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Faster Cancer Treatment Improving Quality of Care Across the Patient Cancer Pathway PREPARED BY John Childs June 2012 Rationale for Faster Cancer Treatment • clinically beneficial • streamlined health service delivery • consistent with indicators implemented in other countries • Focus on efficiency improves quality Data Definitions, Measurement and Indicators Indicator two (best practise – 14 days) Urgent referral with highsuspicion of cancer First specialist assessment Indicator three (best practise – 31 days) Decision-to-treat First cancer treatment Indicator one (best practise – 62 days) 1. Referred urgently with high suspicion of cancer receive first cancer treatment within 62 days 2. Referred urgently with high suspicion of cancer have first specialist assessment within 14 days 3. Confirmed diagnosis of cancer receive first cancer treatment within 31 days of decision-totreat National data definitions, reporting template and frequently asked questions documents have been sent to the DHBs Regional implementation plans • Stock-take against existing DHB information systems (what is currently collected?) • Identify the changes to information systems and internal processes that are required to support consistent collection of the data against the Indicators • Stock-take of existing care coordination roles Regional implementation plans are due 30 June 2012 Implementation • Phased with baseline data collection in 2012/13 • Regional Implementation plans • key initiatives: • Tumour stream standards and pathway frameworks • Care coordination • Multidisciplinary meetings Multidisciplinary meetings • funding advice identified $2 million nationally for MDMs; regional approaches to improve quality and consistency • increase MDM information systems / data collection • coordination • connectivity • number of MDMs across tumour streams • streamline MDM processes to increase proportion of cancer patients reviewed • MDM guidance document released by Ministry Tumour standards • cancer networks supporting development of eight tumour standards: Bowel Haematological Breast Melanoma Gynaecological Upper gastrointestinal Head and neck Sarcoma • urological tumour standards will be developed following the Prostate Cancer Task Force recommendations • implementation of the tumour standards will require local DHB commitment • Standards will support pathway framework Patient pathway coordination • Budget 2012 identified $33 million over four years for up to 40 cancer nurse patient pathway coordinators • positions will help patients through the cancer service pathway in a timely, responsive and seamless fashion • the Ministry is developing a cancer care coordination model that specifies minimum standards of service delivery • Cancer Networks completing a stock-take of existing patient coordination roles in DHB secondary care settings • new funding will be tagged to new clinical positions with the core function of patient pathway coordination Coordination of Care Roles • Nursing/nurse specialist roles • Additional to existing DHB roles • Pan pathway: from suspicion • Provide a single point of contact • Configuration will vary across DHBs: adaptation to local need • Provide nursing care, application of clinical skills (cancer knowledge) and co-ordination Additional initiatives • Establish a patient information resource network • Tools to assist primary care in identifying patients with suspected cancer • Limited funding for service redesign and optimisation