SCN Quarterly Update Q

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1 SCN Quarterly Update Q This Southern Cancer Network Quarterly update highlights the recent activities of the network, as reported in our most recent quarterly report. The quarterly report is a key aspect of our accountability framework where we provide detailed information around the progress we are making with our annual work plan that goes to South Island DHB leadership and to the Ministry of Health. The updates below reflect our key work streams. If you have any queries or would like more information please feel free to contact the team member that has responsibility for that particular piece of work. More information on SCN can be found on our website: Southern Cancer Network Delivering Faster Cancer Treatment (FCT): Who is eligible for FCT? Adult patients who have a confirmed cancer diagnosis and whose treatment is not funded privately, excluding those with other malignant neoplasms of skin. How is FCT measured? There are two FCT indicators that measure time to first treatment, by DHB of domicile: 31 day indicator patients with a confirmed cancer diagnosis receive their first cancer treatment (or other management) within 31 days of a decision to treat 62 day indicator patients referred urgently with a high suspicion of cancer receive their first treatment (or other management) within 62 days of the referral being received by the hospital How is FCT monitored? Both indicators are monitored, nationally, regionally, and within each DHB. The 31-day indicator is measured against a policy priority which states that 85% of patients wait no longer than 31 days for first treatment from date decision to treat. The 62-day indicator is measured against the Health Target that requires 90% of patients triaged with high suspicion of cancer and need to be seen within two weeks to receive first treatment within 62 days from date of receipt of referral. SCN Quarterly Update (Q3 17/18) Page 1

2 What is our FCT performance in the South Island? The 62-day Health Target is reported on a rolling 6 month, covering two quarters. The 31-day Policy Priority is measured quarterly. For further information about Faster Cancer Treatment targets, click here: For further information contact ursula.jewell@siapo.health.nz SCN Quarterly Update (Q3 17/18) Page 2

3 Faster Cancer Treatment Round 2 Funded Projects: The SCN continues to support SI DHBs in delivery of the following MOH-funded FCT projects: Ongoing: Improving the Cancer Pathway for Maori (SI-wide, led by NMDHB) Ongoing: Diagnostics Fast Track Clinics (SDHB) Completed: Pathway Entry, Routes to Diagnosis, part A: Emergency presentations (SDHB) Ongoing: Pathway Entry, Routes to Diagnosis, part B: all cancers (SI-wide, led by SDHB) Completed: Melanoma, find the spot Ongoing: Gynaecology High Suspicion of Cancer Referral Pathway (CDHB) Ongoing: Valuing patient s time in complex cancer: Head and Neck (NMDHB & CDHB) All these projects are on track to be completed by June The Pathway Entry Emergency Department (ED) presentations & Routes to Diagnosis stage B project is of particular interest as it is one of three similar projects across New Zealand where the focus is on timeliness of diagnosis and the impact of certain pathways on morbidity and mortality. The South Island work is in the final stages of analysis and write up and will inform our work plan for 2018/19 and future years. For further information contact ursula.jewell@siapo.health.nz Tumour standards reviews: The SCN Steering Group have endorsed the key findings of the Lung Tumour Standards audit report which will inform future revision/development of tumour standards. The project closure will be completed with working group members contacted to acknowledge the significant contribution they have made to the project. The key findings of the Gynaecological tumour standards audit report will be considered by the working group, along with an any service improvements that have been undertaken during the time taken to complete the review to support the completion of this work. For further information contact Rachael.Crombie@siapo.health.nz SCN Quarterly Update (Q3 17/18) Page 3

4 Multi-disciplinary meetings (MDMs) and clinical decision making: SCN continues its support leading three separate projects within the Supporting MDM portfolio: 1. As at the end of Q3 we now have four Canterbury MDMs and one Nelson Marlborough MDM on the new the South Island Cancer MDM System (SIMMS). A meeting to define requirements to deliver all MDMs on Health Connect South (HCS) was held in February with the SCN Manager, project manager and SDHB IT developer. It was agreed that there was a need to gather requirements from remaining MDM Chairs in Canterbury and NMDHB in order to quantify the scale of work remaining and plan accordingly. A joint commitment has been made to close monitoring of the development work, against a revised timeline for the remaining work. The first meeting of the SI MDM Change Request Group was held and decisions made regarding progression of suggested improvements to the system. 2. SCN has completed the work on the MDM Gap Analysis as requested by the Ministry as part of the Cancer Health Information Strategy. This project enabled the South Island District Health Boards (DHBs) to measure the gap between the current state of SIMMS and the future MDM state as per new Ministry guidance released in This work was undertaken to identify options to progress towards the full implementation of the Ministry guidance. The report was approved by the SI MDM Governance Group in early February then submitted to the Ministry. It was pleasing to see that the SI MDM system achieved almost 90% of the Ministry s MDM Future State Requirements. We now await the Ministry s review of all Network reports and its advice as to next steps. In the meantime, given the importance of local/regional reporting for SI clinicians we are progressing a trial extract from the MDM system and will undertake one-off matching with data from the Canterbury data warehouse as a proof of concept to identify benefits and to see how this could be replicated as a model for other MDMs using the SIMMS. 3. The findings from the MDM quality review were released in early 2017 and the SCN is undertaking work with SI MDMs to implement the recommendations and actions identified as a result of the findings. The MDM Charter (including MDM etiquette guidance) has been shared with MDM Chairs for input and this was widely distributed to all MDM members in early April. A MDM Coordinator workshop in April 2018 was very well received. It gave an opportunity for the coordinators to network and share information and their experience supporting MDMs. The day included a session on pathology to support data entry in these sections of the electronic proforma, as well as other related topics. Work on reviewing MDM coordinator resourcing is underway, we are currently seeking to determine the scope and approach for this work. MDM Chair training will be undertaken in Q4 and we are currently seeking feedback as to the best way to deliver this including local or regional forums. For further information contact: janfrey.doak@siapo.health.nz SCN Quarterly Update (Q3 17/18) Page 4

