Download 2007/2008 - Central Cancer Network

CONTENTS
Chair‘s Introduction
1
Regional Cancer Networks
2
Central Cancer Network
4
CCN - The People
6
Service Groups
8
Project Work
9
Achievements 2007/08
12
Draft Initiatives 2008/09
15
A CRONYMS
AYA
Adolescents and Young Adults
CCC
Cancer Control Council
CCN
Central Cancer Network
CCSIG
Cancer Control Steering Implementation Group
CEO
Chief Executive Officer
DAP
District Annual Plan
DHB
District Health Board
FTE
Full time equivalent
MoH
Ministry of Health
NGO
Non Government Organisation
NSU
National Screening Unit
NZCTWP
New Zealand Cancer Treatment Working Party
NZRCN
New Zealand Regional Cancer Networks
PHO
Primary Health Organisation
RCTS
Regional Cancer Treatment Service
TAS
Technical Advisory Services
WBCC
Wellington Blood and Cancer Centre
C HAIR’ S I NTRODUCTION
Welcome to the first annual report from the Central Cancer Network. It is with pleasure that we can
report on the range of activities that have commenced over the past year and signal the focus areas
for the year to come.
This year has focussed on activities supporting the form and function of the network. Establishing
service and project groups, and supporting the development of local cancer networks has been a
priority. As CCNs structure has evolved there has been a focus on ensuring broad representation on
the various groups, reflecting the breadth of the region and the diversity of the various stakeholders
involved in cancer services. A work plan was developed in late 2007 to support various district, regional
and national initiatives which had been identified. Progress against the plan has been steady with
multiple projects commencing as project staff have been appointed. Where stakeholders have
identified additional projects, CCN has been responsive in undertaking the additional assignments.
CCN continues to develop strong links with the other regional cancer networks and the Ministry of
Health cancer control team.
Looking towards the future, the focus for 2008/09 will be on developing the tumour stream and
‗addressing inequalities‘ work programmes and supporting the regional service specific groups.
On behalf of the CCN governance group and management team I would like to take this opportunity
to thank all stakeholders for their support as we continue to develop Central Cancer Network as a
valuable cancer resource for all.
Mike Grant
Chair, Central Cancer Network
1
R EGIONAL C ANCER N ETWORKS
Background
Establishing regional networks is a priority in the New Zealand Cancer Control Strategy Action Plan
2005-2010 (2005). Networks will provide a formal structure to improve the coordination of care for
patients between cancer services. Since March 2006 meetings and workshops have been held in
various regions to discuss how a network would function in the respective areas, and to develop terms
of reference for each network. By the end of 2006 the MoH had developed the funding model,
principles and objectives to assist with the development of four regional networks.
The Four Networks
The four regional cancer networks are based around the DHB regions:
Northern Cancer Network – Auckland, Waitemata, Counties Manukau, Northland
Midland Cancer Network – Waikato, Bay of Plenty, Lakes
Central Cancer Network – Taranaki, Whanganui, MidCentral, Hawke‘s Bay, Tairawhiti, Wairarapa,
Hutt Valley, Capital & Coast
Southern Cancer Network – Nelson/Marlborough, Canterbury, Otago, West Coast,
South Canterbury, Southland
Note: Taranaki, Tairawhiti, Nelson/Marlborough
link with adjacent networks as they have
significant patient flows into each region.
2
Network Principles and Objectives
The following principles and objectives were developed in 2006 by the MoH and stakeholders to guide
development of regional cancer networks.
Core principles to guide the implementation of the networks‘ structure and function:
Provide a focus on improving the pathway of care for cancer patients, families and whanau by
improving quality, access to and appropriateness of care
Have an organised structure that provides management and leadership to support
coordination of activities and actions by groups and organisations within the network
Are accountable to their constituent DHBs through regular reporting, including performance
against agreed output and outcome measures
Provide collaborative advice to support the existing decision making and accountability
framework of DHBs
Provide a framework to support the input and engagement of Maori, Pacific peoples, NGOs
and consumers
Are multidisciplinary across all providers in cancer care and provide a framework that supports
both tumour and generic service multidisciplinary teams
Have an evidence based approach to advice and work programmes
Provide the focus for implementation of quality assurance programmes, guidelines and
protocols
Facilitate the increase of total system efficiency regarding resources available to the cancer
sector
Provide a transparent framework for the lines of advice, decision making and accountability to
the DHBs.
