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c/- Funding Division MidCentral District Health Board PO Box 2056 Palmerston North P | 06 350 8622 E | [email protected] Central Cancer Network Programme Update (covers the period 29/5/12 to 22/8/12) Updates on the CCN Website www.centralcancernetwork.org.nz Central Region Palliative Care Minutes and link to individual videoed sessions of the forum Cancer Consumer Representative Minutes Collaboration in Action The following meetings have been facilitated and/or attended by the team this period: Local Cancer Network meetings Central Region Palliative Care Network forum (18/7) National Cancer Consumer Representatives Advisory Group (27/6) Consumer Representative Forum (5/7) Faster Cancer Treatment (FCT) Work programme supports the collection and reporting of indicators used to measure the timeliness of cancer treatment and related improvements to service delivery. Regional FCT Steering Group – the group has been established and met via teleconference to review and approve the regional FCT plan. A face to face is planned for later in the year. DHB FCT Implementation Groups - Groups have been established in each DHB to support implementation of the FCT programme in DHBs over the next few years. FCT Regional Implementation Plans – the draft plan was completed and presented to the MOH end of June. The plan focuses on the processes and resources which need to be put in place to develop the reporting requirements around the indicators. The networks are awaiting notification for the MOH re the investment in the plan. From July 1st DHBs are required to start capturing these indictors and CCN is working with DHBs to achieve reporting around these. Care Coordination – The regional stocktake was completed in June and provided to the MOH to inform the work around the new care coordination funding. An Expert Advisory Group has been established to guide the development of these new positions and includes Jo Anson (CCN) and Sue Wood (DHB ead Director of Nursing for Cancer). It is expected that this funding will be rolled out in the October round of funding to DHBs. National Tumour Stream Standards – work on all eight national tumour groups (bowel, breast, gynaecological, haematological, head and neck, melanoma, upper gastro-intestinal, sarcoma) has commenced with national forums and meetings underway. CCN is hosting the haematological group. Lung Tumour Stream Work programme aims to identify service issues across the CCN region for lung cancer patients and to develop and promote standards for service delivery. Stocktake of Current Service Provision for Lung Cancer Patients in NZ –Between August 2011 and July 2012 the NLCWG undertook a stocktake questionnaire and gap analysis to determine the level of services being provided to patients with lung cancer and how close current service provision was to meeting the new national standards for lung cancer. The collated information has been reported in 2 documents: 1. A dashboard report which summarises DHB performance against each of the 13 standards 2. A stocktake report which provides an overview of the methodology used for the stocktake and a summary of current provision of services for patients with lung cancer by DHB and regional cancer network areas. 1 Capital & Coast | Hawkes Bay | Hutt Valley | MidCentral | Tairawhiti Taranaki | Wairarapa | Whanganui The Chair of the NLCWG has recently provided a copy of the Gap Analysis of Service provision for Lung Cancer Patients in NZ Report to the Cancer Programme Steering Group (CPSG) for discussion. The CPSG will agree on how to action the report prior to dissemination to wider stakeholder groups. Bowel Tumour Stream Work programme aims to identify the service issues across the CCN region for patients with bowel cancer, and to develop and promote standards for service delivery. National Bowel Cancer Working Group (NBCWG) - We are not aware of any specific activity this period. Evaluation of the NZ Global Rating Scale (GRS) – A 12 month development trail of the endoscopy service improvement tool known as GRS has just been completed and the report has been provided to the MOH. The findings of the evaluation will partly inform the decision on a national roll out by the MOH and how this might best be implemented. Whanganui Bowel Pathway Project - An audit of 10-20 urgent and semi urgent referrals for suspicion of bowel cancer has been undertaken by Whanganui DHB. The data has been forwarded to Semisi.Aiono for still analysis. Head and Neck Tumour Stream Work programme aims to identify the service issues across the CCN region for patients with bowel cancer, and to develop and promote standards for service delivery. Regional Clinical Audit of Dental Services for H&N Cancer Patients – A Regional Clinical Dental Forum was held in Wellington on the 30th May. The following actions were agreed: 1. Dental assessment should happen prior to MDM discussion 2. Develop a regional prior approval process for funding of complex dental care 3. Escalate funding of complex dental cases to National H&N Cancer Working Group 4. Audit report to be forwarded to National H&N Cancer Working Group once established 5. Robin Whyman to present audit findings to NZDA Conference in August Gynae – Oncology Tumour Stream Work programme aims to identify the service issues across the CCN region for patients with gynaecological cancer, and