Transcript NZ Cancer Networks

New Zealand
Regional Cancer
Networks
Improved cancer control through
increased regional collaboration
Overview
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New Zealand and its people
Cancer in New Zealand
New Zealand Cancer Control Strategy
Key Players
Regional Networks
Work priorities and programmes
People in New Zealand
• 4.27 million
– 68%
– 15%
– 7%
– 9%
– 12%
European
Maori
Pacific Peoples
Asian
Other
Rural / Urban Population
• 72% live in main urban areas
• 5.5% live in rural areas
• 1.6% live in remote rural areas
Cancer in NZ
• Second leading cause of death
• 7,500 people die annually & expected to
rise to 9000 by 2012
• 17,000 new registrations annually and
expected to rise to 22,000 by 2011
• Top 3 for males: lung, bowel, prostate
• Top 3 for females: breast, bowel, lung
Inequalities - Maori
• Age-sex-standardised incidence rates for
cancers overall:
Maori – 219/100,000
Non-Maori – 220.5/100,000
• Age-sex-standardised mortality rates for
cancer overall:
Maori – 117.5/100,000
Non-Maori – 66.3/100,000
Inequalities - Maori
• Cancer registrations
• Cancer deaths
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Source: Hauora Maori Standards of Health
IV – A Study for the Years 2000-2005
Maori
Non-Maori
Lung
Prostate
Female breast
Colorectal
Prostate
Female breast
Colorectal
Melanoma
Stomach
Lung
Maori
Non-Maori
Lung
Lung
Female breast
Colorectal
Colorectal
Female breast
Stomach
Prostate
Prostate
Pancreas
Haka = a traditional Māori challenge
NZ Cancer Control Strategy
• Started 1999 – NZ Cancer Control Trust
• 2000 – NZ Health Strategy
• 2001 – Improving Non-Surgical cancer
Treatment Services in NZ & NZ Palliative
Care Strategy
• 2003 – NZ Cancer Control Strategy
• 2005 – NZ Cancer Control Strategy Action
Plan 2005-2010
Background
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Midland regional service planning
commenced February 2004
Project Manager commenced late 2004
NZ CC Strategy Action Plan – March
2005
Cancer Control Projects – 2 for Midland
1. Midland Cancer Network Framework
2. Midland patient & parallel mapping for the
major tumour groups
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MCN formed October 2006 (CD &
Overall purposes of the Strategy:
Reduce the incidence and impact of cancer
Reduce inequalities with respect to cancer
NZ CC Strategy Goals
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Reduce the incidence of cancer through primary prevention
Ensure effective screening and early detection
Ensure effective diagnosis and treatment of cancer
Improve the quality of life for those with cancer, their family
and whanau through support, rehabilitation & palliative care
Improve the delivery of services across the continuum of
cancer control, through effective planning, co-ordination and
integration of resources and activity, monitoring and
evaluation
Improve the effectiveness of cancer control in NZ through
research and surveillance.
Key Players
• Ministry of Health
• 21 District Health Boards
– NZ Cancer Control Implementation Steering
– NZ Cancer Treatment Working Party
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National Clinical Director, CCC
PHARMAC,SPNIA
4 Regional Cancer Networks
Primary Health Organisations
Non-Government Organisations
Consumers
Regional Cancer Networks
• established 2006/07
• Leadership, facilitation & co-ordination role
• Continuum – primary prevention,
screening & early detection, treatment,
rehabilitation & support, palliative care,
research & surveillance
• Complex organisational & service delivery
structures
Regional Cancer Networks
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Work across organisational boundaries
Strong clinical and managerial leadership
Involves patient & public
Maori and Pacific participation/partnership
Strengthen Primary involvement
Quality assurance & clinical governance
Deliver a set of comprehensive, integrated
& best practice cancer services
RCN Service Requirements
• Investigate and address systemic causes of
cancer inequalities
• Develop patient pathways & improving the
experience of care
• Cancer data analysis capacity
• Regional Strategic Cancer Control Plan
• Tumour specific and service improvement MD
work groups
• Support service planning to maximise finite
resources
RCN Alignment with National Goals
Two key work programmes:
1. Patient & service mapping
2. Reducing inequalities
Work Streams:
• Service improvement
• Tumour groups
RCN Management Team
• Funding $550,000 pa
– management infrastructure
• Clinical Director (part time)
• Manager
• Service Improvement Facilitators
– Patient and service mapping
– Addressing inequalities
• Administration support
RCN Structure
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Each network slight structure differences
All lead DHB and CEO
All have a governance group
All have work groups
RCN Work Programme
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RCN Operating framework
Regional Cancer Control Strategy Plans
Service & Patient Mapping
Development of patient management
frameworks
• Reducing inequalities
• Establishment of AYA OHS
• Palliative Care
Primary Prevention
Cancer Pathway
Recognition
Initial Diagnosis
Determination of treatment
Implementation of treatment
Follow up program
Recognition of recurrence
Re treatment programme
End of life care
Addressing inequalities
Supportive Care
Confirmation of diagnosis
Supportive Care
Care Co-ordination Framework
Multidisciplinary Meeting Framework
Tumour Stream Steering Groups - Network Patient Journey Mapping
Addressing Inequalities
Potential cancer signs &
symptoms, or abnormal results
from a screening test of
investigation
Initial diagnosis & referral
Determination of treatment
Treatment
Follow-up care
Determination of plan &
treatment for recurrence
End-of life care
Specialist Palliative Care Service Specifications
Including End of Life Programme
National Data Projects
Screening Programmes
PATIENT MANAGEMENT
FRAMEWORK
Guidelines e.g. Clinical, Supportive Care, GP Referral, Medical Imaging
Network Focus
National Focus
New National Priorities
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HPV programme
Bowel Screening Programme
Supportive Care Guidelines
Information Systems project
Specialist palliative care service
specifications & gap / costing analysis
• Other guidelines – suspected cancer in
primary