By providing a framework to improve collaboration and coordination across cancer groups and
services, networks are expected to achieve the following key objectives:
The efficient and effective use of finite resources within and across DHB populations
Reduce disparities and improve equity of access
Close existing gaps in services and reduce duplication
Greater coordination of service planning and delivery
Promote a focus on patient access to, and experience of, the best quality care
Reduce barriers to coordinated service provision in order to ensure seamless care across
providers
Account for performance across provider organisations
Provide expertise to support planning and development of services
Enable clinical audit and outcomes reporting
Implement multidisciplinary teams and clinical guidelines.
3
CENTRAL CANCER N ETWORK
Development of the Network
Consultation with stakeholders in the CCN region on the structure and function of the regional network
commenced in early 2007. Appointment of the governance group and recruitment of the Clinical
Directors and network manager occurred in mid 2007. Administration and project personnel were
recruited during the year as the work plan was rolled out.
Aim
To link cancer services across District Health Board areas, strengthening existing collaborative
arrangements and developing new ones where required.
Purpose
To provide a framework that supports the linkages of DHB planners, DHB specialist service providers,
NGOs, PHOs and consumers in the coordination and implementation of the Cancer Control Strategy
Action Plan across DHB regional areas.
Structure
The following diagram reflects CCN‘s current structure which has altered from that originally proposed
as a result of the change in approach to establishing regional continuum specific work streams.
Further, as work has progressed, three stakeholder groupings have emerged:
Addressing Inequalities–this reflects an emerging partnership model with Maori and Pacific
peoples
Service Groups—these are groups of regional stakeholders which are based around a particular
service or role
Tumour Stream Steering Groups—these are groups of regional stakeholders who have a role or
interest in a particular type of cancer.
It is expected that the network structure will continue to evolve.
CEOs of DHBs
Ministry of Health
Cancer Control
Council
Lead CEO
David Meates
Wairarapa DHB
Management Team
Clinical Directors
CCN Regional Mgr
Service Improvement
Facilitators
Admin Support
Network Governance Group
Representatives from across Central region and the continuum—including DHB, NGO,
Consumer, Maori and Pacific Peoples
Chair—Mike Grant, General Manager Funding Division, MidCentral DHB
Addressing
Inequalities
Maori partner ship
Pacific Peoples
partnership
4
District Health
Boards
Service Groups
DHB Cancer Managers Group
Regional Palliative Care Network
Care Coordinators Forum
Paediatric/Adolescent and Young Adults
(proposed)
Local Cancer
Networks
Tumour Stream
Steering Groups
Lung
Head & Neck
Colorectal (proposed)
Funding
MidCentral DHB is the designated lead DHB for CCN, receiving the operational funding from the
Ministry of Health via a Crown Funding Agreement variation. The funding for the network includes
$250,000 per annum over the next three years for core network infrastructure and operations. In
addition, the Ministry has made available $250,000 per annum to address systemic causes for cancer
inequalities and $50,000 per annum for data analysis to support network operations and planning.
