Delivering better cancer services is a priority for the Ministry of Health. In 2009 the Ministry established the Bowel Cancer Programme to lead work aimed at improving bowel cancer outcomes for all New Zealanders.
The programme priority is to strengthen bowel cancer services across the country to effectively meet both the current demand and increased demand in the future. This involves ensuring diagnostic, surveillance and treatment services are working effectively and to a high standard.
Significant funding has been invested to help district health boards (DHBs) reduce waiting times for publicly funded colonoscopies and improve the quality and efficiency of endoscopy services.
The National Bowel Cancer Working Group
The National Bowel Cancer Working Group provides advice to the Ministry on bowel cancer diagnosis and treatment and on the Bowel Screening Pilot.
Its role is to:
- promote the early diagnosis of bowel cancer
- ensure the care provided to patients is carried out in a timely way and is accessible for all patients
- ensure that people with bowel cancer receive quality treatment options.
The National Bowel Cancer Working Group (NBCWG) aims to achieve national consistency in the diagnosis and care of bowel cancer patients. The expert group, established in 2011, is made up of clinicians, representatives from the four Regional Cancer Networks and other key stakeholders.
The NBCWG provides advice on:
- the development of bowel cancer specific patient management frameworks to guide and promote uniform standards of service provision across New Zealand for patients in primary, secondary and tertiary care services
- the development of national clinical minimum standards guidelines, referral pathways and prioritisation criteria – drawn from evidence based guidelines including prevention, screening, diagnosis, treatment, palliative and supportive care for all patients with bowel cancer in primary, secondary and tertiary care services
- appropriate key performance indicators of service delivery and clinical outcomes
- appropriate national minimum datasets and quality measures of service delivery and clinical outcomes
- systemic barriers and gaps in services and ways to resolve these
- new developments that may impact on bowel cancer outcomes
- initiatives related to bowel cancer that inform the national cancer prioritisation process
- bowel cancer research and appropriate directions for research in the New Zealand context.
The NBCWG has worked to improve national consistency in treating bowel cancer. This included:
- reviewing and updating national colonoscopy referral criteria for clinicians. This criteria, known as the Referral Criteria for Direct Access Outpatient Colonoscopy or CT Colonography helps ensure all patients receive consistent care
- developing a position statement on the appropriate use of CT colonography for detecting colorectal cancer
- developing national guidelines for bowel cancer multidisciplinary meetings (supporting the work already underway in district health boards)
- evaluating the timeliness of treatments, and the outcomes for patients
- supporting the Bowel Screening Pilot
- reviewing new evidence relating to other bowel screening tests
- developing guidance for clinicians on addressing inequities along the bowel cancer pathway, to help imrpove bowel cancer outcomes.
Priority areas include:
- improving data collection along the clinical pathway to support clinical process (linking in with existing initiatives)
- addressing variations in the surgical and oncological management (chemotherapy and radiotherapy) of bowel cancer.
- Associate Professor Ian Bissett, colorectal surgeon (Chair)
- Associate Professor Susan Parry, gastroenterologist
- Dr Christopher Jackson, medical oncologist
- Dr John McMenamin, general practitioner
- Dr Iain Ward, radiation oncologist
- Dr Helen Moore, radiologist
- Dr Nina Scott, Māori health expert
- Dr Teresa Chalmers-Watson, gastroenterologist
- Anne Cleland, clinical nurse specialist, gastroenterology
- Mr Adrian Secker, general surgeon
- Mr Ralph Van Dalen, general surgeon
- Judy Warren, clinical nurse specialist
- Denise Robbins, consumer representative
- Mr Rowan Collinson, general and colorectal surgeon.