to develop and promote standards for service delivery. No specific activity this period. The National Plan for Gynaecology Cancer Services is still under discussion and has not yet been released for circulation to wider stakeholder groups. This will be progressed by the national gynaecological tumour stream group. Multi-disciplinary Meetings (MDM) Work programme aims to improve access to an MDM opinion and to enable cancer treatment MDMs to function more efficiently. MDM Regional Conferencing Project – the dates for installation of the video conferencing solution to support cancer MDMs have now been finalized. These have been scheduled as follows. Capital & Coast Hutt Valley MidCentral Wairarapa Hawkes Bay Taranaki Whanganui 10th Sept to 17th Sept 24th Sept to 28th Sept 8th Oct to 12th Oct 22nd Oct to 26th Oct 30th Oct to 2nd Nov 12th Nov to 16th Nov 26th Nov to 30th Nov General MDM Development – Government funding to extend MDMs for all main cancer tumour streams is to be used for additional MDM activity. Work that is required to be undertaken over the next 12 months includes: 1. Patient information leaflet – circulated and agreed 2. The function of MDM coordination is scoped at each site 3. Agreed referral pathways established for all local and regional MDMs 2 Capital & Coast | Hawkes Bay | Hutt Valley | MidCentral | Tairawhiti Taranaki | Wairarapa | Whanganui 4. Review all local and regional MDMs, do these meet the needs of the region, and are they resourced appropriately? Clinicians agree which MDMs should have a regional focus and which DHB should host these. Develop a regional funding model to ensure funding is channelled appropriately between host and referring DHBs 5. MOH Guidance for implementing quality MDMs is implemented: Meeting protocols are developed – all DHBs will have terms of reference Membership of existing MDMs is reviewed Criteria for discussion is developed 6. Documentation processes will need to be established. Initially this may have to be paper based but electronic proformas will be rolled out alongside implementation of Concerto. This will capture the following information: Meeting outcomes – communicated back to the initial referrer and GP (if different). Collection of data – core data sets agreed for each MDM which support clinical decision making Audit – agree on an audit tool for monitoring MDMs Cancer Centre Update Work programme supports improved relationships and the identification of collaborative activities between the two cancer centres in the central region Radiation Oncology –National wait time target is being met by both centres (patients receive radiation therapy within 4 weeks). RCTS and WBCC are working with the MOH to model future linac capacity requirements for the region. Medical Oncology (MO) – the Steering Group (Dr Andrew Simpson, Chair) have developed a 12 month national work plan for the New Models of Care for Medical Oncology. The plan covers both service and workforce development activities and is awaiting Ministerial sign-off. Engagement with Iwi/Maori Work programme supports engagement and partnerships with Maori to improve overall cancer care and address inequalities Hei Āhuru Mōwai: National Māori Cancer Leadership Group (NMCLG) – Hei Āhuru Mōwai Inc. is now an incorporated society and has held its inaugural hui in May 2012. A Maori Provider Development grant proposal has been successful. The group is now formalising its terms of reference; work plan and communication plan. The second meeting of Hei Āhuru Mōwai Inc is currently being planned for September 2012. Engagement with Pacific Communities This work programme aims to support engagement and partnerships with Pacific communities to improve overall cancer care and address inequalities Discussions are underway with the DHB Pacific Advisors in Capital & Coast, MidCentral and Hawkes Bay to identify where CCN can best work to support Pacific communities and cancer control going forward. Engagement with Consumers Work programme supports engagement and partnerships with Consumers to improve overall cancer care and address inequalities National Cancer Consumer Representative (CCR) Contract The second meeting of the cancer consumer representatives was held in June. Representation includes consumers from each of the regional cancer networks, national cancer organisations and Maori. The group confirmed the terms of reference and the workplan. A proposed training package for consumer representatives was presented and will be further developed. The group confirmed their role as providing advice and guidance to cancer organisations regarding consumer representation and inclusion. 