Budget and Actual Expenditure for 2007/08
$000
Year
07/08 Actual
Income
CCN Annual Funding
Genesis Oncology Trust for Prostate project - one off funding
New addressing inequalities/analyst funding (note 1)
06/07 Surplus (note 2)
Total Income
$000
Year
07/08 Budget
$000
Variance
250
0
0
180
430
250
13
75
180
518
0
-13
-75
0
-88
115
25
32
55
50
0
0
0
277
125
27
32
55
55
15
16
16
341
10
2
0
0
5
15
16
16
64
Expenditure Total
22
0
0
22
299
40
13
16
69
410
18
13
16
47
111
Surplus 07/08 (note 6)
131
108
23
Expenditure (note 3)
Network Manager & Chair
PA/Office Manager
Tumour Stream Service Improvement Facilitator
Clinical Director - MDHB
Clinical Director - CCDHB
Analyst support - $50K pa which may be utilised differently from year to year
Addressing Inequalities Service Improvement Facilitator
General project support
Projects
Meeting costs - CCN facilitated meetings
Genesis Oncology funding for Prostrate project - presenters and meeting costs (note 4)
Consumer representative training course - one off funding (note 5)
Note
1. The Funder has successfully accounted for the $75K as 08/09 income
2. 06/07 Total income
$250K
Total expenditure $70K
Surplus c/f
$180K
3. Personnel costs include travel, accommodation, overheads and incidentals
Costs were lower than budgeted due to delays in appointing personnel
4. Project to be completed and invoiced for in 08/09
5. Funding not required
6. Surplus will be used to offset projected deficit in 09/10
5
CC N – T HE PEOPLE
CCN Governance Group
The CCN Governance Group reflects representation from across the region and cancer continuum,
including: district health boards, non government organisations, Maori populations, Pacific peoples and
consumers.
Representation
Member as at 30 June 2008
MidCentral/Chair
Mike Grant, General Manager, Funding Division, MidCentral DHB
Capital & Coast
TBA
Consumer
Denise Robbins, Chair CancerVoices
Hawke‘s Bay
Dianne Keip, Cancer & Palliative Care Portfolio Manager, Hawke‘s Bay DHB
Hutt Valley
Dr Annette Nesdale, Public Health Physician, Hutt Valley DHB
MidCentral
Litea Meo-Sewabu, Public Health, Massey University
Nelson/Marlborough
Dr Kate Gregory, Medical Oncologist, Nelson/Marlborough DHB
NGO
Bronwen Laurenson, Central Districts Division Cancer Society of NZ
Taranaki
Kevin Nielsen, CEO, Hospice Taranaki
Tairawhiti
Virginia Brind, Cancer Portfolio Manager, Tairawhiti DHB
Wairarapa
Marie McKay, Cancer Portfolio Manager, Wairarapa DHB
Whanganui
Judith MacDonald, CEO, Whanganui Regional PHO
Members present at the governance‘s July 2008 meeting
The governance group meets on a six weekly basis and oversees the operational activities of the
network management team.
CCN would like to acknowledge the contributions of the following governance group members who
have resigned from the group during the year:
Dr Simon Snook, GP Wairarapa
Pania Ruakere, Tairawhiti DHB
Kathryn McKeefry, Wellington Blood and Cancer Centre
Dr Barry Mahon, Cardiothoracic Surgeon, Capital & Coast DHB.
CCN also links with Central TAS via Andrew Campbell-Stokes who regularly attends meetings.
6
CCN Management Team
The network management team operates under the principles of a governance framework and is
accountable to MidCentral DHB‘s Funding Division General Manager. The responsibilities of the team
include:
Facilitating delivery of the agreed work programme
Coordinating, convening (where appropriate) and providing support to network groups
Supporting site specific and service delivery improvement work streams
Facilitating active communication within and between network groups, the wider network and
national bodies
Working with local DHBs on funding and implementation issues associated with the work
streams.
Team Members
Dr Simon Allan – Clinical Director
Simon is a Medical Oncologist and Clinical Director of the Regional Cancer Treatment Service,
MidCentral DHB. Simon is also a Palliative Care Specialist and works with the team at Arohanui
Hospice. Simon works 0.2FTE for CCN.
Dr Andrew Simpson – Clinical Director
Andy is a Medical Oncologist and Clinical Director for the Wellington Blood and Cancer Centre,
Capital & Coast DHB. Andy works 0.2FTE for CCN.
