Background and Context:
Tumour standards describe the services that people with cancer should be able to access, including timeliness and quality parameters. In New Zealand (NZ) Lung cancer standards were published 2011. These have led to service improvement and provided an exemplar to develop standards for further tumour streams.
Aim:
Standards for further tumour types were developed to promote nationally coordinated and consistent levels of service provision across NZ.
Strategy/Tactics:
The standards were developed by national tumour stream groups (TSG) including surgeons, physicians, nurses and allied health professionals from across the cancer pathway plus consumer representatives. The TSGs also had access to further expert advisors including Maori.
Programme/Policy Process:
The standards are grouped into clusters: prevention and early identification; timely access to services; communication and referral; data collection; investigation, diagnosis and staging; multidisciplinary care; supportive care; care co-ordination; treatment; follow-up and surveillance; clinical performance monitoring and research.
Individual standards within a cluster describe the level of care or service required. They are not intended to be at the level of detail found in guidelines. The supporting rationale section provides reasons why they are considered important supported by international literature or expert opinion. Monitoring requirements were included.
The draft standards underwent wider consultation. They were published as ‘provisional’ December 2013. District Health Boards (DHBs) are expected to use the tumour standards to review services.
Outcomes/What was learned:
There is variation in the number and detail of the standards (breast 40, bowel 23, and lung 13). The standards have provisional status so they can be updated once DHBs have completed their reviews. The reviews will inform whether the standards are measureable, are focused where quality can be improved, and will improve patient experience.
This has been an iterative process and the standards will be evolving documents informed by regular review.