Midland Region All Boards Development Days. Midland Cancer Network. 15, 16 October, 2015

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1 Midland Region All Boards Development Days Midland Cancer Network 15, 16 October, 2015

2 NZ cancer incidence Source: NZ Cancer Numbers ASR

3 NZ cancer mortality Source: NZ Cancer

4 NZ cancer survival rates are behind Australia Source: NZMJ 19 December 2014, Comparison of cancer survival in New Zealand and Australia, , Phyu S Aye, J Mark Elwood, Vladimir Stevanovic

5 NZ life expectancy at birth data (Source: Statistics NZ, NZ Life Tables, Various) Period Non-Maori Males Maori Males Non-Maori Females Maori Females

6 NZ amenable mortality rates

7 NZ cancer inequities in treatment and outcomes Survival (%) Māori Non-Māori Years since diagnosis All adult cancers, Source: Cancer patient

8 Midland region cancer and equity Waikato New cancers p.a. = 1832 Cancer deaths p.a. = 780 Lakes New cancers p.a. = 569 Cancer deaths p.a. = 250 Bay of Plenty New cancers p.a. = 1311 Cancer deaths p.a. = 756 HauoraTairāwhiti New cancers p.a. = 200 Cancer deaths p.a. = 87

9 Registrations Mortality

10 Cancer Health Target

11 Midland FCT Health Target

12 We know targets work Percentage achieving target week target 6 week wait target 4 week wait target Q1 07/08 Q2 07/08 Q3 07/08 Q4 07/08 Q1 08/09 Q2 08/09 Q3 08/09 Q4 08/09 Q1 09/10 Q2 09/10 Q3 09/10 Q4 09/10 Q1 10/11 % Q2 10/11 Q3 10/11 Q4 10/11 Q1 11/12 Q2 11/12 Q3 11/12 Q4 11/12 Q1 12/13 Q2 12/13 Q3 12/13 Q4 12/13 Q1 13/14 Q2 13/14

13 Colonoscopy

14 Cancer Risk Factors

15 Midland Cancer Network - Who are we all stakeholders involved in cancer control primary, public health, secondary-tertiary health professionals, planning & funding, service management non-government organisations Maori health providers consumers and carers network management team work across organisational and service boundaries

16 Midland Cancer Network governance Ministry of Health cancer team Midland Regional Governance Group (DHB Chairs & CEs) HealthShare Limited (Shared agency) Midland DHB Chief Executive Group Other Midland DHB Forums COO, GM P&F etc Hauora TDH, Waikato National Lung Cancer Working Group Midland Cancer Network management team Midland Cancer Network Executive Group Midland Hei pa Harakeke Work Group Midland Cancer Consumer and Carer Work Group Midland Tumour Specific Work Groups Lung Midland Service Specific Work Groups FCT Colorectal Medical oncology Colonoscopy Radiation oncology Breast Supportive care Gynae others ad hoc Cancer CNS/ coordinators

17 Summary of successes to-date reduced our smoking rates and harm HPV immunisation to reduce cervical cancer delivering more specialist services closer to home introduced new technologies & services grown our specialist workforce delivering more diagnostics and treatment improved coverage & functionality of MDMs implemented standards of service provision made service improvements

18 What do we wish to achieve The launch of the second Midland Cancer Strategy Plan sets the direction and framework for a cohesive and coordinated approach. The primary purpose of this plan is to lift our performance to: reduce the number and overall incidence of cancer, especially those that are preventable reduce the appalling inequities we have have more timely access to quality services improve health outcomes for the people diagnosed with cancer reduce the mortality rate improve our survival rates Cancer is the leading cause of death in New Zealand accounting for nearly a third of all deaths.

19 Midland Cancer Strategy Plan Vision: Working together to achieve better faster cancer care Strategic objectives: 1. To reduce the cancer incidence through effective prevention, screening and early detection initiatives 2. To reduce the impact of cancer through equitable access to best practice care 3. To reduce inequalities with respect to cancer 4. To improve the experience and outcomes for people with cancer

20 Strategy Plan core principles Care must be: patient centred culturally appropriate evidence based best practice multidisciplinary coordinated delivered safely as close to home as possible inclusive of strong multidisciplinary team engagement Strategies must be: equitable clinically led integrated sustainable collaborative with a partnership approach innovative and responsive to change research and knowledge driven

21 Strategic objectives are supported by 5 enablers 1. Infrastructure 2. Information systems 3. Workforce 4. Supportive care 5. Knowledge and research

22 Patient centred focus across the cancer pathway Living Beyond Prevent & Detect Screen Diagnose & Treat Followup Palliative Last days of Life

23 Key activities for 2015/16 (1) Regional reviews against national tumour standards of service provision sarcoma and lymphoma Implement regional review recommendations lung, colorectal, gynae-oncology, breast Improve coverage and functionality of MDMs Improve timely access to colonscopy Implement Midland Psychosocial & Supportive Care Plan

24 Key activities for 2015/16 (2) FCT round 2 service improvement initiatives 2015/18 Midland/Waikato PMB and Endometrial Cancer Pathway project Midland/Waikato Faster Access to Cancer Services project Midland/Lakes FCT Service Improvement project Midland Routes to Cancer Diagnosis, Diagnostics and Treatment project Midland Patient Information Resources project Determine, test and implement viable ways of improving the FCT pathway for Maori in Bay of Plenty project

25 Key activities for 2015/16 (3) Community health literacy - Kia Ora e te iwi Improve timely access to radiation oncology, medical oncology and haematology Lakes / Waikato non-surgical cancer treatment Midland Adult Specialist Palliative Care Service Development Plan Lead for national lung cancer work programme Support the national work programme Cancer Health Information Strategy focus on MDMs Prostate

26 Planned activities for Continue same as 2015/16 Regional reviews against national tumour standards of service provision melanoma, myeloma, head and neck, upper GI Improve timely access to radiation oncology and medical oncology Waikato radiation non-surgical cancer treatment Cancer Health Information Strategy? Possible national bowel screening roll out 2017?

27 Key challenges manage the increasing demand address equity issues & improve Maori outcomes improve information systems address specialist workforce shortages be in state of readiness bowel screening improve the populations health literacy improve palliative care & last days of life access and fund proven new technologies address late effects & needs of cancer survivors

28 While we are curing some.

29 We ve got a long way to go before the sun goes down

30 Addressing Maori disparities Health literacy Access to primary care, access to diagnostics Breast & Cervical screening targets HPV immunisation targets Hepatitis vaccination Smoking cessation, healthy lifestyle behaviours Early detection of lung cancer Improve coordination of services, supportive care for whanau Palliative care and last days of life

31 Information systems & technology ProVation regional MDM management Data capture for tumour datasets and measuring tumour standards of service provision Telehealth Waiting list management Integration of clinical information outreach clinics, NGOs as part of the MDT, CNS

32 Bowel Screening National business case to Minister end of year Scope and parameters of service yet to be decided Likely to be different to breast/cervical - possible implications on service boundary flows???? Possible roll-out 2017 Not all DHBs at once possible regional approach? Dependent on DHBs readiness Midland not ready focus on BE READY Earlier we start screening the quicker we are likely to improve Midland outcomes