From 'Market Umpires' to 'Relationship Managers'? The Future of the NHS Regional Offices in a Time of Transition

This article considers the theoretical and management implications of the recent reorganization of UK cancer services on network lines in which the intermediate tier of the Regional Office (RO) has played an important implementation role. Empirical evidence drawn from the first stage of a national evaluation of the Calman-Hine report (1995) is used to explore regional approaches to the setting-up of 'cancer care networks'. The literature predicted that strategic differences between the regions would permeate the implementation process, reinforcing variations in service change. The study highlights mixed evidence to support this claim. Initially there was a pattern of organizational divergence at RO level. However, this diversity has eroded and appears to be a transitional phenomenon. The findings of the study indicate that service reorganization is now leading towards a possible convergence around a model of the 'delivery network' which is 'instrumental' in nature.