5 Reducing inequity: Te Waipounamu Māori Leadership Group (TWMLG) continues its active leadership and support of three projects focused on Māori health. The projects are: 1. The delivery of a report identifying key motivations and barriers to participation in cervical screening for Māori communities in the South Island. This project used qualitative methodology and involved participation of screeners, users and service providers. Following feedback received, the author is currently undertaking refinements on the final report. An updated version is to be presented to Te Waipounamu Māori Leadership Group at its June 2018 meeting. 2. A project with a focus on providing coordinated and joined up services for Māori patients with cancer across the South Island (Project B). The identification of gaps and barriers to care has been the basis for recommendations and development of implementation plans for each of the DHBs. Implementation of local initiatives is now underway across the four participating South Island DHBs. The initiatives being undertaken include: Improving accessibility to information for whānau who speak Te Reo Māori, and linking consumers and health professionals to consistent online resources. A kaupapa Māori programme for whānau that addresses early signs and symptoms of cancer and understanding of the services and support available. Increasing local linkages and collaboration between cancer service providers across the cancer pathway Māori health providers, community and hospital service providers. Training and education activities for health professionals supporting cultural competency and improving referral processes. 3. A third South Island wide project being led out of NMDHB has a focus on educating service teams, through a Māori Health Educator approach (Project A). Work is continuing on developing the education and other initiatives of the project into a package that describes what has been done and how. This is to facilitate the next phase of the project where some aspects will be offered for delivery in other parts of the South Island. SI DHBs will be able to choose which initiatives fit in with their plans which have been developed under Project B. DHBs have identified local initiatives to improve the collection, storing and output of ethnicity data through Project B. There is also a regional focus on improving ethnicity data from Te Herenga Hauora and a national focus with the release of updated HISO Ethnicity Data Protocols. Scoping is being undertaken for an initiative that takes into account this existing work. The proposal will be informed by findings from the Southern Cancer Network Routes to Diagnosis project and align to initiatives to target inequitable health outcomes for vulnerable and high risk populations. TWMLG members have commended the development of information to identify unwarranted variation in radiation oncology practice and the use of this data to inform the treatment of breast cancer by radiation therapy. TWMLG members noted DHB initiatives identified in the Improving SCN Quarterly Update (Q3 17/18) Page 5

6 the Cancer Pathway for Māori projects and encourage continued activity for sustainable benefits. TWMLG made recommendations to the Southern Cancer Network on the draft work plan for 2018/19. TWMLG will develop a work programme aligned to the finalised work plan. South Island Cancer Consumer Group Update: The South Island Cancer Consumer group (SICCG) continues to provide a forum for consumer engagement and input on key SCN initiatives. Recently members discussed the Routes to Diagnosis work and some of the potential roadblocks for patients understanding symptoms or accessing care. Guidance was also sought from the group about online resources and raising awareness of the evidenced-based sites available that provide accredited information for consumers. Members highlighted the importance of utilising patient voices and experiences in the development of improvement initiatives. SCN has a responsibility to incorporate these perspectives in all aspects of its work. South Island Regional Radiation Oncology Partnership: The South Island Regional Radiation Oncology Partnership is continuing work focussing on tumour streams where variation is notable, developing recommendations for greater consistency in treatment. The recommendations for the treatment of early stage breast cancer have been finalised and are currently being implemented. The recommendations in relation to this work are being prepared for consideration by the GMs Planning and Funding, GMs Hospital and CMOs, before going forward to the South Island Alliance Leadership Team. The next tumour stream under consideration will be colorectal. For further information contact: janfrey.doak@siapo.health.nz South Island Cancer Intelligence Service: NZ Cancer Health Information Strategy is yet to be finalised for implementation. Regional psychological and social support initiative: SCN continues to provide support to the Regional Steering Group for the Psychological and Supportive Care Initiative across the South Island. The Ministry has recently approved their ongoing oversight of the Cancer Psychology and Social Support Initiative for a further period of two years. The initiative is being reviewed nationally and Upper South Island services are due to take part in this evaluation in April The SCN Steering Group continues to take a keen interest in the effectiveness of the pathway that this initiative offers newly diagnosed patients, especially with regard to timeliness of access and use of the specialist capacity the initiative offers. SCN Quarterly Update (Q3 17/18) Page 6

7 He Anga Whakaahuru, Supportive Care Framework He Anga Whakaahuru, Supportive Care Framework has been recommended by the NZ Regional Cancer Network Collaborative as a reference tool to inform national supportive care standard development. The planned review of the current South Island DHB position against national guidance/models for supportive care has been impacted by the time taken in developing national supportive care and survivorship guidance. This work is being incorporated into the revised approach nationally to tumour standard development and consideration of its place as a core standard for development nationally. Once the national approach is confirmed, the next steps will include identification of key stakeholders and relevant guidance/models from across the sector to scope areas of priority for patient and whānau supportive care services in the South Island. SCN Quarterly Update (Q3 17/18) Page 7