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Memo to To: From: Subject: Date: For Your: Regional Stakeholders Shirlee McLean, Project Manager Regional Bowel Report – Implementation Priorities 12 August 2010 ACTION DECISION INFORMATION X The Central Cancer Network (CCN) has been working with service providers to develop a regional report on bowel cancer which identifies issues relating to the bowel cancer pathway and makes recommendations to address these. The following is a summary of the actions yet to be progressed at national, regional and local levels. Activity already being addressed via other programmes of work is highlighted on page 2 of this memo. Progressing Recommendations at a National Level To achieve national consistency in the care of patients with colorectal malignancy it is likely that a National Bowel Tumour Working Group will be established later this year. It is expected that the National Bowel Cancer Working Group may address the following recommendations: The development of diagnostic targets or quality standards The development of standard prioritisation criteria for access to colonoscopy Standardisation of staging systems in relation to data collection Investigate the development of a national/regional database and data collection for bowel cancer A system for recognition of training accreditation and recertification is developed for Medical Specialists (identified as regional but has national implications) Progressing Recommendations at a Regional Level Those recommendations identified in the Regional Bowel Report that are not addressed within current regional programmes of work include: Review DHB policies on the delivery of sensitive/bad news to patients for possible regional adaption/adoption. Processes are improved for communicating and co-ordinating patient care between public and private facilities Progressing Recommendations at a Local Level At a local level DHBs need to incorporate the following initiatives in their action plans: Referral pathways are streamlined for bowel cancer patients o Single entry referral is investigated by DHBs o GP direct access for colonoscopy is investigated by DHBs DHBs review colonoscopy capacity including workforce and facilities to support timely access to colonoscopy Local Cancer Networks consider access to Psycho-Oncology services for their populations and monitor the situation, advising as appropriate There is a number of the recommendations/implementation priorities in the Regional Bowel Report have already been identified and are currently being addressed at a national or regional level. The following activity is identified in either the Cancer Control Work Programme 2009/10 or the CCN Work Plan 2010/11. Key Focus Area National Bowel Cancer Screening programme National Bowel Cancer Working Group Development of guidelines/protocols/policies/ and frameworks KPIs/quality standards Workforce Development MDM Development Improving access to services Data collection & pathway monitoring Health Promotion Supportive Care Output/Activity Develop the screening pathway and quality standards for the Bowel Cancer Screening Programme Promote Clinical governance through the establishment of multidisciplinary tumour stream work groups and work with them to undertake identified activities Develop an implementation plan for the Suspected Cancer in Primary Care guideline Develop a Demystifying Cancer for Maori programme Develop wait time indicators for bowel cancer from referral to 1st treatment Develop national standards for multidisciplinary teams Develop and implement initiatives to enhance colonoscopy workforce capability and capacity A framework to support the functioning of MDM across the region is developed and implemented Funding for PET-CT to DHBs includes criteria for bowel cancer patients Support DHBs to implement CFA including development of a variance committee Gather baseline information for wait times from referral to 1st treatment for bowel cancer patients Identify the current percentage of bowel cancer patients presented at MDMs by DHB & ethnicity Monitor radiation oncology wait times and report Develop core cancer and palliative care data definitions to HISO standard Improve access to cancer information The development of integrated health promotion planning is supported by developing or promoting a methodology to assist the process. Develop a national implementation plan for Supportive Care Guidance Assist local cancer networks to undertake care coordination stocktake to identify current care co-ordination coverage / resources and opportunities for improvement Lead Responsibility MOH MOH MOH CCN MOH MOH MOH CCN CCN CCN CCN MOH/CCN MOH MOH CCN MOH CCN