Jo Anson – Network Manager
Jo comes from a radiation therapy and management background and has worked in the
cancer field for the past 20 years. Jo provides leadership for the overall planning and delivery of
the work programme for the network.
Shirlee McLean – Project Manager
Shirlee joined CCN in February 2008 to undertake the project management of a number of CCN
projects that were identified in the work plan. Shirlee, who comes from a nursing and
management background, will be concentrating on the tumour stream focus for the network as
we move into the next year.
Ali Hamlin – Service Improvement Facilitator (Addressing Inequalities)
Ali comes from a health promotion background with the Cervical Screening Programme and
joined CCN in June 2008 to undertake the addressing inequalities work programme. Ali grew up
in Hawke‘s Bay and connects to Ngati Kahungunu, Ngati Porou, Tuwharetoa and Ngati Rangi.
Celeste Alway – Office Administrator/PA to Network Manager
Celeste joined CCN in December 2007, and will leave in September 2008 when she and her
husband return to Australia.
7
S ERVICE GROUPS
Local Cancer Networks
Local cancer networks are developing in DHB areas. These networks are comprised of key
stakeholders from within the district and across the cancer continuum. They focus on the needs of
their populations and contribute to the planning and development of cancer services in their area.
To assist with the establishment and functioning of local cancer networks, CCN developed guidelines
outlining the proposed form and function of these groups and has worked with stakeholders to
progress the initiative.
A local cancer network was established in Wanganui in February 2008. Judith MacDonald, CEO of
Whanganui Regional PHO and a member of CCN‘s governance, says of the local network:
It was considered a welcome opportunity to sit around the table and discuss cancer
as a continuum with key stakeholders within our communities. There was general
concern that the patient journey for cancer patients was not as good as it could be
and there was a necessity to really tackle some of the barriers that we readily
identified, such as transport. Whanganui DHB has been proactive in this regard and
already there is a project underway reviewing transport services for our urban and
rural consumers.
The local cancer network is a good focal point for looking critically at what is working
and what could be improved.
Central Region Palliative Care Network
The Central Region Palliative Care Network has been functioning in the region since 2006 and is
comprised of clinicians and managers of both hospice and hospital based specialist palliative care
services. This group meets 3-4 times per year to work together in the ongoing planning and
development of palliative care services in the region.
CCN has been meeting regularly with this group and supporting them to progress a number of
regional initiatives, including the development of a Not For Resuscitation Guideline for hospices and a
regional medical specialist model.
In June 2008 attendees agreed to seek a more formalised structure to the group which included
mandated attendance from representatives from district palliative care networks and the
formalisation of the relationship with CCN. Within this relationship it is acknowledged that palliative
care services are wider than cancer and that the Cancer Control Strategy Action Plan is a vehicle for
a number of service developments currently in progress.
DHB Cancer Managers Group
This group comprises managers from the planning and funding division and the cancer service
provider arm of each of the DHBs. The group has met twice during the year to provide updates on
cancer control activity in each area and to identify and progress opportunities for regional
approaches to the planning and delivery of services.
8
PROJECT W ORK
As part of the network‘s work plan, a number of projects have been initiated this year; some of which
are featured here.
The Early Detection of Prostate Cancer in General
Practice: Supporting Patient Choice
For most people a souvenir from Australia might be a boomerang or
didgeridoo; but Dr Quinten King was no ordinary tourist–he returned
home with an interactive decision aid for GPs and their patients to
discuss prostate cancer testing.
Following his attendance at an Australian medical conference in early
2007, Quinten returned to Palmerston North passionate about the need
to introduce the ―GP/patient showcard‖ here. With prostate cancer
the third most common cause of male cancer deaths in New Zealand,
and accounting for 3.6% of all deaths, he believed the tool would be a
valuable aid concerning early detection testing for prostate cancer.
