Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
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)