Institute of Epidemiology & Health Care



Reorganising specialist cancer surgery for the 21st century: a mixed methods evaluation

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Study overview

A research team, led by Professor Naomi Fulop (UCL Department of Applied Health Research), has been awarded £1.2 million by the National Institute for Health Research Health Services and Delivery Research Programme to study the centralisation of specialist cancer surgical services.

Focus: the study, which started in September 2015, focuses on centralisation of specialist surgical pathways for four cancers across two health care systems: London Cancer (a network of providers across North Central and North East London, and West Essex; population 3.2m) and Greater Manchester Cancer (covering Greater Manchester and East Cheshire; population 3.1m).

The team: The research team is formed of clinicians, patients, and academics from London and Greater Manchester (see study team).

Approach: the research (see study protocol) combines quantitative and qualitative methods to analyse how the centralisations were planned and implemented, and the impact of the changes on organisation and delivery of care, clinical outcomes, patient experience, and cost-effectiveness. The study also analyses patient, professional, and public preferences for changes of this kind (see our at a glance summary).

Contribution: in doing so, this evaluation addresses a number of important gaps in the evidence on centralising specialist cancer surgery, addressing key priorities highlighted in the Five Year Forward View. In addition, it builds on methods developed by the team in conducting high impact research on other forms of major system change.


Study team

  • Chief Investigator: Professor Naomi Fulop (UCL)
  • Co-investigators: Professor Steve Morris, Professor Kathy Pritchard-Jones, Professor Ruth Boaden, Dr Angus Ramsay, Ms Rachael Hunter, Mr John Hines and Mr David Shackley
  • Patient collaborators: Veronica Brinton, Patrick Fahy and John Sandell  
  • Clinical/organisational collaborators: Mr Ravi Barod, Professor Mark Emberton, James Leighton, Claire Levermore, Mr Satish Maddineni, Ms Caroline Moore, Professor Muntzer Mughal, Mr Dipankar Mukherjee, Mr David Shackley, Ms Maxine Tran and Mr Jonathan Vicker
  • Researchers: Dr Caroline Clarke, Dr Mariya Melnychuk, Dr Catherine Perry, Dr Cecilia Vindrola, Dr Victoria Wood and Dr Georgia Black

Publications (all free to download)

Full study report:

Study protocol:

Research findings:

At a glance summary:


Further information

NIHR HS&DR project page

Key Contacts:

News item:

Remembering our colleague Neil Cameron

Sadly one of our patient collaborator colleagues, Mr Neil Cameron, died on 15 May 2017. Neil contributed a great deal to the study, from the development of the proposal, in particular providing essential feedback on our research questions in relation to patient experience, through to the work of the study to date. We will continue to acknowledge Neil’s contribution to our study in any outputs that we make.