The National Cancer Programme Update provides the latest information about key areas of our work. New information is added regularly.
In this update:
- New clinical advisors bolster the Cancer Services team
- Cancer Psychological and Social Support Initiative updates and developments
- First DHB achieves the Faster Cancer Treatment health target
- Final evaluation report of the Cancer Nurse Coordinator initiative published
- Feedback on draft national Radiation Oncology plan received and preparation for regular data reporting continues
- First meeting of the new Cancer Programme Leadership Board
- Revitalising the national tumour standards work programme
- Focussing on Prostate Cancer Services for men
- Cancer Health Information Strategy Programme – December 2016
- Find the Spot project
Welcome to the latest edition of our newsletter, which highlights key areas of our work programme.
As advised in our previous newsletter, during 2016 Dr Andrew Simpson National Clinical Director, Cancer, has been seconded to the position of Chief Medical Officer for the Ministry of Health. This secondment has recently been extended through 2017.
‘This continues to be a great opportunity for Andy and we are very happy to support his ongoing secondment,’ says Sarah Eames, Manager, Cancer Services. ‘However, we were conscious of the need to ensure ongoing clinical input and leadership to the National Cancer Programme during this time.’
To support this, in August 2016 the Ministry ran an Expressions of Interest (EOI) process to recruit to a Clinical Advisor role(s) to take on some of the day-to-day functions of the National Clinical Director.
‘We were very impressed by both the enthusiastic response and the calibre of the people who applied. As a result we have ended up appointing not one, but four part-time Clinical Advisors: Scott Macfarlane, Suzanne Beuker, Kim McAnulty and Natalie James. This team brings a wealth of expertise and experience, as well as a multi-disciplinary scope that will be a real advantage to our work.’
Profiles of the four Clinical Advisors are provided below.
The Clinical Advisors have already met together twice and are working with the Cancer Services team on identifying portfolio areas that they will take a lead in.
Scott Macfarlane (0.3FTE)
Scott Macfarlane is the National Clinical Leader, Child Cancer and a paediatric oncologist at Starship Children’s Hospital. He was appointed as a foundation member of Cancer Control NZ and was deputy chair when it was disestablished in 2015. He was a member of Cancer Treatment Advisory Group for many years.
Scott received his training in New Zealand and Australia and spent his first 10 years as a specialist paediatrician and oncologist at Waikato District Health Board. He has been Oceania President for the International Society of Paediatric Oncology and served on its board. He has held leadership positions in both Waikato and Auckland district health boards as well as a number of charitable organisations.
Suzanne Beuker (0.2FTE)
Suzanne Beuker is a urological surgeon and currently the district-wide Head of Department for Urology at Nelson Marlborough District Health Board.
She undertook her primary medical degree at the University of Auckland. After completing Fellow of Australasian College of Surgeons in New Zealand she spent 18 months as a Urology Fellow at the Oxford Radcliffe NHS Trust, with clinical teaching duties at the University of Oxford.
Suzanne has recently completed a Post-Graduate Diploma in Public Health through Massey University.
Kim McAnulty (0.1FTE)
Kim McAnulty has a long association with Radiology at Waikato District Health Board, transitioning from medical student to radiologist. Her clinical interests are focused on thoracic radiology and service innovation in the delivery of the radiology services.
Kim has worked with the Ministry of Health since September 2013, leading a national radiology service improvement initiative that resulted in a significant reduction in patient wait times for CT and MRI.
Natalie James (0.2FTE)
Natalie James was seconded from Auckland District Health Board in 2013 to work with the Ministry of Health as National Nurse Lead for the Cancer Nurse Coordinator Initiative. Natalie has an extensive clinical background in cancer nursing and has worked in a variety of senior nursing roles in both paediatric and adult settings.
She has a strong interest in developing the cancer nursing workforce and works closely with the University of Auckland to develop their postgraduate cancer nursing curriculum.
The Cancer Psychological and Social Support Initiative (the Initiative) continues to progress and develop across the country. Referrals are being received and the feedback from patients and other staff about the service has been positive.
An external evaluation of the Initiative has commenced led by Sapere Research Group. The purpose of the evaluation is to gain a better understanding of whether the services currently being provided meet the needs of cancer patients, and their families and whānau. The evaluation will also be an opportunity to highlight areas for service improvement and to share any learnings.
