CANCER PATHWAYS – PROPOSED PRIORITISATION PROCESS FOR 2016/17
Based on what we’ve learnt over the past year or so, we propose approaching the prioritisation of cancer pathways as follows:
Four step process:
- Establish and maintain a Cancer Pathways Prioritisation Pool, based on
- Tumour Standards which have had a Regional Service Review, and
- Primary Care demand
- Assess the interest and capacity of diagnosing specialists representing the cancers in the Priority Pool, to allocate time to collaborate on initial draft pathways
- Convene (annual, if possible) 3D Cancer Pathway Prioritisation meeting, involving
- the diagnosing specialists who indicated interest and capacity
- Medical and Radiation Oncology Clinical Leads
- Carey Virtue, Alison Hannah, Justine Lancaster and Antoinette Ehmke
- CCN – Equity representation (Carol? Jo?)
- Establish by consensus the priorities and work programme for the next year, based on
Cancer Pathways Prioritisation Pool (updated Dec 2015)
Cancers for which Tumour Standards have been published
- Bowel (service reviewed 18 months ago; published)
- Lung (service reviewed 12 months ago; Standards are currently reviewed again)
- Breast (service review completed; implementation underway)
- Gynae (service review completed; implementation underway)
- Upper GTI cancers (service review starts Feb 2016)
- Head & Neck Cancers (service review starts April 2016)
- Thyroid Cancer
Other cancers – much needed in Primary Care / already live on 3D
- Prostate Cancer
- Bladder Cancer
- Neurology (Headaches)
- Haematology (several)
Dermatology, Plastic Surgeons, Radiologists, Pathology
Upper GTI cancers
Gastroenterologists, upper GI surgeons, Radiologists, Oncologists; Pathology
Haematology, General surgeons, radiologists; Pathology
Head & Neck Cancers
ENT, plastic surgeons, oral surgeons, Radiologists; Pathology
ENT surgeons, Radiologists; Pathology
Haematologists, radiologists, General physicians; Pathology
General Surgeons, Orthopaedic surgeons, Radiologists; Pathology
Prostate / Bladder Ca
Urology; Radiologists; Pathology
Neurologists, neurosurgeons, radiology, (pathology?)
9 Considerations to use as a basis to reach consensus about the priorities:
- Which diagnosing specialists are available, and when in the next year, to collaborate on initial drafts? (1 – 3x 90 min meetings, 2 weeks apart, followed by short chunks of time for electronic review and communication)
- Which arrangements have to be in place in order for the Medical and Radiation Oncologists to review and comment on the initial drafts?
(No meetings; just 1 – 2 chunks of 15 -60 minutes for electronic review and commenting)
- Which arrangements need to be in place for other members of the MDM to review the 2nd draft and provide input? (No meetings; just 1 – 2 chunks of 15 -60 minutes for electronic review and commenting)
- With which cancers lie the greatest needs for improved outcomes in terms of prevention, risk assessment and early diagnosis?
- With which cancers lie the greatest needs for improving equity of access to services? The 3 drivers of inequity are
- Determinants of Health
- Access to healthcare services
- Quality of healthcare services
- Which conditions are most common in primary care?
- Which conditions are difficult to identify and need clear guidance for work up in primary care?
- Which live 3D pathways with associated cancers are ready to be reviewed, and/ or for which cancer-related conditions can existing (Canterbury) Healthpathways Pathways be used as a basis to work from (as opposed to having to start from scratch)?
- Which pathways have already been worked on by Mid-Central (MoM) (i.e. where we can we access work already done relatively locally to avoid duplication of effort ?
3D Cancer Pathway priorities for Jan – June 2016:
- Complete Lung Cancer pathways
- Complete gynae cancer pathways
- Start Prostate & Bladder Cancer pathways*
*Provided that the diagnosing specialists are available from April – July
Potential priorities for July – Dec 2016
Tumour standard service reviews have proven to take around 8 months to complete. If the review for Upper GTI Cancers starts in Feb, completion (or near-completion) can be expected around October 2016. If the review for Head & Neck Cancers start in April 2016, completion could be expected around December 2016. This will give us a gap to fill between July and October 2016.
3D already has live pathways for Headaches in Adults (Neurology) and a large batch of Haematology pathways. We may suggest bringing either or both of these categories of pathways forward for revision between Jul – Oct 2016 and use the opportunity to integrate cancer-related information into them. Please note - our cancer work programme for 2016 is still in draft phase.
In summary, our Draft Cancer Work Programme for 2016/17: