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Guidance on commissioning cancer services: improving outcomes in upper gastro-intestinal cancers the manual

Calman and Hine's 'A Policy Framework for Commissioning Cancer Services' (DH, 1995) proposed that cancer services should be based around Cancer Units and Cancer Centres, working together to create Cancer Networks involving NHS Trusts, Health Authorities, Primary Care Groups/Trusts, and the voluntary sector. This guidance manual on improving outcomes for upper gastro-intestinal cancers (affecting the oesophagus, stomach, and pancreas) notes that service provision in England and Wales has tended to be fragmented and disorganised. It sets out a specific service model which would make specialist care available to all patients, following the basic structure of the Calman and Hine model. Appendix 1 summarises results of an economic modelling exercise estimating cost implications of the guidance recommendations. Appendices 2 and 3 explain the guidance's production process and provide details of organisations, researchers, and focus groups involved. Appendix 4 contains a glossary. Cites numerous references.