The evaluation is still in its beginning stages. There has been an initial meeting with the Ministry to provide background information on the Initiative. The evaluators are meeting with the Regional Leads from each of the six cancer centres in early January 2017. An initial data and information scope regarding the Initiative has also been completed, which will help inform and develop robust evaluation methodologies.
With regret and sadness, in December 2016 Clare Greensmith ended her time as National Clinical Lead for the Cancer Psychological and Social Support Initiative. We are very thankful for Clare’s work in successfully establishing the Initiative and leading it to its development stage.
An expression of interest for the National Clinical Lead role has been circulated and applications will close on 21 December 2016.
Steady progress continues to be made towards the Faster Cancer Treatment (FCT) health target.
Latest results published on 22 November 2016 were based on patients who received their first cancer treatment between 1 April and 30 September 2016.
National achievement improved by over 4 percent to the highest result yet of 78 percent, up from the baseline result of 66 percent.
The 85 percent target was also achieved by a DHB for the first time, with Waitemata District Health Board achieving a result of 86 percent.
Dr Andrew Simpson, the Ministry’s Acting Chief Medical Officer and FCT Health Target Champion, says implementing sustainable service improvement can be challenging, but the steady progress being achieved by DHBs is encouraging. FCT remains a top priority for service delivery for DHBs and further progress is expected during 2017/18.
You can see the full results here on the Ministry website.
The final evaluation of the Cancer Nurse Coordinator Initiative (CNCI) has been published on the Ministry of Health website.
The report provides information about the implementation and outcomes of the CNCI and shows that the CNCI has:
- improved access to diagnostic and treatment services
- improved patient experience through diagnosis and initiation of treatment
- identified areas for improvement in care coordination and the patient pathway.
Following the report, the CNCI was featured on One News. Watch the clip here on the TVNZ website.
The Cancer Nurse Coordinators (CNCs) continue to work on a number of projects which support improved care coordination; these include refining the process of assigning a level of care coordination to patients and developing a national approach to nurse assessment. If you have any questions about the CNC work programme or the evaluation please contact Natalie James, National Nurse Lead, NatalieJ@adhb.govt.nz.
Feedback on draft national Radiation Oncology plan received and preparation for regular data reporting continues
Sector consultation has concluded on an updated radiation oncology national linear accelerator and workforce plan. The plan will take a broader perspective than the previous plan released in 2014 and will inform both clinical service planning and capacity/workforce planning. A service planning tool has been developed for use by the cancer centres, DHBs and the Ministry. The final plan will be published in early 2017.
As part of the project, all nine private and public cancer centres submitted an historical minimum dataset from 2012-2015. The Ministry is planning to introduce regular reporting in 2017. A data specification for the next year has been finalised which will ensure the quality of the data. Reports formulated from the data will be used to identify variation in radiation oncology treatment throughout the country. The Radiation Oncology Work Group will provide advice to the Ministry on this matter. In future the data will form part of a cohesive hub of cancer information, as guided by the Cancer Health Information Strategy.
The new Cancer Programme Leadership Board met for the first time on 18 November 2016. The Cancer Programme Leadership Board has been established to provide executive leadership over the National Cancer Programme, ensure it aligns with the New Zealand Health Strategy, and provide a long-term vision for cancer services in New Zealand.
The members of the Cancer Programme Leadership Board are:
- Jill Lane - Director, Service Commissioning, Ministry of Health
- Dr Andrew Simpson - National Clinical Director, Cancer, Ministry of Health
- Clare Perry - Group Manager, Integrated Service Design, Service Commissioning, Ministry of Health
- David Meates - Chief Executive, Canterbury and West Coast District Health Boards
- Cath Cronin - Director of Hospital Services, Waitemata District Health Board
- Helene Carbonatto - General Manager Strategy, Planning and Outcomes, Hutt Valley District Health Board
- Dr Diana Sarfati - Professor Public Health, University of Otago
- Stephanie Turner - General Manager Māori and Pacifica, MidCentral District Health Board
- Jo Stafford - cancer survivor, Chair, Cancer Consumer NZ.