3 Capital & Coast | Hawkes Bay | Hutt Valley | MidCentral | Tairawhiti Taranaki | Wairarapa | Whanganui Patient Story project with UCOL CCN and UCOL are currently scoping the potential of patient stories being integrated into the learning outcomes of three groups of professional at UCOL, as a research project. The project group has appointed 2 consumer representatives. Awaiting the signed Memorandum of Understanding from UCOL and will then commence the literature review. Consumer Representation on National Health IT Board Projects Stephanie Fletcher has been appointed as a consumer representative to provide input on a number of national IT projects. Steph’s involvement enables the network to keep abreast of developments in this space and to ensure that a cancer perspective is provided. Activity this period includes: Attendance at the HINZ conference in Auckland Wairarapa Better Sooner More Convenient Governance Group NHITB consumer panel meeting – note that road shows have commenced to inform the public of the progress of Connected Health Records Addressing Inequalities Pilot Funding Work programme supports Local Cancer Networks to identify and address inequalities in their districts Round 1 Funding – Most projects now complete. Awaiting evaluation report for the Pacific radio project and Hawkes Bay are yet to complete their pacific focussed initiative. Round 2 Funding – Projects are now underway. Supportive Care This work programme aims to improve the delivery of supportive care services for cancer patients Patient Diary (Cancer Society NZ lead) – Stephanie has taken over as joint project lead with Sarah Penno, CSNZ. The resource, called “My Health Matters’, has been developed, and will be piloted in a joint initiative between CSNZ, MDHB and CCN. A reference group has been established and the project scoped. Provider training will commence August with the dissemination of the kits starting mid September Service Directory – CCN is exploring ways of promoting the web-based resource including placing stickers on all cancer resources from the Cancer Society and Cancer Centres. Talks still need to be had with some providers. Community Health Development Project Project aims to identify opportunities to improve the integration of planning and delivery of health promotion activities to better support community health development. No activity this period. Equity Project Manager to review information and discuss next steps with the Advisory Group. Regional Cancer Nurse Directors’ Programme Project supports cancer nursing leadership, networking and development across the region The Nursing in Cancer Care Strategy has been drafted and feedback has been provided by the Advisory Group. A paper will be presented at the NZ Regional Cancer Networks forum in Aug to discuss the potential for the strategy to be adopted nationally. Central Region Palliative Care Network (CRPCN) This network provides a forum to enable key stakeholders to share information and work collaboratively in the ongoing planning and development of palliative care services across the region. CRPCN Education Forum – this annual forum was held in Palmerston Nth on the 18th July, attended by over 70 health workers and researchers. The theme was Vulnerable Populations and Palliative Care and presentations covered health literacy, Maori workforce models, research on cultural components of the Liverpool care pathway and nursing models in primary care. Videos and presentations from the day can be found on the CCN website. Regional Service Planning Regional Services Plan - the plan for regional cancer services has been completed for 2012/13 and covers the following mandatory areas of focus: Timely and improved access to radiotherapy and chemotherapy services 4 Capital & Coast | Hawkes Bay | Hutt Valley | MidCentral | Tairawhiti Taranaki | Wairarapa | Whanganui Timely and improved access to diagnosis and cancer treatment services – faster cancer treatment programme and MDM development Development of regional data repositories Improved colonoscopy wait times and quality of service CCN Work Plan 2012/13 – the plan has been drafted and will be discussed at the Regional Clinical Forum and local cancer network meetings over the next few weeks. Regional Clinical Forum – this was held on the 21st Aug in Wellington and attended by over 60 clinicians and managers from across the region. Key topics covered the Faster Cancer Treatment programme, MDM development plan, Nursing in Cancer Care plan and clinical leadership. Tairawhiti Cancer Services Review – TDH Board have announced that they will be shifting their tertiary cancer services from MDHB to Waikato from July 2013. As a result Tairawhiti shifted into the Midland Cancer Network (MCN) at the end of June 2012. CCN, MCN and TDH worked through a transition plan. Additional Activities for this period: Submission on the Central Region Transport & Accommodation Report Submission on the Health Quality & Safety Commission’s Partners in Care Framework Major Activities Planned for Next 6 - 8 Weeks: Faster Cancer Treatment – working with DHBs to: Collate the first few months of FCT data Identify and assess options for a more automated data collation process going forward Ongoing MDM development including Video conferencing implementation commenced identify and implement new care coordination roles Implement project and analytical resource as identified in the plan (subject to MOH funding) Working with CRISP to identify the requirements around the FCT work Working with the Haematology Work Group to draft standards for the Lymphoma and Myeloma pathways Completing the Nursing in Cancer Care Strategy and commencing implementation Establishing the Regional Oncology Social Work lead position (subject to CCN Governance Group approval) Supporting the development of the regional smokefree plan (TAS lead) Supporting the My Health Matters pilot (Cancer Society NZ lead) Supporting submission writing workshops in Palmerston Nth and New Plymouth (PHA lead) Prince2 project training for management team members 5 Capital & Coast | Hawkes Bay | Hutt Valley | MidCentral | Tairawhiti Taranaki | Wairarapa | Whanganui