Haire K, Burton C, Park R, Reynolds J, Stewart D, Purushotham A D
Darzi Fellow, St Georges Hospital, London, UK.
Primary Care South East London, UK.
London J Prim Care (Abingdon). 2012;5(1):29-34. doi: 10.1080/17571472.2013.11493369.
This article explores the potential for integrated cancer systems to improve the quality of care and deliver cost efficiencies and improve outcomes for cancer patients. Currently, patients in the UK still have poorer survival rates than comparable countries such as Canada, Sweden, Norway and Australia. Improving the quality of cancer services is a key policy objective and cancer is a priority outcome measure in both the NHS and Public Health Outcomes Framework. Evidence suggests that better integrated delivery has the potential to improve the quality and reduce the cost of healthcare, and ultimately improve health outcomes. One of the key themes from the Model of Care for Cancer Services (1) was that cancer services should be commissioned along pathways and that provider networks should be established to deliver care. London has two integrated cancer systems; one covering north central and east London (London Cancer) and the other covering west and south London (London Cancer Alliance). There a number of areas in cancer care that the current model of service provision has failed to adequately address and which have the potential to improve significantly though implementation of integrated services. These include improving early diagnosis, reducing inequalities in access to treatment and outcomes and maximising research and training across the system. Important drivers for the integration of cancer services are strong clinical leadership, shared informatics systems, focusing on quality of services and improving patient experience. Emerging needs of integrated cancer in London are around strengthening the involvement of primary care, public health and the third sector; working to develop sufficient capacity and expertise in primary care and collaborating more closely with commissioners to develop integrated systems.
本文探讨了整合癌症系统在提高医疗质量、实现成本效益以及改善癌症患者治疗效果方面的潜力。目前，英国患者的生存率仍低于加拿大、瑞典、挪威和澳大利亚等可比国家。提高癌症服务质量是一项关键政策目标，癌症也是英国国家医疗服务体系（NHS）和公共卫生成果框架中的一项优先成果指标。有证据表明，更好的整合式服务 delivery 有潜力提高医疗质量、降低成本，并最终改善健康结果。癌症服务照护模式（1）的一个关键主题是，癌症服务应按路径委托，并应建立提供者网络来提供照护。伦敦有两个整合癌症系统；一个覆盖伦敦中北部和东部（伦敦癌症），另一个覆盖伦敦西部和南部（伦敦癌症联盟）。在癌症照护方面，当前的服务提供模式未能充分解决一些领域的问题，而通过实施整合服务，这些领域有显著改善的潜力。这些领域包括改善早期诊断、减少治疗和结果方面的获取不平等，以及在整个系统中最大化研究和培训。癌症服务整合的重要驱动因素包括强有力的临床领导力、共享信息系统、关注服务质量以及改善患者体验。伦敦整合癌症的新需求围绕加强初级医疗、公共卫生和第三部门的参与；努力在初级医疗中发展足够的能力和专业知识，并与委托方更紧密合作以开发整合系统。