Secretariat support is being provided by the Ministry of Health.
The Ministry is reviewing the provisional tumour standards, which were published in 2013. The tumour standards are an excellent resource and we want to maximise their value and ensure that they can be readily updated and easily measured. We are intending to develop the tumour standards into an online resource, with one core standard common to all streams and tumour-stream-specific standards that sit alongside the core standard.
Revision of the standards will include alignment with the New Zealand Health Strategy 2016, and coordination with the Cancer Health Information Strategy and other work that is already under way.
The work is currently being scoped and will be further defined over the next few months. If you have any questions about this work please contact Vanessa James, Senior Advisor, Cancer Services, email: firstname.lastname@example.org.
The Prostate Cancer Awareness and Quality Improvement Programme has recently transitioned to the Cancer Services team. The programme focuses on improving outcomes for men with prostate cancer by:
- ensuring men have better access to consistent information about prostate cancer
- supporting GPs to effectively manage men presenting for assessment of prostate cancer or prostate cancer risk
- removing barriers that restrict the effective use of diagnostic and treatment services
- ensuring that all men have consistent care and equitable outcomes across the whole prostate cancer care pathway.
As part of the programme, an advanced and metastatic sub-group is being established to address how we can provide high quality care and services for men with advanced and metastatic prostate cancer. The key purpose of the sub-group is to:
- develop and implement guidelines for managing advanced and metastatic prostate cancer
- develop information on the benefits and risks of prostate cancer treatment options, including the impact on health-related quality of life.
Prostate Cancer Decision Support Tool (DST) is another project that sits within the programme. The aim of the DST is to provide access to clear, evidenced-based information about the risks, benefits and side effects of prostate cancer tests and treatments so men, and their families and whânau can make informed decisions about their health. Another aspect of this programme deliverable is that there is a DST that provides guidance and support to GPs and other primary care health professionals with their clinical management of men with prostate cancer concerns.
We have received a proposed design for the DST, which has just recently undergone a review process. This will help determine what the delivery priorities will be and what requirements will be necessary in order to move on to developing and implementing the DST. We envision the DST will be available for use by June 2017.
The Cancer Health Information Strategy (CHIS) team has been extremely busy over the last few months with key achievements being:
- completion of the multidisciplinary meeting (MDM) data and process requirements
- radiation oncology data collection
- analysing the data and information that is available within the Ministry of Health and working on what intelligence we can glean from it
- producing guidance for cancer service providers around how to develop meaningful measures and understanding the data required.
We’d like to welcome Ruth Pirie to the Team. Ruth has come to us with a wealth of knowledge and experience in turning data into information and presenting it back to the sector in useful and meaningful ways.
Over the coming months the programme will be:
- working with Medical Oncology Working Group and Radiation Oncology Working Group to provide meaningful insights into these services
- investigating and producing indicators for Ovarian services
- assessing Stage data, what would be meaningful to collect, where the gaps are and what can we tell with existing stage information. There is an initial Stage scoping workshop scheduled for mid-February 2017
- looking across the sector and gauging how we can add value and build stronger cancer intelligence partnerships.
- partnering with the Tumour Standards and regional MDM initiatives
- releasing guidance on the data/information required to support clinical decision making at Multidisciplinary Teams by the different tumour streams
- gaining a broader and deeper understanding of the cancer data and information that is available across the nation.
The Faster Cancer Treatment ‘Find the spot’ project undertaken by Canterbury District Health Board concluded in October 2016. The aim of the project was to work towards the achievement of the Faster Cancer Treatment target by improving the diagnosis, follow up and surveillance of melanoma. The project saw the successful implementation of a range of initiatives including:
- a South Island teledermoscopy service
- dermoscopy training in the South Island (around 170 GPs and nurses attended this course)
- movement of follow-up care for low-medium risk patients to primary care to increase equity of access
- the development of a robust follow up service to manage high risk patients post renal transplantation.
While many of the key outcome measures of the project are not yet available, initial results are promising. For example, Canterbury District Health Board reported that 100 percent of melanoma patients met the Faster Cancer Treatment 62-day target in the July-August 2016 quarter. The Cancer Team would like to thank all those at Canterbury District Health Board who contributed to the Project.