Clinical Network highlights in 2015

Monday 7 December, 2015

Thank you Clinical Network Members

The Clinical Network team thank you for another successful year. Your commitment and support is invaluable and as you can see made significant contributions to improve patient care for all Victorians affected by cancer. Members have contributed to a range of initiatives including:

• contributing to consultations
• reviewing submissions and guidelines
• event planning and presentations with approximately 600 attendances at Clinical Network events
• input into research and member surveys
• attending advisory group and committee meetings with over 400 Clinical Network members contributing including the development of the revised Optimal Care Pathways
• media commentary: almost 30 Clinical Network members have been involved in over 60 news stories across TV, radio and print media and
• providing expert advice to Cancer Council Victoria

 Below you can find updates and links on:

  • Advocacy efforts
  • Clinical trials
  • Agenda for Cancer Control
  • Events 

Clinical Network Advocacy Efforts


Informing the next Victorian Cancer Plan

Through workshops, working parties and online surveys over 140 clinicians and health professionals provided input into the priorities for the next Victorian Cancer Plan. As a result a very comprehensive overview of the opportunities and challenges facing cancer care in Victoria has been developed. Clinicians expressed a strong desire to be able to contribute to the planning, implementation, monitoring and evaluation of the Cancer Plan.
The findings have been submitted to the Chief Advisor on Cancer, Department of Health and Human Services, Prof Robert Thomas, and will soon go to the Minister for Health for consideration. It is intended that the report will inform ongoing discussions with the Victorian Government to build a visionary cancer plan for Victoria. The report will also be used to inform the Clinical Network's next strategic plan.
A copy of the report can be found here.

Esther Sadek, Projects & Communications Officer, has presented the outcomes of this work at the COSA Annual Scientific Meeting 2015 and Health Services Research Association: Health Services and Policy Research Conference: "Gaining clinicians views to inform the next Victorian Government Cancer Plan" (poster presentation). A copy of the poster can be found here.


Medicinal Cannabis in Cancer Care - Survey and submission

The Clinical Network and the McCabe Centre for Law & Cancer made a submission to the Victorian Law Reform Commission's (VLRC) Medicinal Cannabis Issues Paper. The submission was informed by findings from the survey of Clinical Network members' attitudes and experiences of medicinal cannabis in cancer care. The submission featured significantly in the VLRC's Final Report.

Rachel Whiffen, Manager, presented the survey findings at COSA Annual Scientific Meeting 2015 and a copy of the poster can be found here.

Based on the VLRC's recommendations medicinal cannabis will be legalised under exceptional circumstances in Victoria by 2017. Cancer patients will be able to access the scheme for the management of pain, nausea/vomiting, and weight loss. Specialist medical practitioners will determine patient eligibility and GPs monitor for efficacy and side effects.

The VLRC's Final Report can be found here.

CCV are reviewing the recommendations from the final report to assess impact on cancer patients and clinicians. CCV's position statement ‘Medical cannabis in cancer' will be reviewed and updated based on the submission.


Victorian Parliamentary Inquiry into End of Life Choices

Clinical Network and McCabe Centre for Law and Cancer worked with key Clinical Network members to develop CCV's submission to the Victorian Parliamentary Inquiry into End of Life Choices. The submission makes recommendations clarifying existing legislation relating to:

• decision making powers and expanding legislation relating to advance care planning and advance care directives;
• improving the integration of advance care planning into practice;
• increasing patient, carer and health professionals understanding of advance care planning and legal frameworks available to support decision-making at end of life;
• earlier integration of palliative care through the expansion of palliative care services in particular community palliative care services and support for health professionals to refer to palliative care; and

• increased understanding of patients and carers as to the role of palliative care as part of comprehensive cancer care.


Victorian Health & Medical Research Strategy Discussion Paper

The Clinical Network team and Research Governance Unit worked with the Clinical Network Executive Committee in developing CCV's submission to the Victorian Government's Health and Medical Research Discussion Paper. The submission centred on the integration of research, education and health care into health services; increasing patient recruitment into clinical trials, putting forward the UK model as a suggested approach; increasing investigator-initiated clinical trials in Victoria; enhancing capacity to undertake research relating to advance disease, palliative care, and end of life care; and opportunities to support longitudinal outcomes data monitoring and reporting to support practice.

A copy of the submission can be found here.

Senate Inquiry - Availability of new, innovative, specialist cancer drugs in Australia

In May the Clinical Network submitted a response to the Senate Inquiry regarding "The availability of new, innovative and specialist cancer drugs in Australia".

A report has now been released which includes two main recommendations (abbreviated):

1) the Australian Government initiate a comprehensive review of the system for the registration and subsidisation of medicines.
2) the Australian Government commission a review of current data collection mechanisms for cancer medicines.

Many submissions raised similar and important points, including our own. The details can be found in the report. We look forward to contributing to the reviews from the recommendations.
Our response can be accessed here.

Guidelines for the timely initiation of chemotherapy

Clinical Network reviewed the proposed guidelines for timely initiation of chemotherapy - a proposed framework for access to medical oncology and haematology cancer clinics and chemotherapy services in Victoria. These guidelines were developed as part of a proposed framework for the Department of Health and Human Service's consideration. In seeking comment on the guidelines, the Clinical Network committees of breast, lung, gynaecological, haematological and gastrointestinal cancers, were invited to review the guidelines. Based on the comments received we supported the summary recommendations with some additional comments. The final guidelines can be found here.


Clinical Trials Program

NHMRC Clinical Trials Initiative 'Clinical Trials Ready'

NHMRC has developed an initiative to officially recognise clinical trial sites that are ‘ready, willing and able' to carry out high quality clinical trials. The initiative is aimed at increasing Australia's international competitiveness as a destination of choice for the conduct of clinical trials. A response was developed to the submission by the Clinical Research Professionals Committee. The report has been release and is available here.


