This year the Clinical Network managed over 40 committee and project steering group meetings involving over 500 cancer clinicians. Our focus this year has increased on advocacy and project work, much of which applies across the continuum of care for all cancers.
Influencing the November State Election
In April we held consultation sessions with Clinical Network key stakeholders (Chairs, Deputy Chairs, Executive Committee, and key members) to identify the top priorities for improving survival and the cancer experience. These priorities were endorsed by our Executive Committee and used to inform the Cancer Council Victoria's State Election Platform and to drive our future advocacy work.
The information gained at these consultations will be highly valuable in the work we are commencing to contribute to the Victorian Government next Cancer Plan, due in 2016. Read more about this work here.
Progress in our Agenda for Cancer Control
Our Agenda for Cancer Control launched in 2012 outlines the advocacy priorities decided by Clinical Network for improvements in cancer control in Victoria. Progress on the following areas has been achieved:
Improving Access to Cancer Care Coordinators
The results of the systematic review of the literature relating to the role of cancer care coordinators were released in July. Here is the Executive Summary .
A steering group was initiated to drive our work in this area. The group will develop a pilot project with a specific patient cohort. Representatives met with Department of Health in November to present the literature review findings and discuss project opportunities.
Improving Access to Patient Transport and Accommodation
The Clinical Network has been working closely with the McCabe Centre for Law and Cancer and Cancer Council Victoria's Cancer Information and Support Service to progress this issue. A VPTAS Alliance was established with over 30 agencies, all with expertise and experience in supporting patients who need to travel for treatment.
Through a mix of behind the scenes, media activism and letters to the previous Victorian Health Minster, the Alliance successfully lobbied the Victorian government to commit to improving the VPTAS, including a promised 13.8 million dollars in the 2014 Victorian state budget.
This year improvements were made to the scheme including changes to the accumulative millage, the administration of the scheme and increases in the reimbursement amounts from $35 to $41 for accommodation and in petrol, 17 cents per km to 20 cents. The alliance continues to encourage the Victorian Government to fulfil its commitment to improve the VPTAS.
Improving Access to the National Bowel Cancer Screening Program
With 70 and 74 year olds eligible to participate in the National Bowel Cancer Screening Program from 2015, it is important that eligible adults (people aged 50, 55, 60, and 65 years) are supported in taking up bowel cancer screening.
With this expansion of the NBCSP, the Gastrointestinal Cancer Committee (GICC) has identified that colonoscopy wait times for people with a positive FOBT and symptomatic patients will increase. A recent survey of Gastrointestinal Directors, undertaken by the GICC, found that a majority of sites (7/9) reported patients requiring colonoscopy had to wait more than the 30 day recommendation (Category 1) to undergo a colonoscopy. A summary of these results have been provided to the Victorian Department of Health. Using these results, the GICC has identified that wait list management initiatives and the introduction of mandatory reporting of colonoscopy wait times are central to improving colonoscopy access and will continue to work with the Department of Health and Endoscopy Services in this area.
Improving access to radiotherapy
The Clinical Network supports the significant state and national government investment in radiotherapy infrastructure within Victoria over recent years that has enabled a closer alignment between the number of linacs in operation with current treatment service demands. There is however growing investment in radiotherapy services delivered by the private sector. Through its ROHPG submissions the Clinical Network and CCV have strongly advocated that facility operators establish arrangements that provides for public patient admission to ensure that all patients have access to a facility closest to their home. We will continue to reinforce this message and support a review of the Victorian radiotherapy service plan to inform future service planning.
Integrating IT and data to support improved cancer care
The Clinical Network acknowledge that the area of IT and data integration is extensive and an ambitious priority. The role of the Clinical Network in this area has primarily been to advocate and support the improvements to the Victorian Cancer Registry. The VCR has undertaken many improvement programs this year including:
The Clinical Network will continue to advocate for improvements relating to data collection as identified through our State Election consultations including:
Commitment to reporting of outcome measures including both patient reported and disease outcomes; expand cancer registries to include mandatory reporting of staging data across
all tumour streams; reform current data discrepancies by linking data to quality reporting at health
service levels; and investment in better IT infrastructure to facilitate data entry/reporting.
