A health care service strategy helps to articulate the vision set out for provision of quality care service. The directions of the service that the health service plan will include will in a way help to broadly indicate the services that require development in order to meet the health care needs of the common people. This paper aims to develop a health care plan for provision of cancer care. The strategy of health care service is developed based on the previous clinical stream service planning activities which is undertaken by the State-wide Cancer Clinical Network (SCaCN) (South Western Sydney Local Health District – Home, 2018). This in responsible for providing a service direction in a state-wide basis which in turn helps to guide the enhancements wherever necessary especially to improve the local service delivery.
Policy and framework
The healthcare service plan addresses the issues and the needs of cancer care mainly through the stakeholder consultation which was drawn upon service needs that reflected the national perspective from the National Service Improvement Framework for Cancer (2006). The policies and frameworks is intended on outlining the risks of cancer and what the health care system should be aimed at providing. The National Service Improvement Framework for cancer is responsible for describing the available high quality care for cancer. The policies and frameworks mainly focuses on what should be expected to happen for all people with cancer, based on optimal pathways of care (Publications.qld.gov.au, 2018).
The proposed framework for the healthcare plan in this paper should address the aim which will include the reduction of the risks of cancer. Next it should address the patient centred cancer services along with the needs of the people and the ideal survive. The framework also requires to state what is happening in the present that is the current practises in order to meet the consumer needs. Next priorities for improvement of care is addressed along with the national actions needed for the change to occur.
The determinants of health for the population of Australia includes the general socio-economic along with the cultural and the environmental conditions which in turn involves the living and the working conditions, unemployment, water and proper sanitation, the health care services, housing, agricultural and food production, education and work. There are also social and community networks that act as determinants of health in addition to the individual lifestyle factors comprising of age, sex and the factors of constitution.
The burden of the disease data for cancer shows that cancer is largest element of the total burden of disease along with injury mainly in the indigenous population of Australia. This tends to comprise of 19 per cent of all DALYs (disability-adjusted life years lost). By the year of 2016, it was detected that cancer remained the leading the burden of disease (Publications.qld.gov.au, 2018).
It was also reported that cancer was seen to be the largest cause of premature deaths which was reported to be about 39 % in 2010 and additionally it was seen to be the second largest cause of all deaths. Hence the mortality rate due to cancer in the above mentioned population was quite high. According to the morbidity rate, it was reported that the average five-year relative morbidity in 2004–2008 was 67 per cent compared to 64 per cent in 1998–2002 (South Western Sydney Local Health District, 2018).
The needs and the issues that are addressed by the proposed health care service plan helps to identify the following which includes the service profile included in the Local health district.
The relevant facilities includes Quality cancer service, End of life care, Information systems. The services includes Multidisciplinary care, Patient centric care, Service delivery models, Service networks and surgical oncology access. The models of care involves the multidisciplinary care, the inpatient and outpatient care, and other care services. The current inpatient and outpatient activity levels shows an increase of 20 per cent (17,204) in the four year period with the new patient clinic consults increasing by 57 per cent. The bed days by facilities showed that there were 41,507 overnight hospital separations occupying 266,463 bed days with an average length of stay of 6.4 days (New York State Department of Health, 2018).
Strategic Issues and Priorities
The strategic issues and priorities includes certain service actions which are short term, medium term as well as long term in nature.
The short term strategies and priorities covering 1 to 2 years include establishment of cancer performance measures which are related to the clinical outcomes which in turn can be aligned with the national benchmarking. There should be contamination of cancer education program in order to provide comprehensive education across all fields especially in cancer care. The short term action also includes support training along with peer support from the clinical streams (Rowland, 2018). The medium term strategies involve the facilitation of the collaboration between the cancer services of public and private sector. It also includes the reviewing of and strengthening of the cancer workforce skills mainly at all levels along with the investigation and the obstacle removal that are presented to limit the access to research and education. This medium term action plan covers 2 to 5 years (Kotronoulas et al., 2014). Finally the long term action plan which covers nearly 6 to 10 years including any solution, or any option in order to be explored with the aim of implementation of an integrated oncology information solution incorporating a wide range of capabilities which in turn could help in supporting the patient referral along with the outpatients, training, clinical handover along with peer support. There is also data capture in addition to the provision of patient information that is critical for the whole journey throughout the health system. There is also inclusion of information collection which is mandatory for, staging, diagnosis as well as treatment and research. It also covers all the aspects of treatment which includes the medical, surgical and radiation oncology along with clinical haematology. Incorporation of access by rural, remote and cross-border settings is present. The system inter-operability in addition to the health systems with the aim of information sharing is also incorporated (Friesen, Comino & Powell Davies, 2014).