Additional Funding Intervention Trial (AFIT)

2015 has focused on the dissemination of the findings of the AFIT.

Cat Parker, Projects Coordinator, Clinical Trials has presented the findings at the following:

• American Society of Clinical Oncology Annual Meeting in Chicago in May.
• Australian Clinical Trials Alliance (ACTA) - International Symposium in Sydney in October.
• COSA ASM in Hobart in November.

The Executive Summary is available here and for a copy of the poster presented at ASCO click here

Acknowledgement of co-authors: A/Prof Jeremy Millar, A/Prof Michael Jefford, Prof David Dilts, A/Prof Rory Wolfe, A/Prof Ray Snyder.


Victorian Cancer Trial Link App

Watch the App in action - Clinical Trials App short film

This year, the Clinical Network in collaboration with Cancer Trials Australia launched an app version of the Victorian Cancer Trials Link (VCTL) for download on Apple and Android devices.

There have been more than 500 downloads and more than 140 users subscribe for push notifications (notification to their smart phones when a new trial is added). Updates to trials are being made at least weekly and all feedback is welcome, including trial updates to trialslink@cancervic.org.au 

The app features open to accrual, treatment clinical trials from across Victoria. Users are able to:

• search for a trial via keyword, hospital, and filters including a molecular target
• Contact the trial site coordinator directly from your device as contact details are integrated with your smart phone.

Clinical Trials Management Scheme (CTMS) Review

As part of the CTMS, every year the Clinical Network provides funding to trials sites across Victoria to support data managers and facilitate patient recruitment. In 2015, $700K was allocated to 45 clinical trial departments to support clinical trials.
Based on the findings of AFIT and to ensure philanthropic funding is allocated strategically, CCV undertook a review of the CTMS to inform the CTMS program from 2016 onwards. The Steering Committee will present the findings to CCV's CEO in the coming month. More communication to come in early 2016.

 Agenda for Cancer Control


Cancer Care Coordinators in Victoria

The Clinical Network is very pleased to announce the recent appointment of Deakin University to undertake the Cancer Care Coordinators Mapping Project. The aim of this project is to ascertain the current landscape of Cancer Care Coordinators in Victoria. This includes identifying geographical locations in which these roles operate and current scope of practice. This project will start in 2016 and is informed by the systematic review of the literature relating to the role of cancer care coordinators undertaken in 2013-2014.

Improving Access to Patient Transport and Accommodation

The Clinical Network raised concerns about equity relating to the State Government Victorian Patient Transport and Assistance Scheme (VPTAS) and access to treatment by country Victorians in 2011. CCV and the Clinical Network have been progressing this with success in increasing the VPTAS subsidies in the State Budget in 2014.

A VPTAS Alliance was established in 2014 with over 30 agencies, all with expertise and experience in supporting patients who need to travel for treatment. This year, the Alliance developed and launched a VTPAS poster for GP and supportive care unit waiting rooms with the aim of increasing patient awareness about the scheme. The launch was successful in generating many media stories and increased exposure of the VPTAS generally. The poster has been distributed widely among the VPTAS Alliance networks. Pleasingly, the Victorian Government have committed to reviewing the VPTAS biannually. The next review will begin early in 2016 with improved guidelines to take effect in 2017. The Victorian Government have indicated they will consult with the Alliance on the next review.


Improving Access to the National Bowel Cancer Screening Program (NBCSP)

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. In 2015, the State Government has undertaken a number of initiatives aimed at improving wait list management of colonoscopies in health services. In light of these initiatives, the survey of Gastrointestinal Directors, undertaken by the GICC in 2014, will be repeated early next year to assess if there has been changes to colonoscopy wait times amongst Victorian services.


Improving access to radiotherapy

Once again, CCV via the Clinical Network made submissions to the Radiation Oncology Health Program Grants Scheme, strongly advocating that facility operators establish arrangements that provides for public patient access to ensure that all patients have access to a facility closest to their home.

Events

In 2015 over 600 Clinical Network members and other stakeholders attended Clinical Network events. The following events were held in 2015:

  • Cancer Plan consultation with clinicians and consumers to gain clinician and consumer input to the next Victorian Government Cancer Plan
  • Psycho-Oncology and Palliative Care Think Tanks to develop priorities related to psycho-oncology and supportive care and palliative care services for the next Cancer Plan.
  • Brain Cancer Community Information and Education Day.  The program included information on the latest in clinical trials, and the direction of new treatment options, understanding more about seizures, the emotional challenges of managing uncertainty and practical challenges related to finances, driving and respite options and additional support options.
  • VPTAS Launch to launch a poster to increase awareness of the VPTAS for clinicians and country Victorians
  • Webinars in partnership with McCabe Centre for Law & Cancer;  
  • Law and cancer: research and implications for clinical practice. Over 70 attended the event that included a case study  panel discussion and two presentations relating to research on informed consent in medical practice.  The calibre of the MC, speakers and panellists made for a robust discussion about the interaction of the law and patient care. The case study discussion was an ideal way to discuss the realities and complexities of the rights and responsibilities of both clinicians and cancer patients and was appreciated by the audience members. For a copy of the presentations and event resources please click here.

 

Whats Next? Clinical Network plans in 2016

The Clinical Network Strategic Plan is in its final year. The Clinical Network team are currently drafting the next four year plan with the Executive Committee. As part of this work we will be assessing whether the committee structure is the best way to support and work with our members. This will involve looking at a variety of options to engage our members and to stay informed on the issues affecting practice. We welcome members' thoughts as we continue to develop the Strategic Plan.