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 ,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 – 219/100,000 Non-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 MaoriNon-Maori LungProstate Female breastColorectal ProstateFemale breast ColorectalMelanoma StomachLung MaoriNon-Maori Lung Female breastColorectal Female breast StomachProstate 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

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 Goals 1.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 Supportive Care Addressing inequalities Cancer Pathway Primary Prevention

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