PALM SPRINGS, Calif--The United Kingdom, not unlike the United States, is undergoing a period of radical change in the organization of cancer services, the status of the medical professionals delivering those services, and the climate for conducting clinical research, Ann Cull, PhD, said at the American Society for Psychiatric Oncology/AIDS meeting.
Such changes are creating a crisis for psychosocial oncology, but may also open up new opportunities, as the need for psychosocial services and research to help control cost becomes apparent, she said.
The National Health Service, the UK's central socialized medicine delivery system, is being gradually dismantled, Dr. Cull said, and replaced by local health trust organizations.
With the intent of establishing primary care physicians as the principal providers of services to cancer patients, the government is setting up "cancer units" in district hospitals designed to manage patients with common cancers under the direction of practice guidelines.
Larger designated cancer centers will be responsible for handling the full range of cancer diagnoses, as well as providing specialist and consultant services, said Dr. Cull, a clinical psychologist and researcher at the Western General Hospital, a regional cancer center in Edinburgh.
Although the rationale behind the development of this new structure for cancer care delivery appears to be directed toward improving standards of care, she said, members of the oncology community worry that these changes will lead to a "leveling down" of services.
"In the area of psychosocial oncology, where the provision of services is somewhat patchy even in the cancer centers, there is concern about how these smaller cancer units will be able to provide comprehensive care," she commented.