new zealand regional cancer networks improved cancer control through increased regional...
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New Zealand Regional Cancer
Networks
Improved cancer control through
increased regional collaboration
Overview
• 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% European– 15% Maori– 7% Pacific Peoples– 9% Asian– 12% 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 – 219/100,000Non-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
• 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
• 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
• MCN formed October 2006 (CD & Manager)
Overall purposes of the Strategy:
Reduce the incidence and impact of cancer
Reduce inequalities with respect to cancer
NZ CC Strategy Goals1. Reduce the incidence of cancer through primary prevention
2. Ensure effective screening and early detection
3. Ensure effective diagnosis and treatment of cancer
4. Improve the quality of life for those with cancer, their family and whanau through support, rehabilitation & palliative care
5. 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
6. 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
• 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
• 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
• Each network slight structure differences
• All lead DHB and CEO
• All have a governance group
• All have work groups
RCN Work Programme
• RCN Operating framework• Regional Cancer Control Strategy Plans• Service & Patient Mapping• Development of patient management
frameworks• Reducing inequalities• Establishment of AYA OHS• Palliative Care
Recognition
End of life care
Determination of treatment
Implementation of treatment
Follow up program
Recognition of recurrence
Re treatment programme
Initial Diagnosis
Confirmation of diagnosis
Su
pp
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re
Ad
dressin
g in
equ
alities
Cancer Pathway
Primary Prevention
PATIENT MANAGEMENT FRAMEWORK
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Na
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ata
Pro
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Sp
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Incl
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Mu
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Me
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Tu
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Str
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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
Scr
ee
nin
g P
rog
ram
me
s
Network Focus National Focus
New National Priorities
• 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