1. 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

2. 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

3. 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”

4. 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

5. National Cancer Strategy Philosophy
Hope . Healing . Care

6. 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

7. 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

8. Care philosophy
Healing
Service
Hope

9. 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

10. 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

11. 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

12. 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

13. 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

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

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

16. 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

17. Referral pathways Primary Care provider National Oncology Centre
Specialist Oncology Care

18. National Oncology Centre
National and Regional Services

19. 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

20. 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

21. Images of the National Oncology Centre Architectural Renderings

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

23. National Oncology Centre

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

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

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

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

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

30. Cyclotron and Radiopharmaceutical Laboratory

31. GE 3-Tesla MRI

32. GE PET/CT

33. 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

34. THANK YOU