The ICS and DHHS have recognised the need to coordinate and jointly develop projects of state-wide significance. A state-wide approach is adopted when common outcomes are required. There are a number of projects that fit this description, and participation in these has been a significant focus of LMICS work this year, as described below.
The nationally-endorsed Optimal Cancer Care Pathways (OCPs) outline key principles for evidence-based and best-practice care at key points along the cancer patient journey, providing a framework to assess and improve cancer care throughout the health system. They underpin the activities of the ICS in demonstrating and improving the provision of optimal cancer care. The OCPs are available in a detailed clinical version and as a quick-reference guide for clinicians. Consumer versions are available in plain English and six other languages.
DHHS has implemented a program in conjunction with ICS and Primary Health Networks to implement 2–3 pathways each year. In 2016–17, the focus has was on lung, colorectal and ovarian cancer. In 2017-18 it was on Oesophagogastric and Prostate cancer. 2018/19 will include pancreatic and head and neck cancers.
Clinical trials are research investigations in which people volunteer to test new treatments, interventions or tests as a means to prevent, detect, treat or manage various diseases or medical conditions.
Clinical trials might also compare existing interventions, test new ways to use or combine existing interventions or observe how people respond to other factors that might affect their health (such as dietary changes).
Clinical trial interventions include but are not restricted to:
Clinical trials can also help to improve health care services by raising standards of treatment. Doctors and hospital staff involved in clinical trials are continually trained to provide best practice patient care.
Bendigo Health has an active clinical trials unit who work with centres across Australia and the world to provide pharmaceutical and community trials. Many other patients living in the Loddon Mallee region are enrolled in trials in Melbourne.
A project led by the Barwon South Western Regional Integrated Cancer Service (BSWRICS) has delivered a framework with a suite of measures to monitor performance and outcomes of cancer care in Victoria. This framework – called the Victorian Cancer Performance Monitoring Framework (VCPMF) – contains a range of measures that are useful to clinicians, hospitals, ICS, and DHHS to monitor the cancer care system across the patient pathway and, thus, drive service improvement.
The data for these measures come from multiple state-wide datasets: the Victorian Cancer Registry (VCR), the Victorian Admitted Episodes Dataset (VAED), the Victorian Radiotherapy Minimum Dataset (VRMDS), the Victorian Emergency Minimum Dataset (VEMD), the National Death Index (NDI) and the Victorian Death Index (VDI). DHHS has incorporated the VCPMF measures into an interactive application for gaining insights into cancer care. The interactive application will be trialled across selected ICS in 2018 before becoming available to all ICS.
LMICS has actively disseminated VCPMF findings to its clinical network. This included hosting a “data dinner” attended by the key clinicians in the region, and providing feedback to the project team.
Neighbourhood Houses are a place-based community development initiative of the Victorian Government. Of the approximately 400 neighbourhood houses in Victoria, 54 have active community transport programs. Many of these incorporate health-related transport.
LMICS has funded two clusters of neighbourhood houses in the region, representing 41 houses, in a project to help identify sustainable models for cancer patient transport.
In 2018/19, LMICS conducted the DHHS-led Patient Experience of Cancer Care (PECC) survey within most cancer care services in the region. This survey is a validated tool that can be found online (https://www2.health.vic.gov.au/about/health-strategies/cancer-care/cancer-projects/victorian-cancer-patient-experience-survey-tool-project).
It will be used to create a baseline of consumer experience in Loddon Mallee cancer services, allowing services to measure and identify appropriate local projects as benchmarked against these survey results. Findings will be disseminated through health service reports, written consumer feedback, conference presentations and research papers.