Education and Events
The Clinical Network hosted international and interstate cancer experts and ran a number of educational events with over 500 attendees made up of cancer clinicians or health professionals. Topics included treatment updates, grant writing, advocacy training, clinical trials design and conduct.
Members were involved in GP education sessions, community education at events and through the reviewing of Cancer Council patient information resources.
The Familial Cancer Committee worked with the Breast Cancer Committee to develop a BRCA1/2 genetic testing for Hereditary Breast and Ovarian Cancer fact sheet for GPs. This will be released early next year.
Clinical Network members represented Cancer Council Victoria in the media on a number of occasions on topical issues and in the lead up to the state election.
The Cancer Council Victoria is undertaking a review of the Optimal Care Pathways . Several Clinical Network members have participated in expert working groups on development of the various pathways, four of which are now published online (prostate cancer, hepatocellular carcinoma, colorectal cancer and lung cancer). The development of further pathways will continue next year, and will be adopted nationally.
Clinical Trials Projects
Clinical Trials Management Scheme (CTMS)
Forty-four different departments across 26 Victorian hospitals participated in the review and received a total of $800K. Sites reported that 2021 new patients entered into clinical trials in Victoria last year, compared with 2279 new patients for 2012. This equates to a recruitment rate of 6.8%. Sites reported that a total of 4800 patients were continuing on follow up in 2013, compared with 4616 in 2012.
Additional Funding Intervention Trial (AFIT)
This randomised trial allocated extra funding to 16 CTMS sites (18 control sites also participated) for the purpose of testing the hypothesis that increased funding at a site level, increases patient recruitment. There was also an extensive survey undertaken of both the control and intervention sites. The report is currently being finalised and will be communicated back to the participating sites in the New Year and will be made available for the wider membership.
Victorian Cancer Trials Link (VCTL)
Additional work has been undertaken so that each site is able to list the most appropriate trial co-ordinator contact for each trial. This feature is now live on the site.
Mid-2014 saw the first survey undertaken of the Clinical Network membership to ascertain broad VCTL awareness and suggestions for improvement. Coming from this survey, a genomic filter will be added to the website, in the ‘advanced search' area, in the first quarter of 2015. Some results from this survey were presented at the World Cancer Congress in Melbourne this December.
Position statement and submission development
We developed statements on behalf of the Cancer Council Victoria on topical issues affecting cancer patients:
- Medical cannabis use in cancer care
- The proposed Medicare Copayment: proposal for patient contributions for general practitioner, pathology and diagnostic imaging services announced in the 2014-2015 Budget.
A number of position statements were developed relating to clinical research by the Clinical Research Professionals Committee:
- Refinement of the standard list of items associated with conducting Clinical Trials in Australia
- Monitoring and reporting of safety for clinical trials involving therapeutic products
- Accreditation of Radiology departments by Central Imaging Companies
- Electronic Case Report Form (eCRF) Training
The Palliative Medicine Committee reviewed the National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care in Acute Hospitals.
Find our statements and submissions here.
Clinical Network team presented work at the World Cancer Congress, 4-6 December in Melbourne relating to the Victorian Cancer Trials Link (VCTL), the Additional Funding Intervention Trial (AFIT and advocacy efforts to improve the Victorian Patient Travel Assistance Scheme (VPTAS).
In March 2014 two presentations were given at the COSA Cancer Care Coordinator Conference by the Clinical Network team on the work relating to the systematic review of the literature of cancer care coordinators and the Clinical Network's commitment to advocate for cancer care coordinators through inclusion in the Agenda for Cancer Control.
In 2015 we will continue our advocacy efforts, focusing on informing the next Victorian Cancer Plan.
The new Improving Cancer Outcomes Act mandates the Victorian Government develop a four yearly Victorian Cancer Plan. The Clinical Network aim to ensure the clinician voice is heard in this plan.
Through two hour workshops in February, we will build on previous consultations with Clinical Network members, to identify what cancer clinicians and advocates believe should be prioritised and included in a Victorian Cancer Plan. We will seek endorsement of the recommendations developed from these workshops by the Cancer Council Victoria Board and present these to key Government decision makers. To attend a session, register here.
Thank you Clinical Network members
We thank you for a productive year, progressing our efforts to improve clinical care and patient outcomes for all Victorians affected by cancer. Your commitment and support is invaluable. We look forward to continuing to support you and the work of committees in 2015.