Quinten, Specialist Urologist at MidCentral Health, together with Dr
Warren Nicholls—also an advocate for the tool—held a workshop for
GPs in June 2007, in Palmerston North. Additional help to further promote
Dr Quinten King
the showcard came from the Central Cancer Network, and the Genesis
Oncology Trust. (Warren—MidCentral DHB‘s GP Liaison and Primary Care
Advisor—applied for funding from the Genesis Oncology Trust which
supports a range of quality research and education initiatives in the field
of cancer control and palliative care, and was awarded $13,000).
The GP/patient showcard
is a tool to aid GPs and
CNN established a project to pilot the delivery of a training package to
the patient in a joint
GPs and evaluate the benefits of the training and the tool, then to
decision making process
consider how the tool might be adapted to the NZ context and rolled out
concerning prostate
across the wider region. As well as Quinten and Warren, key participants
testing pathways and
have been Don Baken of the Psycho-oncology Service at Massey
suitability for referral.
University, David Swallow representing consumers, Dr Simon Allan CCN‘s
Clinical Director and Shirlee McLean CCN‘s Project Manager. The project
The showcard displays an
aims to promote best practice by GPs regarding the early detection of
anatomical diagram of
prostate cancer, whilst specifically supporting a patient‘s individual
the male pelvis, six
choice.
decision steps, current
age based risk estimates
One Manawatu GP who now uses the tool had been unaware of it
for prostate cancer and
before this project. He finds it very useful as have his patients, and
a values clarification
recommends it to colleagues.
exercise.
The resource was
designed to be easily
scanned visually and
suitable for a brief
consultation.
9
Regional Palliative Care ‘Not For Resuscitation’
Guideline
CCN supported the Regional Palliative Care Network to develop a Not For Resuscitation Guideline for
hospices across the region. The Guideline has provided an opportunity for hospices without guidelines
to develop them using the document as a reference. Hospices with existing guidelines have used the
document to review their current policies/guidelines to ensure a consistent approach.
The Guideline provides supplementary information about acceptable resuscitation practices for
palliative care which considers the clinical needs of the patient, the patients and/or families‘ wishes
and current legal obligations encompassing the Health and Disability Commissioner‘s Code of Rights.
Multidisciplinary Framework
DHBs have received funding to support a range of cancer control strategy initiatives, including the
formation of multidisciplinary cancer teams. The purpose of a multidisciplinary team is to facilitate best
practice for the treatment and care of patients. The multidisciplinary meetings (MDMs) are a formal
mechanism to determine the most beneficial treatment plan, engaging professionals with expertise in
the diagnosis and management of all patients with cancer.
CCN has developed a Multidisciplinary Framework to support the functioning of multidisciplinary
meetings as identified in DHB action plans. The framework provides some structure for multidisciplinary
meetings but does not presume that ‗one size fits all‘ in terms of multidisciplinary working in cancer
services. Instead, this framework recognises the need to adopt the structure and functions of a
multidisciplinary team according to local needs and circumstances. The framework includes: meeting
protocols, terms of reference for MDMs, an MDM checklist and an audit tool.
The framework has been well received by clinicians and implementation across the region is expected
by the end of the year.
Cancer Medical Imaging Guidelines
The Cancer Control Strategy Action Plan specifies that all diagnostic and treatment providers are
required to demonstrate a protocol/guidelines approach in patient diagnosis and management.
Experience shows that there are inconsistencies in the types of examinations and technical approach
to examinations across the region which at times necessitate patients undergoing repeat imaging,
and delays in the patients being seen.
CCN is facilitating a project to develop Cancer Medical Imaging (CMI) Guidelines that will promote
consistency of practice and reporting across the region for imaging cancer patients at the time of
diagnosis, staging and surveillance. In principle the guidelines will:
Provide evidence based guidelines to direct practitioners on appropriate imaging modalities
and techniques for cancer patients
Ensure standardised medical imaging and reporting practices for cancer patients across the
CCN region
Reduce the number of patients undergoing unnecessary repeat examinations.
