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"Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration

Background: The reconfiguration of specialist hospital services, with service provision concentrated in a reduced number of sites, is one example of major system change (MSC) for which there is evidence of improved patient outcomes. This paper explores the reconfiguration of specialist oesophago-gas...

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Autores principales: Perry, Catherine, Boaden, Ruth J., Black, Georgia B., Clarke, Caroline S., Darley, Sarah, Ramsay, Angus I.G., Shackley, David C., Vindrola-Padros, Cecilia, Fulop, Naomi J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kerman University of Medical Sciences 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10105206/
https://www.ncbi.nlm.nih.gov/pubmed/35297232
http://dx.doi.org/10.34172/ijhpm.2022.6389
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author Perry, Catherine
Boaden, Ruth J.
Black, Georgia B.
Clarke, Caroline S.
Darley, Sarah
Ramsay, Angus I.G.
Shackley, David C.
Vindrola-Padros, Cecilia
Fulop, Naomi J.
author_facet Perry, Catherine
Boaden, Ruth J.
Black, Georgia B.
Clarke, Caroline S.
Darley, Sarah
Ramsay, Angus I.G.
Shackley, David C.
Vindrola-Padros, Cecilia
Fulop, Naomi J.
author_sort Perry, Catherine
collection PubMed
description Background: The reconfiguration of specialist hospital services, with service provision concentrated in a reduced number of sites, is one example of major system change (MSC) for which there is evidence of improved patient outcomes. This paper explores the reconfiguration of specialist oesophago-gastric (OG) cancer surgery services in a large urban area of England (Greater Manchester, GM), with a focus on the role of history in this change process and how reconfiguration was achieved after previous failed attempts. Methods: This study draws on qualitative research from a mixed-methods evaluation of the reconfiguration of specialist cancer surgery services in GM. Forty-six interviews with relevant stakeholders were carried out, along with ~160 hours of observations at meetings and the acquisition of ~300 pertinent documents. Thematic analysis using deductive and inductive approaches was undertaken, guided by a framework of ‘simple rules’ for MSC. Results: Through an awareness of, and attention to, history, leaders developed a change process which took into account previous unsuccessful reconfiguration attempts, enabling them to reduce the impact of potentially challenging issues. Interviewees described attending to issues involving competition between provider sites, change leadership, engagement with stakeholders, and the need for a process of change resilient to challenge. Conclusion: Recognition of, and response to, history, using a range of perspectives, enabled this reconfiguration. Particularly important was the way in which history influenced and informed other aspects of the change process and the influence of stakeholder power. This study provides further learning about MSC and the need for a range of perspectives to enable understanding. It shows how learning from history can be used to enable successful change.
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spelling pubmed-101052062023-04-16 "Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration Perry, Catherine Boaden, Ruth J. Black, Georgia B. Clarke, Caroline S. Darley, Sarah Ramsay, Angus I.G. Shackley, David C. Vindrola-Padros, Cecilia Fulop, Naomi J. Int J Health Policy Manag Original Article Background: The reconfiguration of specialist hospital services, with service provision concentrated in a reduced number of sites, is one example of major system change (MSC) for which there is evidence of improved patient outcomes. This paper explores the reconfiguration of specialist oesophago-gastric (OG) cancer surgery services in a large urban area of England (Greater Manchester, GM), with a focus on the role of history in this change process and how reconfiguration was achieved after previous failed attempts. Methods: This study draws on qualitative research from a mixed-methods evaluation of the reconfiguration of specialist cancer surgery services in GM. Forty-six interviews with relevant stakeholders were carried out, along with ~160 hours of observations at meetings and the acquisition of ~300 pertinent documents. Thematic analysis using deductive and inductive approaches was undertaken, guided by a framework of ‘simple rules’ for MSC. Results: Through an awareness of, and attention to, history, leaders developed a change process which took into account previous unsuccessful reconfiguration attempts, enabling them to reduce the impact of potentially challenging issues. Interviewees described attending to issues involving competition between provider sites, change leadership, engagement with stakeholders, and the need for a process of change resilient to challenge. Conclusion: Recognition of, and response to, history, using a range of perspectives, enabled this reconfiguration. Particularly important was the way in which history influenced and informed other aspects of the change process and the influence of stakeholder power. This study provides further learning about MSC and the need for a range of perspectives to enable understanding. It shows how learning from history can be used to enable successful change. Kerman University of Medical Sciences 2022-03-14 /pmc/articles/PMC10105206/ /pubmed/35297232 http://dx.doi.org/10.34172/ijhpm.2022.6389 Text en © 2022 The Author(s); Published by Kerman University of Medical Sciences https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Perry, Catherine
Boaden, Ruth J.
Black, Georgia B.
Clarke, Caroline S.
Darley, Sarah
Ramsay, Angus I.G.
Shackley, David C.
Vindrola-Padros, Cecilia
Fulop, Naomi J.
"Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration
title "Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration
title_full "Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration
title_fullStr "Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration
title_full_unstemmed "Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration
title_short "Attending to History" in Major System Change in Healthcare in England: Specialist Cancer Surgery Service Reconfiguration
title_sort "attending to history" in major system change in healthcare in england: specialist cancer surgery service reconfiguration
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10105206/
https://www.ncbi.nlm.nih.gov/pubmed/35297232
http://dx.doi.org/10.34172/ijhpm.2022.6389
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