title: Life after the cancer strategy: analysis of surgical workload in the general hospital setting.
abstract: BACKGROUND
  The National Cancer Strategy heralded a major reorganisation of the delivery of cancer services in Ireland. As a result of this policy, cancer care was centralised to eight centres. The impact of this strategy on hospitals no longer providing cancer services has not been analysed to date.
  
  
  OBJECTIVE
  The aim of this study was to examine the impact of centralisation of cancer services on surgical workload at Mayo General Hospital.
  
  
  METHODS
  Data pertaining to all surgical procedures performed in 2007 (prior to the introduction of the National Cancer Strategy) and 2011 were obtained using the Hospital Inpatient Enquiry system. Histopathology reports and theatre registers were also analysed to ensure accuracy of the data.
  
  
  RESULTS
  The numbers of elective and emergency surgical admissions during 2007 and 2011 were broadly similar (2,581 vs. 2,662). One hundred and thirty-five oncological procedures (colorectal and breast) were carried out in 2007 compared with 50 (colorectal) in 2011. This represents a 63% reduction in cancer surgery workload following the implementation of the National Cancer Strategy. There was a concomitant increase in surgery performed for benign conditions (laparoscopic cholecystectomy and hernia repair), which coincided with the innovative introduction of 43 ring-fenced surgical in-patient beds in June 2010.
  
  
  CONCLUSIONS
  This study demonstrates the impact of the centralisation of cancer services on surgical workload in a non-cancer centre. Our results show that there continues to be a role for general hospitals in the provision of elective surgical services. Hospital network arrangements have the potential to facilitate such developments.
authors: Department of General Surgery, Mayo General Hospital, Castlebar, County Mayo, Ireland. lizconcannon@gmail.com
authors: E
authors: E
authors: Concannon
authors: I
authors: I
authors: Robertson
authors: F
authors: F
authors: Bennani
authors: W
authors: W
authors: Khan
authors: R
authors: R
authors: Waldron
authors: K
authors: K
authors: Barry
mesh_terms: D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D007494:Ireland; D009313:National Health Programs; D009369:Neoplasms / Q000601:surgery*; D016522:Oncology Service, Hospital / Q000706:statistics & numerical data*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data*