Download Faster cancer treatment indicators

Faster cancer treatment indicators:
Frequently asked questions
The following are the answers to frequently asked questions that have been raised during
the development of the faster cancer treatment indicators.
1.
Are these new faster cancer treatment indicators part of the Shorter waits for
cancer treatment: radiotherapy and chemotherapy health target?
No, the faster cancer treatment indicators (the FCT indicators) are not part of the
Shorter waits for cancer treatment health target reporting. They are a development
measure and were in the 2012/13 District Health Board (DHB) Planning Package,
with each District Health Board (DHB) expected to begin implementing the FCT
indicators during 2012/13.
2.
How are the FCT indicators different from the Shorter waits for cancer treatment
health target?
The FCT indicators are different from the Shorter waits for cancer treatment health
target in the following ways:
a. the FCT indicators measure three different timeframes 14, 31 and 62 days (see
Figure 1 below); whereas the health target measures only one timeframe of four
weeks
b. the definition of first cancer treatment in the FCT indicators includes surgery
(excludes diagnostic procedures), radiation treatment, chemotherapy, targeted
therapy, non-intervention management, and palliative care; whereas the health
target, from 1 July 2012, includes radiation treatment and chemotherapy
c. the FCT indicators include inpatients, outpatient and day-patients; whereas the
health target includes all radiation treatment patients and only chemotherapy
outpatients.
Figure 1: Faster cancer treatment indicators
Indicator two (best practice – 14 days)
Urgent referral
with
high-suspicion of
cancer
First specialist
assessment
Indicator three (best practice – 31 days)
Decision-to-treat
First cancer
treatment
Indicator one (best practice – 62 days)
3.
Our systems and processes do not currently record this information, what do we
do?
Where systems and processes do not already exist, it will be necessary for each DHB
to develop a method of recording that supports the reporting of the FCT indicator data.
The information required to report data against the FCT indicators may be kept in more
than one computer system. When determining your process it is important to consider
all possible options. These may range from an electronic solution in a patient
management system, to using an excel spread sheet. As the reporting on the FCT
indicators is retrospective keep systems and processes simple and appropriate for the
number of patients being treated.
4.
It is a lot of work to record this new data, why is it important?
The Ministry of Health (the Ministry) appreciates it will be a lot of effort to set up
systems and processes for collecting the indicator information. There is currently very
limited consistent data collected across the patient journey. To understand how
services to cancer patients can be improved it is first necessary to understand the
length of time taken along the clinical care pathway and where any bottlenecks exist.
Improved planning and coordination of the patient’s care leads to improved outcomes.
5.
How will the patient and their family benefit?
Timely access to quality cancer treatment is important to support good health
outcomes for New Zealanders. A suspicion of cancer or a cancer diagnosis is very
stressful for patients, family and whānau. It is important that they have a clear
expectation giving certainty about how quickly they can receive treatment. Long
waiting times can result in delayed symptom management for palliative patients and
affect local control and survival benefit for other patients. The collection of the FCT
indicator data will help clarify what is happening.
Clinicians support the need to take a patient pathway approach to cancer wait times.
They also recognise the need to better understand the management of patients
through diagnostic and other services.
6.
What will the data be used for?
The collection of baseline data will give an initial view of where bottle-necks in the
pathway might be. The indicators will also enable international comparisons. The
information collected (against the FCT indicators) will help DHBs and the Ministry
identify initiatives that improve services.
7.
Where did the FCT indicator timeframes come from?
The FCT indicator timeframes are based on service delivery indicators used in
England, Wales and Scotland. Similar indicators are also being implemented in
Manitoba, Canada.
The document Standards of Service Provision for Lung Cancer Patients in New
Zealand aligns with the FCT indicators. The document sets out two standards for
timely access to services – Standard 1 addresses the 62-day indicator and Standard 2
addresses the 14-day indicator.
8.
Our patients have to go to a different DHB for treatment, why doesn’t that DHB
report on the FCT indicators?
The reporting of data against the three FCT indicators is the responsibility of the DHB
where the patient is domiciled. To ensure coordination of care and to support referred
patients receiving timely care, it is important that clinicians within the DHB of domicile
keep a watching brief over all their patients.
Faster cancer treatment indicators - frequently asked questions (March 2012)
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9.
How often do we report on the FCT indicators?
DHBs are required to report data against the FCT indicators monthly. The Ministry
recognises that it may take a few months to get the necessary processes in place to
record this information.
10.
Where can we find information on the FCT indicators?
The FCT indicators reporting template and data definitions are available from the
Ministry’s Nationwide System Framework Library (NSFL) see www.nsfl.health.govt.nz.
11.
Will the patients who have radiation treatment and / or chemotherapy be
reported in both the FCT indicator reporting and the health target reporting?
Yes, patients will be reported twice. As the four week health target timeframe is less
than 31 days the patients in the health target reporting will meet the required FCT
indicator timeframe. Where inpatients receive chemotherapy as their first cancer
treatment they will be included in the FCT indicator reporting only. This means that
inpatient chemotherapy will be expected to start within 31 days of the decision-to-treat.
12.
Does the patient need to have a histological diagnosis which confirms a cancer
diagnosis?
While a histological diagnosis is ideal there are a small number of patients whose
diagnosis of cancer will be based on diagnostic imaging. If these patients have been
referred urgently with a high-suspicion of cancer they are included in the FCT
indicators.
13.
If the patient has no pathology or radiology confirming a cancer diagnosis but
the patient is having chemotherapy, are they included in the FCT indicator
reporting?
No, the patient is excluded from the FCT indicators.
14.
How will the quality of care be maintained?
The Ministry is working with the regional cancer networks and clinical leaders to
develop a number of quality initiatives which include nationally consistent standards of
service provision for different tumour types and improving multidisciplinary meetings.
These initiatives will support the establishment of common expectations around a
patient’s level of care, leading to an improved patient experience as a result of a focus
on the patient pathway.
Faster cancer treatment indicators - frequently asked questions (March 2012)
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