10
To progress this work, an advisory group was established:
Dr Garry Forgeson, Medical Oncologist, MidCentral DHB
Dr Trevor Fitzjohn, Specialist Radiologist, Pacific Radiology Ltd, Wellington
Dr Peter Dixon, Specialist Radiologist, Broadway Radiology, Palmerston North/MidCentral DHB
Dr Nick Humpheries, Specialist Radiologist, Hutt Valley DHB
Dr Alina Leigh, Fulford Radiology, New Plymouth
Dr Umesh Pandey, Specialist Radiologist, Hawke‘s Bay DHB
Dr Kevin Smidt, Nuclear Physician, MidCentral DHB
Paula Jones, Team Leader, Department of Radiology, Hawke‘s Bay DHB
David Binning, consumer representative.
Advisory group members have agreed to use the UK Guidelines: ‗Recommendations for Cross
Sectional Imaging in Cancer Management‘ as the foundation for the CMI Guidelines and are currently
reviewing them for adaptation to the NZ context. This project is supported by the Royal Australia and
New Zealand College of Radiologists and permission to adapt the UK guidelines has been granted by
the authors of this work, the Royal College of Radiologists (UK).
Lung Cancer Tumour Stream Project
The CCN Tumour Stream project aims to meet the goals outlined in the Cancer Control Strategy (2003)
and also acts as a vehicle for the implementation of a number of objectives within the Action Plan
2005-2010. The vision for the project is:
‘To ensure that there are coordinated, consistent, equitable and responsive services for the
management of patients with lung cancer across the CCN region—services which support each
patient and their family and whanau throughout the cancer journey.’
A steering group was established to lead work on developing and promoting standards for service
delivery across the CCN region, with a focus on addressing and identifying issues for patients with lung
cancer. Membership is multidisciplinary, inclusive of service providers from all parts of the cancer
control continuum, and includes consumer representation.
In this current year, project milestones delivered include:
Development of the project scope and terms of reference for the steering group
Establishment of a Lung Cancer Steering Group to take a leadership role within the region,
advising on best practice and monitoring
Undertaking the Lung Audit within MidCentral DHB region
The start of mapping of the current journey for patients across the CCN region
Initiating the Lung Cancer Data Project.
Ken Wheelen, CEO of Capital & Coast DHB, is Project Sponsor. The steering group comprises:
Dr Andy Simpson, (Chairperson) Clinical Director CCN
Denise Robbins, consumer representative
Maria Potaka, consumer representative
Dr Glen McKay, Cardiothoracic Surgeon, Capital &Coast DHB
Dr David Hamilton, Radiation Oncologist, Capital &Coast DHB
Dr James Curtis/Dr Rob Armstrong, Respiratory Physicians, Hawke‘s Bay DHB (shared position)
Dr Helen Winter, Medical Oncologist, MidCentral DHB
Dr Claire Hardie, Radiation Oncologist, MidCentral DHB.
11
ACHIEVEMENTS 2007 /08
In September 2007, CNN developed and consulted on a work plan for the network which
complemented and built on existing service providers‘ plans for the 2007/08 period. Progress against
this work plan has been steady and stakeholders have been regularly updated via quarterly reports.
The following tables identify the relevant activity from the work plan and summarise progress.
Leadership Initiatives
Activity
Progress
CCN develops strong partnership with Maori
across the region
CCN has commenced active engagement with
Iwi/Maori via an initial hui
CCN develops strong partnership with Pacific
peoples across the region
CCN is preparing to engage with the Pacific
community via a series of fono
CCN develops strong relationships with DHB
based local cancer networks
CCN developed guidelines for local cancer
networks and assisted with the introduction of
these across the region
CCN develops strong partnerships with providers
and promotes open and regular communication
CCN communicates regularly with stakeholders
via quarterly reports, email updates and face to
face meetings
A work plan is developed which identifies and
prioritises activities
A work plan was developed and consulted on in
late 2007. These key achievements represent
progress against the work plan
Develop strong relationships with the other three
regional networks in NZ
The four regional cancer network management
teams, MoH and CCC meet regularly
Engage with the DHB annual planning processes
Upcoming initiatives have been signalled for the
DAP planning process via the DHB Cancer
Managers Group
Engage with the TAS led Regional Clinical
Service planning process
CCN receives regular updates regarding the
plan and has provided expert advice for the
cancer related sections
Network manager attends Cancer Control
Implementation Steering Group meetings.
