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Surgical Cancer Centres Invest Heavily in Unproven Technologies to Attract Patients, or Face Threat of Closure

For the first time an analysis of the impact of NHS patient choice and competition on the reorganisation of surgical cancer services and investment in high cost medical technologies published in The Lancet Oncology has revealed that retaining competitive edge through new technology investment, rather than quality improvement, appears to be a powerful driver in the reconfiguration of surgical cancer centres in England.

Of the 16 prostate cancer surgical centres that closed between 2010 and 2017, none had done so because of explicit evidence of poor quality care. Instead, patients often travelled to alternative centres that provided robotic surgery, leaving other centres that couldn’t attract the same level of patients faced with the threat of closure. Between 2010 and 2017, the number of robotic centres has more than tripled – increasing from 1 in 5 (12/65) centres providing the technology in 2010 to over three quarters (42/49) in 2017. This has occurred despite a lack of evidence of improved outcomes in terms of survival and side effects for robotic surgery compared to open surgery. The authors say that better regulation is needed to assess technology delivery in the NHS, and that quality indicators should be made available to inform patient …

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