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What are the experiences of English NHS managers, clinicians, and patients of the National Cancer Waiting Times targets?

Wright, Heather ORCID: 2022. What are the experiences of English NHS managers, clinicians, and patients of the National Cancer Waiting Times targets? DHS Thesis, Cardiff University.
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National cancer waiting times targets were introduced over 20 years ago in the NHS to ensure the delivery of timely diagnosis and access to treatment. Whilst the targets have been praised for improving waiting times and encouraging early diagnoses, they have been critiqued for distorting clinical priorities, creating cultures of cheating, eroding clinician autonomy, and neglecting certain patients. Yet, there is little empirical research exploring the impact of targets in practice. Drawing upon semi-structured interviews with patients, clinicians, and managers (N=27) in Merseyside and Cheshire, I explore how the cancer targets affect their perceptions and experiences of delivering/receiving care, and how the targets are viewed as impacting upon patient pathways, service design, and practice. I found that patients are concerned about accessing secondary care and waiting to receive a diagnosis, yet they are less concerned about the time it takes to be treated (i.e., whether within a waiting time target) as long as they have a clear healthcare plan. Managers and clinicians painted a complex picture. They believed that whilst open and reciprocal communication was essential to practice, there was more ambiguity and disagreement about whether patients should be informed about targets. The targets were identified as providing focus for individuals and organisations, yet managers highlight the constraints limited resources place on cancer services provision, and how challenges emerged when liaising with other Trusts. Moreover, clinicians and managers felt that targets created a two-tier system that prioritised some patients over others. Finally, clinicians dismissed the targets as under the remit of managers and not affecting their daily practice. To conclude, I discuss the implications of my study and identify future directions for research. I consider the renewed interest in cancer waiting times following the COVID-19 pandemic and how the NHS can contribute to the recovery of cancer services.

Item Type: Thesis (DHS)
Date Type: Completion
Status: Unpublished
Schools: Social Sciences (Includes Criminology and Education)
Subjects: H Social Sciences > H Social Sciences (General)
Date of First Compliant Deposit: 17 May 2022
Last Modified: 10 Jun 2023 02:00

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