Loss associated with subtractive health service change: The case of specialist cancer centralization in England.

ABSTRACT:

Objective

Major system change can be stressful for staff involved and can result in 'subtractive change' - that is, when a part of the work environment is removed or ceases to exist. Little is known about the response to loss of activity resulting from such changes. Our aim was to understand perceptions of loss in response to centralization of cancer services in England, where 12 sites offering specialist surgery were reduced to four, and to understand the impact of leadership and management on enabling or hampering coping strategies associated with that loss.

Methods

We analysed 115 interviews with clinical, nursing and managerial staff from oesophago-gastric, prostate/bladder and renal cancer services in London and West Essex. In addition, we used 134 hours of observationa

SUBMITTER: Black GB 

PROVIDER: S-EPMC9548928 | biostudies-literature | 2022 Oct

REPOSITORIES: biostudies-literature