National Cancer Programme Update - October 2018

In this update:


A word from the Manager, Cancer Services

It has again been a busy three months for the National Cancer Programme. Highlights of the period have included:

  • starting indicator identification for urological and lung cancers, and further developing of bowel cancer and neuro-endocrine tumour indicators
  • releasing the Radiation Oncology online tool
  • the Ministry partnering with the Otago University School of Medicine, to hold a Cancer Control conference in February 2019.

I would like to say a big thank you to those of you working with us on our key service improvement projects, and for those who continue to provide quality care to those in need.

Regards, Dawn Wilson, Manager Cancer Services

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Cancer Care at a Crossroads Conference and workshops

The Ministry of Health is partnering with the Otago University School of Medicine, the Cancer Society and the New Zealand Society for Oncology to hold a cancer control conference to address challenges in cancer care, equity, prioritisation, and cancer control. The Cancer Care at a Crossroads conference will be held from 31 January 2019 to 1 February 2019 in Wellington, with the Ministry hosting workshops on 2 February.

The goal of the conference is to:

  • bring together the brightest minds and most influential personalities from across the cancer control continuum
  • draw knowledge and experience from international contexts that have faced similar problems to us
  • paint a picture of the current major challenges that we face, and identify possible solutions to these challenges
  • provide a forum for debate, and an opportunity to build networks and bridges across the continuum
  • bring together funders, academics, clinicians and providers, policy leaders, and decision makers.

The conference will feature keynote international speakers, including Professor Richard Sullivan, Professor of Cancer & Global Health at Kings College London and Rami Rahal, Executive Director, Cancer Control at Canadian Partnership Against Cancer in Toronto Canada.

For more information and to register, please visit the conference webpage.

Following the conference, on 2 February from 9.30 am to 12.30 pm, we are running a number of workshops. Read more about the workshops.

To register your interest in the workshops please email cancerteam@moh.govt.nz with ‘Workshops’ in the subject line (note there is a limit on spaces). There is no charge to attend the workshops.

We look forward to seeing you all at the conference and workshops.

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Standard of care for people affected by cancer

The review of the national tumour standards is now complete and work on the new standard of care is well under way. The Tumour Streams Working Group, consisting of representatives from all the tumour streams, met in early August and agreed to prioritise the following work:

  • developing the generic components of the standard of care for people affected by cancer, to replace the provisional standards of service national tumour standards
  • identifying measureable indicators for all tumour streams.

The generic components of the standard of care include aspects of care and treatment that are not tumour-specific, including survivorship, care coordination, and multi-disciplinary meetings (MDMs). To be involved in this work or to find out more, please contact Vanessa James, Principal Advisor, Cancer Services, at vanessa_james@moh.govt.nz

Developing indicators for bowel cancer is nearing completion (further details below), and identifying indicators for urological cancers (further details below), lung cancer and neuro- endocrine tumours is underway. A number of other tumour streams will commence over the coming months. For more information about this work, please contact Joyce Brown, Programme Manager, at joyce_brown@moh.govt.nz

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Bowel cancer quality performance indicators pilot

The Ministry, working with the National Bowel Cancer Working Group, have identified a proposed set of quality performance indicators for bowel cancer diagnosis and treatment. The list of these draft indicators was sent out to DHBs and other professional bodies and agencies for consultation in November 2017.

National collections data has been used to measure eight of the 20 proposed indicators. We are preparing a report with the indicators where we have confidence that the national sources are measuring what we intended. There will be an opportunity for each DHB to review the results in October and November, prior to the release of the report. The public report is scheduled for release in January 2019.

We have put together a toolkit of the templates and methods used to identify the bowel cancer indicators so that other tumour streams can follow the same process if appropriate.


