Download Better, faster cancer care

Better, faster cancer care
Dr Andrew Simpson
National Clinical Director, Cancer
PREPARED BY
Ministry of Health
New Zealand Cancer Plan 2015-18
The New Zealand Cancer Plan sets out all
activities underway and planned for the next
three years to implement the Government’s
priorities for cancer.
The New Zealand Cancer Plan is guided by
the following principles:
• equitably, effectively and sustainably
meet the future demand for cancer
services
• maintain high quality of care and improve
the quality of life for people with cancer
• ensure fiscal responsibility.
Cancer incidence 1948-2011
25000
400.0
350.0
20000
Numbers
300.0
ASR
250.0
15000
200.0
10000
150.0
100.0
5000
50.0
2010
2008
2006
2004
2002
2000
1998
1996
1994
1992
1990
1988
1986
1984
1982
1980
1978
1976
1974
1972
1970
1968
1966
1964
1962
1960
1958
1956
1954
1952
1950
0.0
1948
0
Source: NZ Cancer Registry
Cancer mortality 1948-2011
Source: NZ Cancer Registry
Our survival rates are behind Australia
Source: NZMJ 19 December 2014, Comparison of cancer survival in New Zealand and Australia, 2006–2010, Phyu S Aye, J Mark
Elwood, Vladimir Stevanovic
And inequities in treatment and outcomes
Survival (%)
Māori
100
Non-Māori
90
80
70
60
50
40
30
20
10
0
0
1
All adult cancers, 2010-11
2
3
4
5
6
Years since diagnosis
7
8
9
10
Source: Cancer patient survival covering the
period 1994–2011 : Ministry of Health, 2015
Timely access to excellent cancer services
National cancer programme
• Brings together the work of DHBs, regional cancer
networks and the Ministry.
• Aims to improve cancer outcomes for all New Zealanders.
• Key themes
 Waiting times: all people get timely services
 Access: all people have access to services that maintain good
health and independence
 Quality: all people receive high quality services wherever they
are
 Financial sustainability: all services make best use of
available resources.
Activity underway in the Programme
Bowel screening pilot and colonoscopy
• Bowel cancer screening pilot began in 2011 to inform a
decision on a national roll-out.
• Particular focus on increasing number of colonoscopies.
• Budget 2015 allocated a further $12.4 million to extend
the bowel cancer screening pilot to December 2017.
• July 2015 Minister announced consultation with the
health sector to inform next steps towards potential roll
out of a national bowel screening programme.
• Consultation underway & business case development
Cancer Health Information Strategy
• The purpose of the Strategy is to:
define a cohesive vision for Cancer Health
Information
detail how this vision can be achieved
align with the IT Health Board Strategy and enable
the National Cancer Programme.
• The Strategy will be used to prioritise cancer initiatives
and inform funding.
National radiation oncology plan
• To help DHBs manage rising demand with plan for linear
accelerator and workforce capacity for next 5-10 years.
• Reviewing metrics to ensure quality and consistency
across centres and support service improvement.
• Procurement aims to promote equity, clinical and costeffectiveness.
Medical oncology models of care
• To help DHBs manage rising demand have developed
new models of care for medical oncology services.
• Focus is on workforce, key performance indicator
development and measurement, and quality
improvement:
Knowledge and Skills Framework for Cancer Nursing
education programme for chemotherapy
administration for nurses
implement recommendations from Guidance for
Medical Oncology Senior Medical Officer Roles.
Faster cancer treatment programme
Service improvement projects – Midlands
• Midland Routes to Cancer Diagnosis and Treatment Project
(October 2015 - June 2018)
• Midland Cancer Patient Information Project (December 2016 June 2018)
• Waikato DHB Endometrial Cancer and Post-Menopausal Bleeding
Service Improvement Project (October 2015 - November 2016)
• Lakes Faster Cancer Treatment Project (October 2015 - June 2018)
• Waikato Faster Access to Cancer Services with a Staged Approach to
Tumour Streams and Treatment (October 2015 - June 2018)
• Determine, Test and Implement Viable Ways of Improving the FCT
Pathway for Māori in the Bay of Plenty (October 2015 - June 2018)
Faster cancer treatment health target
85% of patients receive their
first cancer treatment (or
other management) within 62
days of being referred with a
high suspicion of cancer and a
need to be seen within two
weeks by July 2016
Increasing to 90% by June
2017
We know targets work
Percentage achieving target
100.0
80.0
60.0
8 week target
4 week wait target
6 week wait target
40.0
20.0
0.0
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
Q3
Q4
Q1
Q2
07/08 07/08 07/08 07/08 08/09 08/09 08/09 08/09 09/10 09/10 09/10 09/10 10/11 10/11 10/11 10/11 11/12 11/12 11/12 11/12 12/13 12/13 12/13 12/13 13/14 13/14
% 96.0
96.0
91.0
97.0
97.0
96.0
97.0
98.4
99.5
97.5
96.9
99.3
99.5 100.0 98.9
99.9 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 99.9 100.0
Measure the whole cancer pathway
Hospital Triage
Faster cancer treatment – results (percent)
DHB
Q2
Q3
Q4
Bay of Plenty
57
66
74
Lakes
54
37
55
Tairawhiti
74
79
61
Waikato
68
65
57
National
66
67
68
While remembering to…
keep the patient at the centre
Don’t hit the target but miss the point
Questions?