National Cancer Strategy Government of the Republic of Trinidad and Tobago Ministry of Health Caribbean Medical Providers Practicing Aboard (CMPPA) Annual Medical Conference Cancers in the Caribbean Stewart Smith Senior Health Systems Advisor June 13, 2015

Premise “Strengthening the health system’s response to cancer in the Caribbean is critical to winning the battle against cancer and reducing the burden of this disease on the health system of the English Speaking Caribbean” To ensure access to: Health Education, Early Detection and Screening, Accurate Diagnosis, Timely Treatment, Patient-centred Care and Complementary Support

National Cancer Strategy for the Caribbean Toward this end, the Government of Trinidad and Tobago has taken a leadership role in developing a formal National Cancer Plan and National Cancer Strategy that has informed the design and construction of a state-of-the-science ambulatory cancer treatment facility, the National Oncology Centre (NOC) at the Eric Williams Medical Sciences Complex (EWMSC) that would  serve as the centre of excellence and beacon of hope for cancer care in the Caribbean”

Presentation Objectives Describe the National Cancer Strategy – its Philosophy Principles Priorities Pillars Present the framework and structure of the National Cancer Plan Provide and overview of the services to be provided at the National Oncology Centre (NOC) Explain the regional leadership role of the NOC as the centre of excellence for oncology care in the English Speaking Caribbean

National Cancer Strategy Philosophy Hope . Healing . Care

Strategy The conceptual framework to inform the direction, tactics and actions to achieve the objectives, goals and mission of the organization. It is the thought-leadership that translates ideas to action, actions to service and service to impact

Objectives of national cancer strategy Provide the framework for the development and implementation of the National Cancer Plan and programs Define the philosophy for care Inform the clinical evidence and technology Promote people development, skill retention and talent management Drive the regulatory framework, quality standards, customer experience and monitoring and evaluation processes

Care philosophy Healing Service Hope

Principles: National Cancer Strategy ‘Hub and spoke’ design of decentralized care Comprehensive, coordinated continuum of seamless care from prevention to diagnosis to treatment to palliation Standardized clinical algorithms of care National antineoplastic drug formulary Single patient registration with a comprehensive EMR Specialist driven care with team clinical management Primary care provider Collaboration - partnering with private and NGO sectors Leadership from the Ministry of Health International best-practice through partnership

Strategic Priorities: National Cancer Strategy Implementation of the National Cancer Plan Construction of the National Oncology Centre Establishment of a Diagnostic Imaging Unit at the NOC Establishment of a Regional PET CT Centre with Cyclotron and Radiopharmaceutical Lab at the NOC Development of Nuclear Policy and Law for ionizing radiation protection and regulatory framework for licensing and monitoring of RT tx facilities, radiation sources and exposure Strengthening national cancer surveillance and the National Cancer Registry with a central Lab Information System (LIS) Development of Clinical Centres of Excellence (CCE) Development and retention of human resource talent International partnering with recognized experts Research – Evidenced-Based Medical practice

Seven Pillars National Cancer Plan Governance and Structure – Coordination of Cancer Control Cancer education for patients and public Cancer prevention Early detection and improved diagnosis Efficient and effective cancer services Access to cancer services Professional education, data collection and research Taken from the WHO Framework

Hub and spoke… National Oncology Centre National Radiotherapy Centre Scarborough General Hospital Palliative Support Services San Fernando General Hospital Couva General Hospital Sangre Grande Hospital EWMSC Hospitals General Hospital POS Primary Care

Service Elements National Cancer Plan Prevention, early detection and screening Treatment and Cure: Surgery; Chemotherapy; Radiation Therapy; Hormonal Therapy Patient-centric coordinated care - EMR Complementary Care Palliation and Support Quality Assurance Professional development and education Technology development Research

National Oncology Centre Coordinating Role Comprehensive Patient Care Palliative Supportive Care Radiation and Chemotherapy Treatment Diagnosis and Treatment Planning

Continuum of Care National Oncology Centre Prevention Early Detection and Screening Treatment and Care Specialist Care Palliation and Support Research

Centres of Excellence National Oncology Centre Breast /Women's Centre NRC Lung Centre EWMSC Pediatric Cancer EWMSC Uro-Oncology SFGH Neuro-Oncology GHPOS Rehabilitation Penal

Referral pathways Primary Care provider National Oncology Centre Specialist Oncology Care

National Oncology Centre National and Regional Services

National and Regional Clinical Services Radiation Therapy Stereotactic Radiosurgery (SRS) HDR Brachytherapy Superficial Skin Treatment External Beam Radiation Therapy Chemotherapy Hormonal Therapy Surgery Complementary Care Supportive Care Palliative Care

National and Regional Clinical Services Outpatient Clinic Services Laboratory Services Pharmacy Services Same-Day Surgery Services CT Simulation CT Scans MRI Scans PET CT Scans

Images of the National Oncology Centre Architectural Renderings

National Oncology Centre, Port-of-Spain, Trinidad and Tobago

National Oncology Centre

National Oncology Centre, Port-of-Spain, Trinidad and Tobago Entrances

Linear Accelerator Treatment Bunkers With Full Stereotactic Radiosurgery (SRS) IMRT, IGRT, Respiratory Gating

Similar Cancer Treatment Rooms to the Designs for the National Oncology Centre

Similar Cancer Treatment Rooms to the Designs for the National Oncology Centre

Diagnostic Imaging Unit Courtesy Phoenix Park Gas Processors Limited (PPGPL) TT$60 Million

Cyclotron and Radiopharmaceutical Laboratory

GE 3-Tesla MRI

GE PET/CT

Conclusion In short a world-class, first-class state-of-the science cancer treatment facility with comprehensives services in service of the people of the Caribbean Commissioning date November 2016

THANK YOU