The Calman–Hine report: a personal retrospective on the UK's first comprehensive policy on cancer services

Calman–Hine was the first comprehensive cancer report to be produced in the UK, and set out principles for cancer care and the clinical organisation for service delivery. It advocated a change from a generalist model (eg, care given by general surgeons and physicians) that was supported by specialists to a fully specialist service. The process of policy development was innovative and the report was accepted widely throughout the UK. However, implementation, which began at a time of organisational change across the UK National Health Service (NHS), was not addressed sufficiently in the years immediately after publication. Consequently, change was more variable both geographically and within a single location and took longer than necessary. Evidence from research, routine data, and external assessments suggest that the policy was eventually successful and a worthwhile change. Well thought out and sustained mechanisms for policy implementation are as crucial as well-designed policies, and government health reforms can conflict with specific policies for quality improvement.