Goals, objectives and strategies
Cancer care services should promote care in a consistent way of care across the state through using evidence-based treatment protocols, multidisciplinary teams and guidelines to ensure quality care to people (Tognela et al., 2013).
- Improve cancer care delivery to patients, each having a new case or a stage of cancer which is accurately assessed and recorded, as well as documented for evidence-based treatment plan
- Improve cancer care decision making with the aim of involving patients along with their general practitioner making them active partners in making of decision about their care and keeping them and their carers informed while in their cancer journey.
- Continue promotion of care consistency through the evidence-based referral making and treatment protocols, as well as through support of education which is accessible across the state for all providers.
- Continuation of the implementation of the cancer care coordination model which helps in incorporating the psycho-social support.
- Seek endorsement of Department of Health for a state-wide clinical cancer care framework aiming for cancer services linked with national service improvement frameworks
- Methodology development for the support oversight along with consultative leadership provision to the implementation of an state-wide clinical cancer care framework that is endorsed.
- Incorporation of local health service planning that are appropriate in actions and strategies for alignment of services to the state-wide clinical cancer care
- Monitoring and auditing of the uptake regarding recommended evidence-based standards along with guidelines, policies, protocols and multidisciplinary team pathways. This includes identification of obstacles and implementation of ways for improvement uptake when required.
Cancer care services should be provided using a network of services that might be linked to develop an integrated as well as coordinated service partnering between the private sector and non-government support services (George et al., 2013).
- Improvement in system governance arrangements for overseeing and guiding the development of cancer care services of the state.
- Conduction of local health service for planning in order to coordinate and integrate cancer care services
- Enhancement of service networks making them more clearly defined, as well as encompassing both public and private sector services. This includes the rural along with remote service providers in addition to formal links between cancer units, cancer services and cancer centres.
- Exploration of the options required for collaborative service structures existing between rural, regional, private providers, cross-border services in the use of evidence-based cancer care pathways and further develop service networks.
- Continue to improve relationships as well as partnerships with then providers of primary care for the development of integrated and shared care service delivery.
- Working with non-government organisations in order to develop support services further for cancer patients, as cancer survivors as well as their families, developed on the existing models
- Identification and implementation of strategies for the reduction of barriers with the aim of cross-border integration of services like patient referral pathways, diagnostic results to improve patient safety, timely transfer of patent information and service quality.
- Implement mentoring and coordination of training programs in collaboration with major teaching hospitals and the higher education sector to improve local service sustainability and capability including those for surgical-oncology
Cancer care services continuously improve capability to support accuracy and timeliness of cancer diagnosis, access to timely evidence-based cancer treatment services with quality of care sustained over time and access to support programs and/or high quality end of life care services as appropriate (Kotronoulas et al., 2014).
- Improvement in accessing the highly specialised diagnostic services like endoscopy, imaging, genetics and pathology, other specialist services like medical and surgical sub-specialties and pharmacy in line with evidence-based guidelines for the cancer diagnosis and treatment.
- Improvement in processes for enabling timely access to the multidisciplinary teams for reduce variation in outcomes of cancer.
- Improving the sustainability, along with capability, and efficiency of surgery, radiation and chemotherapy services for lowering the patient waiting times.
- Establishing of the targets as well as benchmarks in line with the measures of evidence-based guidelines to access the services which include diagnostic services, outpatient clinics including medical and surgical sub-specialties, along with multidisciplinary teams and surgery for cancer patients.
- Conduction of local planning which is necessary for improving access to clinics, medical, diagnostic and surgical sub-specialties, multidisciplinary teams, support care and treatment services.
- Increasing the uptake of breast screening that includes genetic testing for BRCA genes along with cervical cancer screening programs which are provided with programs in order to reach all rural, remote and disadvantaged communities.
The cancer care services are required to provide treatment in both inpatient settings and ambulatory setting which needs to be followed by transition to supportive or palliative care as might be required. The public sector cancer care services needs to be involved in provision of multidisciplinary service to manage most common cancers and be more specialised. There should be provision for the specialist children’s cancer services with proper outpatient consultative clinics. There should be easily accessible radiation therapy for children where radiotherapy might be provided to the children after proper consultation with the specialist children’s cancer service (Mathews et al., 2013).
In the conclusion of the health service plan some priority actions are required to be highlighted which includes the integration and networking of cancer services in order to improve the continuity of care for the reduction of risk at the end of life care. Establishment of accreditation of the services for cancer along with the credentialing of practitioners about optimal services that are outlined above in the action plan. Development of funding structure is important which in turn will help to improve and support the multidisciplinary care in hospitals and the community thereby uplifting the practitioner payment schedules. Finally there is a need to develop and establish an evidence-based consumer information regarding the environmental, along with behavioural as well as genetic risks of cancer in addition to the early detection, prevention, diagnosis, supportive care and treatment.
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