Clinical Directors attend NZCTWP meetings
Network manager and Clinical Directors
regularly attend these meetings
Development of a regional strategic plan
CCN‘s operations framework and strategic plan
are being developed with a draft due by end of
2008
12
Screening and Early Detection
Activity
Progress
CCN monitors coverage rates for the
BreastScreen Aotearoa and National Cervical
Screening programmes
CCN receives and disseminates widely the
6mthly coverage rate reports from the National
Screening Unit
Introduce GP/Patient show card to assist with
consumer decision making on early detection
testing for prostate cancer
CCN and MidCentral DHB received funding from
Genesis Oncology Trust to undertake five pilot
GP training sessions to educate GPs on the tool.
Training sessions will be completed during JulySeptember 2008
Diagnosis and Treatment
Activity
Progress
Support DHBs to establish local/regional
multidisciplinary meetings for the management
of breast, lung, complex gastrointestinal, head
and neck, and gynaecological cancers
A multidisciplinary meeting framework has been
developed with stakeholders in the region. An
implementation plan will be developed
Work with the MoH, other cancer networks and
all relevant groups to explore the national
adoption of Patient Management Frameworks
for common cancers
Contact has been made with the Victoria
cancer team. The networks and MoH are
hosting a national forum on 21 August 2008 to
learn from the Victorian experience and to
determine if NZ clinicians see value in adopting
and adapting these frameworks
Identify and address access and coordination
issues for people diagnosed with lung cancer in
the CCN region
A Lung steering group and project scope have
been established. Mapping of the patients‘
journey in each DHB is underway
Implementation of consistent medical imaging
diagnostic and staging protocols for cancer
patients across providers in the CCN region
Guidelines are under development and will be
circulated to stakeholders for comment in the
last quarter of 2008
Contribute to the review of the Capital & Coast
DHB paediatric oncology service and monitor
the implementation of any new service model
CCN has been actively monitoring this process
and will be seeking stakeholder interest in the
development of a regional paediatric/
adolescent and young adult service group
Support and Rehabilitation
Activity
Ensure that the various coordinator positions
(navigators, case coordinators, disease specific
nurses) work in a complementary way that best
supports the patients‘ journey
Progress
Stakeholders supported the development of a
forum for cancer care coordinators to network.
First forum scheduled for 20 August 2008
13
Palliative Care
Activity
Progress
Work with the existing Central Region Palliative
Care Network to establish it as the work stream
for CCN to monitor, coordinate and identify
issues with respect to palliative care
CCN meets regularly with this group and
provides administration and project support
Identify existing local palliative care networks
across the region and develop a
communication strategy
A database of existing local palliative care
networks has been developed and CCN is
working with the regional group to assist with
palliative care network development
Opportunities for collaborative activity are
identified
CCN has completed a project to develop a Not
For Resuscitation Guideline for hospices.
MidCentral DHB and CCN have collaborated on
a project to develop a regional palliative care
medical specialist model
Information gained from providers in the region
reviewing their specialist palliative care service
against the Palliative Care Service Specification
will be collated to identify any actions which
could be worked on from a regional basis
The MoH, regional cancer networks and the
specialist palliative care service specifications
advisory group are liaising to determine how the
gap analysis will be undertaken
Service Delivery
Activity
Progress
CCN ensures there is consumer, Maori and
Pacific peoples representation on all the groups
directly associated with the network and
promotes the same for other stakeholder groups/
networks across the region
Consumer participation has been incorporated
into the membership guidelines of advisory and
project groups for CCN. The model is still
developing
Research and Surveillance
Activity
CCN monitors key indicators across the region
and engages with providers as required
14
Progress
Monitoring of screening indicators currently
occurs
D RAFT INITIATIVES 2 0 0 8 / 0 9
CCN‘s work programme supports and informs cancer control activity proposed at district, regional and
national levels which deliver upon the dual goals of the New Zealand Cancer Control Strategy Action
Plan 2005-2010; reduce the incidence and impact of cancer and reduce inequalities with respect to
cancer.
