CCN Equity Programme What we have done well 2008 – 2012 Engaged with communities/stakeholders/networks Contributed to/Led community development/health promotion Contributed to the development of National and Regional Maori and Pacific Leadership groups Disseminated information 2011 Inequalities Project Forum Building capacity in community stakeholders, planning , reporting, evaluation of projects Completed submissions re: reducing inequalities in cancer Applied HEAT lens for service planning and development Funded/Supported Local Cancer Network Inequalities Projects

CCN Local Cancer Networks Inequalities Projects 2012 Whanganui LCN Huarahi Whakamana - Pathway to Strength - Cancer Journey Project 2011-2012 Midcentral LCN “See me as a whole, I am more than my cancer” Te whare tapa wha, a holistic model of well being. Taranaki LCN Mäori Cancer Navigator Project Wellington, Hutt Valley, Porirua-Kapiti Demystifying Cancer Workshop Series Hawkes Bay LCN Kaupapa Tane ; Mens Wellness Project (current)

The uneven playing field: ethnic inequalities in cancer outcomes The uneven playing field: ethnic inequalities in cancer outcomes Associate Professor Diana Sarfati

Inequalities in Cancer The brief Summary: Mäori 18% more likely to be diagnosed with cancer but nearly twice as likely to die from it. Cancer specific survival is lower for Mäori than non-Mäori for most cancers There is good evidence that at least some of this difference in survival is due to health service factors Associate Professor Diana Sarfati

Where to from here? How do health systems address inequalities? System factors Resourcing and location of cancer services Focus of cancer services (structure, organisation delivery of services reflected Pakeha world view) Composition of cancer service workforce Regional factors Improve access to specialists in rural areas Increase support for patients and whanau travelling to cancer services Specialist support for local clinicians Coordination of case management through cancer care pathway Clinical factors Optimise treatment of those with co morbidity Evaluation of patient management against clinical guidelines/audit in peer review context Training in ‘cultural safety’ Associate Professor Diana Sarfati 2013

Proposed Activities 2013/2014 Ministry of Health Service Specifications:   Reducing inequalities in Cancer outcomes by: integrating an inequalities improvement focus through all workstreams disseminating information on successful outcomes widely involving patients, their carers, families/whanau and the public within the region through formal governance structures and/or through regular communication activity. The National Cancer Programme Work Plan The National Cancer Programme covers the Ministry of Health’s, district health boards’ (DHBs), and regional cancer networks’ activity to implement the Government’s priorities for cancer and the New Zealand Cancer Control Strategy. Focus for 2012/13: Wait times: all people get timely access; Access: all people have access to services that maintain good health and independence; Quality: all people receive excellent services wherever they are; Financial sustainability: all services make the best use of available resources.

Proposed Activities Develop an Equity Action Plan alongside MOH, RCNs, DHB’s and Maori Cancer Leadership Aotearoa Implement a programme/s to target gaps identified in service delivery Contribute to the National Mäori Cancer Symposium 2014 Cancer Programme Equity Analysis and Priority Area Implementation plan

Next Steps: Discussion with Key Stakeholders Discussion on Agenda at LCN meetings Draft Equity Plan disseminated Feedback requested Contact: C Wrathall Carol.Wrathall@midcentraldhb.govt.nz Ph: 06 350 8804 Mob: 027 455 4047