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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