Goal 1: Reduce the incidence of cancer through primary
prevention
Engage with stakeholders to promote district wide health promotion planning.
Goal 2: To ensure effective screening and early
detection to reduce cancer incidence and mortality
Stocktake of Cervical screening services in the region, including contracting, service delivery
models, health promotion plans and coverage.
Stocktake of Breast screening services in the region, including contracting, service delivery
models, health promotion plans and coverage.
Complete GP training sessions on the early detection testing for prostate cancer tool and
evaluate (Genesis Oncology Trust supported project).
Consider activities to assist with the implementation of the Suspected Cancer in Primary: Referral
Guidelines.
Goal 3: Ensure effective diagnosis and treatment of
cancer to reduce morbidity and mortality
Develop and implement the Multidisciplinary Framework.
Develop and implement the Cancer Medical Imaging Guidelines.
Engage with stakeholders around pathology guideline development and service configuration.
Engage with RCTS/WBCC around the implementation of the radiation oncology capacity
sharing protocol.
Stocktake of clinical trials services.
Goal 4: Improve the quality of life for those with cancer,
their family and whanau through support, rehabilitation
and palliative care
Work with the MoH to implement the Supportive Care Guidance.
Support the functioning of the Central Region Palliative Care Network, undertaking identified
regional activities as able, including:
Supporting the development of district palliative care networks and formalising the regional
network
Developing and implementing a regional palliative care medical workforce model
Supporting the development of a regional strategic plan
Undertaking projects to develop a service directory, benchmarking and audit framework
and nursing workforce development plan (subject to Genesis Oncology Trust funding
application)
Supporting the implementation of the specialist palliative care service specifications.
15
Goal 5: Improve the delivery of services across the
continuum of cancer control, through effective planning,
coordination and integration of resources and activity,
monitoring and evaluation
Progress the addressing inequalities project including engagement with Maori and Pacific
peoples, and the development of partnership models and identification of district focused
initiatives to address inequalities.
Work with the MoH on a work programme to develop patient management frameworks.
Continue to identify service improvement opportunities along the patient pathway from a
Tumour stream perspective—initial foci: Lung, and Head and Neck. Also consider activities to
assist with the implementation of the Melanoma and Early Breast Cancer Guidelines.
Support the functioning of the regional Care Coordinators forum, undertaking identified regional
activities as able.
Engage with stakeholders on the establishment of a regional AYA/Paediatric Oncology Group
to assist with the development of these services.
Work with the DHB cancer managers group to progress initiatives, including developing DHB
district annual plan initiatives for 2009/10.
Develop and implement a consumer representation framework.
Continue to develop the operations framework for the network.
Develop a regional strategic plan, including a regional cancer health needs assessment report.
Goal 6: Improve the effectiveness of cancer control in
New Zealand through research and surveillance
Work with local cancer networks to develop an outcomes monitoring framework.
16
CONTACTS
Mike Grant
Jo Anson
Chair, Governance Group
Network Manager
Central Cancer Network
Central Cancer Network
[email protected]
p 06 350 8622
e [email protected]
Simon Allan
Shirlee McLean
Clinical Director
Project Manager
Central Cancer Network
Central Cancer Network
[email protected]
p 06 350 8986
e [email protected]
Andrew Simpson
Ali Hamlin
Clinical Director
Service Improvement Facilitator (Addressing
Central Cancer Network
Inequalities)
[email protected]
Central Cancer Network
p 06 350 8804
e [email protected]
Stephanie Fletcher
PA/Office Manager
Central Cancer Network
p 06 350 8918
e [email protected]
Central Cancer Network
[email protected]
www.cancercontrolcouncil.govt.nz (CCN host website)