Standards-Common-To-Provisional-Tumour-Specific-Service-Standards-Dec13

Standards common to most of the provisional tumour-specific service standards

Provisional tumour-specific standards of service provision for cancer patients in New Zealand have been developed by clinical working groups for bowel, breast, gynaecological, haematological (lymphoma and myeloma), head and neck, lung, melanoma, sarcoma, thyroid and upper gastrointestinal cancers.

The individual documents include a number of standards that are common across the set. These are presented below.

Referral and communication

 Patients with suspected cancer are referred to secondary or tertiary care following an agreed referral pathway.

 Patients and their general practitioners (GPs) are provided with verbal and written information about their cancer, diagnostic procedures, treatment options (including effectiveness and risks), final treatment plans and support services.

 Communications between health care providers include the patient’s name, date of birth, national health index number, ethnicity and contact details, and are ideally electronic.

Investigation, diagnosis and staging

 Imaging investigations follow standardised imaging pathways based on the Royal College of Radiologists’ Cancer Imaging Guidelines.1

 Patients with a provisional histological diagnosis of cancer have their diagnosis reviewed by a specialist cancer pathologist affiliated to a cancer multidisciplinary meeting (MDM).

 The histology of excised cancer specimens is recorded in a synoptic format.

 Patients with cancer are staged accorded to the American Joint Committee on Cancer (tumour, node, metastases) staging classification.2

Multidisciplinary care

 All patients with a diagnosis of cancer are registered at an appropriate MDM.

 Patients meeting specific criteria have their treatment plan discussed at a MDM; recommendations are clearly communicated to the patient and their GP.

1 RCR. 2006. Recommendations for Cross-Sectional Imaging in Cancer Management. London: Royal College of Radiologists. 2 Edge SB, Byrd DR, Compton CC, et al (eds). 2010. AJCC Cancer Staging Manual (7th edition). New York: Springer.

Standards Common to Most of the Provisional Tumour-Specific Service Standards 1 Supportive care

 Patients with cancer and their family/whānau have equitable access to appropriate medical, allied health and supportive care services, in accordance with Guidance for Improving Supportive Care for Adults with Cancer in New Zealand.3

Care coordination

 Patients with cancer have access to a clinical nurse specialist or other health professional who is a member of the multidisciplinary team (MDT) to help coordinate all aspects of their care.

Treatment

 Patients are offered early access to palliative care services when there are complex symptom control issues, when curative treatment cannot be offered or if curative treatment is declined.

Follow-up and surveillance

 Follow-up plans include clinical review by appropriate members of the MDT, working in conjunction with patients, their family/whānau and their GP.

Clinical performance monitoring and research

 Data relating to cancer beyond the fields required by the Cancer Registry, including treatment data, are reported to existing and planned national repositories using nationally agreed data set fields.

 Patients with cancer are offered the opportunity to participate in research projects and clinical trials where they are available.

3 Ministry of Health. 2010. Guidance for Improving Supportive Care for Adults with Cancer in New Zealand. Wellington: Ministry of Health.

2 Standards Common to Most of the Provisional Tumour-Specific Service Standards