The NHS organisations chosen by the Commission for Health Improvement to provide a 'snapshot' of progress in reforming cancer services may offer a falsely positive picture, an HSJ survey has found.

Cancer specialist Professor Reg Hall has also questioned the thoroughness of the visits to 50 health bodies planned by CHI and the Audit Commission as part of the national research project.

The teams heading to nine regional locations in England and Wales are due to report their findings next summer.

CHI said it had randomly selected the sites and there was 'no question' of locations being earmarked because they had extra funding.

But of the 24 hospital trusts in England involved, nearly all are either part of the new Cancer Services Collaborative or have received up to hundreds of thousands of pounds each for on-the-spot booking pilots.

CHI said the review findings would give a 'benchmark against which the NHS cancer plan could be judged in future - a snapshot of the state of cancer services'.

They are also designed to provide health secretary Alan Milburn and the Welsh Assembly with an assessment of progress in implementing reforms identified in the 1995 Calman-Hine report on cancer services in England and the 1996 Cameron report in Wales.

Professor Hall, who is head of the Northern Cancer Network, warned of the dangers of CHI not including enough health organisations which had not received special help.

Professor Hall, whose Newcastle upon Tyne-based network is part of the Cancer Services Collaborative, said: 'It's absolutely critical that if CHI believes it is undertaking a review of cancer services as they happen in real life, it's essential it looks not just at places that have preferred funding.'

HSJ understands that a two person team made up of a nurse and a researcher is undertaking the first visits. Professor Hall asked whether this would allow for thorough enough reviews.

'What precisely is the quality of the CHI visiting process?'

According to CHI, the teams would include 'investigative reviewers, cancer nurse specialists, people experienced in conducting focus groups to elicit patient views, GPs and community nurses'.

It said it would name organisations in which good practice had been identified, but would not otherwise link health body names with performance information.

Nine of the trusts chosen were among 60 second-wave GP booked-admissions pilots announced by the government in September 1999 which are designed to speed up access to hospital services. At least a further eight are part of the third wave of pilots announced this autumn.

Four of the other trusts are part of the CSC, which involves nine cancer centres from across the NHS working together intensively until March 2001 to significantly improve the delivery of care for patients.

In England, the community trusts and health authorities chosen by CHI fall within the same geographical areas as the 24 hospital trusts.

CHI said that all 50 were selected for review 'completely randomly based on organisations linked to radiotherapy providers', and it was confident that what it got back would not be skewed by the extra money.

CHI stressed that the site visits were just one element of the study. In addition, all trusts providing cancer services would be surveyed by means of a 'paper questionnaire', and national cancer statistics would be examined.

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