manchester, Manchester, UK.ORCID 0000-0001-5420-6774
Victoria J WoodResearch Associate, Department of Applied Health Research, University College London, London, UK.
Caroline S ClarkeSenior Research Associate, Research Department of Primary Care & Population Health, University College London, London, UK.ORCID 0000-0002-4676-1257
John HinesConsultant Urological Surgeon, University College London Hospitals NHS Foundation Trust, London, UK.
Claire LevermoreHead of Operations, SUMMIT Study, University College London Hospital NHS Foundation Trust, London, UK.
Mariya MelnychukResearch Associate, Department of Applied Health Research, University College London, London, UK.
Caroline M MooreDepartment of Primary Care and Population Health, University of Cambridge, Cambridge, UK.
Stephen MorrisHonorary Clinical Professor, University College London Hospitals NHS Foundation Trust, London, UK.
Muntzer M MughalProgramme Director, UCL Partners Cancer Programme, London and University College London Hospitals Cancer Collaborative, London, UK.
Kathy Pritchard-JonesDirector and Senior Responsible Officer, Greater Manchester Cancer and Manchester Academic Health Science Centre, Christie NHS Foundation Trust, Manchester, UK.
David ShackleyProfessor of Health Care Organisation and Management, Department of Applied Health Research, University College London, London, UK.
Naomi J FulopProfessor of Health Care Organisation and Management, Department of Applied Health Research, University College London, London, UK.

Funding

Department of Health 14/46/19
6 · The paper itself

Abstract

objectiveMajor system change (MSC) has multiple, sometimes conflicting, goals and involves implementing change across a number of organizations. This study sought to develop new understanding of how the role that networks can play in implementing MSC, using the case of centralization of specialist cancer surgery in London, UK.

methodsThe study was based on a framework drawn from literature on networks and MSC. We analysed 100 documents, conducted 134 h of observations during relevant meetings and 81 interviews with stakeholders involved in the centralization. We analysed the data using thematic analysis.

resultsMSC in specialist cancer services was a contested process, which required constancy in network leadership over several years, and its horizontal and vertical distribution across the network. A core central team composed of network leaders, managers and clinical/manager hybrid roles was tasked with implementing the changes. This team developed different forms of engagement with provider organizations and other stakeholders. Some actors across the network, including clinicians and patients, questioned the rationale for the changes, the clinical evidence used to support the case for change, and the ways in which the changes were implemented.

conclusionsOur study provides new understanding of MSC by discussing the strategies used by a provider network to facilitate complex changes in a health care context in the absence of a system-wide authority.

Indexed as

LeadershipNeoplasmsDelivery of Health CareHumansLondoncancer surgeryMajor system changenetworks

Identifiers

PMID32508182
PMCPMC7734603

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.