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Problem Statement

Cancer services at CM Health span 12 tumour streams, four divisions and two district health boards.

The cohort of patients that meet the criteria for measurement by the Faster Cancer Treatment (FCT) Health Target make up only approximately 25% of all cancers registered, according to national Cancer Registry data.

The target is that: 90% of patients who are graded with a high suspicion of cancer and needing to be seen within 14 days, start treatment within 62 days of receipt of their referral.

What are we trying to achieve?

The introduction of the FCT Health Target, described in the diagram below, provided CM Health with an opportunity to develop cancer services and shape the model of care to best suit the needs of the patient.

A focused project began in 2015, with the aim of providing the best possible health service for patients with cancer, ensuring their needs are managed through quality assessment and care.

What have we done?

Performance against the FCT Health Target has been variable across this year, with declining achievement against the health target noted in the months form July 2018 to March 2019. Considerable effort has been invested in understanding the reason for the decline and in taking steps to amend the pathways and address areas of concern.

Our focus for improvement remains on developing sustainable pathways within each tumour stream to enable access to diagnostics, treatment and care coordination for all patients with a suspicion of cancer, not just those who meet the FCT criteria.

A review of performance per tumour stream has been undertaken. The review identified four key tumour stream areas that required further analysis in order to identify the capacity constraints that are preventing them from meeting the 62-day criteria.

In addition, competing demands for services can potentially create prioritisation issues, where clinical need can be at odds with achieving the FCT Health Target. A key focus for the cancer services is ensuring that regardless of how a patient has presented to the cancer pathway, they are prioritised according to clinical need. Performance against the 62-day target may be negatively affected as a result.

Where to from here?

  • Ongoing micro-management of all patients on an FCT 62-day pathway.
  • Review of the cancer pathways for all tumour streams to identify opportunities and challenges.
  • Analysis of capacity constraints and the resources required to sustainably achieve the FCT Health target, within the health board’s current austere budget.

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