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Terms of Reference of the National Breast Cancer Working Group Background and context Timed, effective pathways based on tumour specific quality standards ensure that: patients receive timely and good quality care throughout their cancer journey patients receive the same standard of care regardless of where they live efficient and sustainable best practice management of specific tumour types is developed in the New Zealand health system a nationally coordinated and consistent approach to service provision for the tumour type is promoted. Tumour standards are needed to guide service provision as District Health Boards (DHBs) work to implement the Faster Cancer Treatment (FCT) wait time indicators. The primary purpose for developing these indicators is as a mechanism to inform and drive service improvement for timely access to health services and ultimately to improve patient outcomes for: patients referred with a high suspicion of cancer patients diagnosed with cancer. The Cancer Treatment Advisory Group (CTAG) agreed at its 16 November 2011 meeting that tumour standards and pathways were required to mitigate the risk of patients receiving poor quality care in order for services to meet the timeliness measures associated with the FCT indicators. Tumour specific national standards have already been developed for lung cancer in the Standards of Service Provision for Lung Cancer Patients in New Zealand, published in August 2011. The lung cancer standards were developed by a clinical work group, chaired by a clinical chair. This work group and clinical chair are supported by a lead regional cancer network (RCN). The RCNs have demonstrated expertise in facilitating and supporting regional DHBs to collaborate; and supporting clinical work groups to complete national work with regional representatives. CTAG noted at its meeting on 16 November 2011 that the lung cancer standards have already made improvements to service delivery and clinical practice. It also agreed that this success highlights the importance of nationally developed tumour standards and pathways, and supports the need to develop these for other tumour types. The eight national cancer working groups being established for one year to develop tumour standards, patient pathways and a service framework to support the FCT approach are: Central Cancer Network Haematological Midland Cancer Network Breast Northern Cancer Network Head and Neck Gynaecological Melanoma Southern Cancer Network Bowel Upper Gastrointestinal Sarcoma Date: 27 September 2012 Review: July 2013 Purpose 1. Develop national breast cancer service standards. Breast cancer service standards are needed to guide service provision and promote uniform standards of service provision across New Zealand as DHBs work to implement the indicators. This will ensure the development of efficient and sustainable best practice management of specific tumour types in the New Zealand health system, and promote a nationally coordinated and consistent approach to service provision for the tumour type. 2. Develop a national breast cancer patient pathway and service framework. The patient pathway algorithm describes the journey. The service delivery framework describes the required infrastructure to achieve the standard. 3. Maintain a focus on achieving equity and Whānau Ora when developing service standards, patient pathways and service frameworks by ensuring an alignment with the Reducing Inequalities in Health Framework and its principles (MOH 2002). Membership 1. The National Clinical Director of Cancer and the Regional Cancer Network Clinical Directors have identified the interim chair for the group. 2. The Chair of the National Breast Cancer Working Group (Working Group) will be confirmed by the members of the Working Group. The Chair will be appointed for a one year term. 3. Membership of the Working Group will focus on required clinical expertise, ensuring that professional disciplines, geographical coverage and the continuum of representatives are included. The following disciplines should be considered in the membership of the work group: Chairs of any regional breast cancer working groups, if established (who can also be one of the specialties listed below) Radiation Oncologist Relevant physicians, surgeons Clinical Nurse Specialist Medical Oncologist Radiologist Pathologist Primary Health Regional Cancer Network Clinical representative Director (optional) Research Palliative care Relevant NGO Public Health representation 4. Ministry of Health (MoH) to be ex-officio 5. Membership of the work group will be for one year (see Appendix One for details of current membership). 6. To ensure consumers/carers are involved in the process of developing these standards, each network will utilise its own regional consumer/carer reference group to provide input into the process. 7. To ensure Māori is involved in the process of developing these standards each network will utilise its own regional Māori reference group to provide input into the process. 8. To ensure that an equity focus is applied in a uniform way, a Whānau Ora Health Impact Assessment will be undertaken against each of the standards by the Māori Leadership Group/Equity Manager in each network. Networks will engage with the National Māori Leadership Group through this process. Date: 27 September 2012 Review: July 2013 Meetings 9. The work group will meet as required by the project timelines either face to face or by teleconference. Funding 10. Funding for the Working Group is for 2012/13. Any ongoing provision for the group is dependant on MoH prioritisation 11. The Working Group is not a fund holding organisation. Support 12. The Midland Cancer Network has been contracted by the MoH to host this national work group until 30th June 2013. This contract provides funding for the Clinical Lead, meeting activities and project support. 13. Travel costs and time will be funded through the representative’s employer for employees. The Midland Cancer Network has a limited budget to support travel and appropriate costs for unfunded representatives. Approval will be at the discretion of the cancer network manager. Any expenditure needs to be approved before it occurs. 14. A national breast cancer stakeholder database will be developed and maintained by the Working Group secretariat (Midland Cancer Network). 15. A communications plan will be developed and maintained to ensure that there is appropriate and timely communication to stakeholders and strong links with other national and regional tumour stream work groups. Reporting 16. The Working Group will provide its final drafts to the Cancer Treatment Advisory Group and via this process to the joint DHB/MoH Cancer Programme Steering Group. 17. The Working Group will also report back to its various stakeholder groups and organisations on progress. Conflicts of Interest 18. Members will comply with the MoH’s Conflicts of Interests Policy; and perform their functions in good faith, honesty, impartiality, and avoid situations that may compromise their integrity or otherwise lead to conflicts of interest. Members will be required to complete the MoH Declaration Form prior to their first meeting. The MoH will hold the declaration forms. 19. When members believe they have a conflict of interest on a subject which will prevent them from reaching an impartial decision or undertaking an activity consistent with the advisory group functions, then they must declare a conflict of interest or absent themselves from the discussion and/or activity. 20. Members shall make all reasonable endeavours to support the National Cancer Programme, with the exception of areas where a conflict of interest has been noted. Media 21. The Chair will provide the MoH with advance notice of any media statements. Media statements will be made by the MoH. Interviews are given only by MoH authorised media spokespeople. The Chair may be asked to brief a spokesperson on an issue prior to interview. Date: 27 September 2012 Review: July 2013