Abstract
OBJECTIVES: Oesophago-gastric cancer is one of the most common causes of cancer death worldwide. Care pathways are highly variable and complex to organise;however,there is limited evidence from a service user perspective to inform service design for best experience of care. This study explored the experiences of people living with incurable oesophago-gastric cancer to determine how services can be delivered to best support their needs. DESIGN: Based on interpretivism, this qualitative study used single, face-to-facesemistructured interviews. Interviews were audiorecorded and transcribed verbatim by a professional transcription serviceandinterrogated throughframework analysis. SETTING AND PARTICIPANTS: The study was based in a large UKNational Health ServiceTrust and designated regional specialist cancer centre. A total of27 patientsliving with incurable oesophago-gastric cancer took part in the study. RESULTS: The analysis revealed a central theme of'integrated relationship-centred care'and three subthemes: compassionate care interactions, integrated processes and systems and compassionate care environments. Positive experiences were marked by high-quality relationships with healthcare professionals, further strengthened by care process and environments that responded to their individual symptoms and healthcare needs, effectively spanning multiple agencies and professions. CONCLUSIONS: High quality services require enhanced clinical awareness and integrated service design to address a range of physical and psychosocial challenges which are often overlooked in thispatientpopulation. These essential components of positive care experiences must be driven at policy level to ensure a pathway approach to quality relationship-centred care, which crucially is not interrupted aspatientsmove across organisations and systems.