title: Achieving change in the NHS: a study to explore the feasibility of a home-based cancer chemotherapy service.
abstract: A major focus of current health policy in the United Kingdom is the development of services that meet the public's expectations. To achieve this there is a need to evaluate current provision to ensure that the best use is made of finite resources. The study reported here adopted an interview approach to examine an existing outpatient chemotherapy service, and to consider the feasibility of introducing a home based model. Following a review of literature on this topic data were obtained from in-depth interviews with patients and professionals regarding the present service. These were then combined with an analysis of service contracts and financial estimates. The poor quality of much of the cost-related information limited the conclusions which could be drawn, and emphasised the need for access to more accessible and robust financial information upon which to base change. The study also illustrated the benefits of feasibility studies; especially when cost-effectiveness and patient satisfaction are the driving forces behind proposed changes to clinical services.
authors.affiliation: City University and University College London Hospitals NHS Trust, Mortimer St., London W1N 8AA, UK. d.kelly@city.ac.uk
authors.forename: Daniel
authors.initials: D
authors.lastname: Kelly
authors.forename: Susie
authors.initials: S
authors.lastname: Pearce
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Butters
authors.forename: Warren
authors.initials: W
authors.lastname: Stevens
authors.forename: Sarah
authors.initials: S
authors.lastname: Layzell
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000191:economics / Q000523:psychology; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D018166:Health Care Reform / Q000458:organization & administration; D006297:Health Services Accessibility / Q000458:organization & administration; D006302:Health Services Research; D018718:Home Infusion Therapy / Q000191:economics / Q000379:methods / Q000451:nursing / Q000523:psychology; D006801:Humans; D008495:Medical Oncology / Q000458:organization & administration*; D017146:Models, Organizational; D020380:Needs Assessment; D017060:Patient Satisfaction; D016730:Program Development; D013222:State Medicine / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000970:Antineoplastic Agents