Urology tumour standards and indicators

The inaugural meeting of the National Urological Cancers Working Group was held on 13 August. This multidisciplinary group is tasked with developing a set of quality statements to guide the provision of urology cancer care in New Zealand. Another key function of the group is to select a measurable range of indicators to support these quality statements, which will drive equity and quality improvement. A large group of potential indicators was assessed at the meeting and narrowed down to a short-list for further investigation. It was exciting to see engaged, committed clinicians working with consumers and Māori health experts in such a collaborative way. Prostate cancer will be the initial focus, with bladder cancer and renal cancer addressed next year.

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Radiation oncology collection project

The radiation oncology collection is now live and provides data from all public and private radiation oncology service providers across the country. The online tool for this collection has been provided to DHBs and regional cancer networks so they can begin to analyse and use the data. The Radiation Oncology Work Group are currently working to address unwarranted variation identified from the current data. The group has identified that there may be unwarranted variation in fractionation for rectal cancer and this will be investigated at their next meeting.

If you are a DHB employee and would like access to the online tool, please contact the Radiation Oncology department at your DHB or, if this is not possible, please send a request to Radonc_support@moh.govt.nz

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Release of the Cancer Survivorship in New Zealand – Consensus Statement

Central Cancer Network, Cancer Society NZ and the Cancer Nurses College have partnered to develop a national survivorship consensus statement. Read the final document on the Cancer Society website.

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Release of updates to the Bone Marrow Transplant Plan

The Ministry has published the companion document, the BMT Update Document 2018, which updates The Bone Marrow Transplant Services in New Zealand for Adults – Service Improvement Plan 2011. The BMT Update Document updates the projected demand forecasts in the 2011 document and was developed to assist DHBs develop the capacity for BMT services to 2025.

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Cancer Psychological and Social Support Initiative

This initiative has made significant progress since implementation. Initially there were only small pockets of specialist psychosocial cancer care around the country and now each DHB has a well- functioning service. This initiative has supported and improved the wellbeing of many people with cancer, particularly groups who have previously found it difficult to access this type of service. Over the next two years, the initiative will continue to focus on improving the experience for people with cancer, and supporting equity of psychosocial care.

A successful national forum was held on 3 May 2018, which brought together the initiative workforce from across the country. The forum was a great learning opportunity as successes were shared among colleagues and great discussions were carried out to unravel some initiative challenges.

The evaluation of the initiative is in its final stages with one site visit to be completed. The evaluation findings to date have been encouraging, demonstrating this initiative is having a positive impact on cancer patients, and that the service is really valued by them. Feedback from patients is important to understand what works well and where improvements can be made for them. Patient surveys were completed in September, with the final evaluation findings due to the Ministry in January 2019.

For more information contact Juliet Ireland at Juliet.Ireland@nra.health.nz

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Prostate cancer decision support tools

Kupe is a website to help men decide if a prostate check is right for them or not. Since its launch earlier this year, it has been presented at the Prostate Cancer Foundation Conference in May, at the GP CMEs in Rotorua in June, and Christchurch in August. It was also presented to the Ministry of Social Development Staff Wellbeing Expo, reaching around 2000 staff in August. The Ministry of Pacific Peoples has also been supporting the promotion of Kupe.

Over this coming quarter we will launch some more promotional campaigns to optimise Kupe’s performance. This includes launching online ad campaigns specifically targeting men.

The plug-in tool for GP patient management systems is going 'live' to some Medtech practices this week. Deployment of the tool will be phased but it is hoped to have it continuously rolled out this year.

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Cancer Nurse Coordinator Initiative

From 1 July 2018, the Cancer Nurse Coordinator Initiative was devolved to DHBs to continue providing support for people at the beginning of their cancer journey, particularly to support diagnosis and treatment planning. This service is an important part of the Ministry’s support for those who may have difficulty accessing specialist care in a timely way and who may be at risk of poorer outcomes. It is expected that this important service continues and further service improvements are made where appropriate.

During this time, the Ministry has been privileged to work with Natalie James, National Lead for the initiative. The Ministry would like to acknowledge Natalie for her leadership and efforts in successfully establishing and implementing this workforce.

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