new zealand regional cancer networks improved cancer control through increased regional...

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

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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

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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