Integrated, coordinated, data-driven, high-quality health service systems that consistently deliver optimal cancer care and excellence in outcomes.
Australia has one of the highest cancer survival rates in the world, however, disparities in outcomes exist between and within certain population groups across the nation. High-quality health systems and networks that consistently deliver optimal cancer care and excellence in outcomes and experience for all Australians are needed to address these disparities.
The importance of delivering high-quality, patient-centred cancer care is widely recognised and is central to the Optimal Care Pathways (OCPs).[9] The OCPs aim to improve patient outcomes by setting the benchmark for quality cancer care and ensuring that all people affected by cancer receive the best care, irrespective of who they are or where they live.
To achieve world class health systems for optimal care, priority areas for action focus on:
Integrated, coordinated, data-driven, high-quality health service systems that consistently deliver optimal cancer care and excellence in outcomes.
In achieving this ambition, the Australian health system will be enabled to consistently provide optimal care and high-quality health outcomes for people with cancer.
Aspects of world class health services for optimal care exist throughout Australia, evidenced by generally high cancer survival rates. However, changes are needed to ensure high quality care is accessible to all Australians.
This ambition seeks better service integration and coordination to improve communication and data collection, interpretation, and sharing between health professionals and health service settings. These settings include primary care, including Aboriginal Community Controlled Health Services; specialist care; community care; acute care; chronic and long-term care; and public and private hospital systems.
New developments to improve cancer diagnosis and treatment are occurring continually. The ability of the health system to systematically implement such improvements is important to ensure that people with cancer are offered up-to-date optimal care regardless of geographic location, socioeconomic status, language, or other barriers.
Patient experience and outcomes data are critical to identifying gaps in service delivery, improving cancer outcomes and to building new models of care. Further understanding of how data can be used and implemented nationally to drive improvement is critical.
Part of delivering on this ambition will be to ensure the ability to monitor the differences in service delivery and outcomes for different population groups, including Aboriginal and Torres Strait Islander people, and to record information appropriately and sensitively. This will require patient reported experience and outcome measures to be collected and accessed in a timely way.
Frameworks for high-quality comprehensive health service systems established to deliver better cancer care and improved outcomes.
In achieving this 2-year goal, frameworks that enable and promote high quality, comprehensive, and networked care will be developed for all Australians.
These frameworks will be underpinned by appropriate governance arrangements and planning parameters which will be necessary to progress sustainable, de-centralised, equitable and optimal care across all priority populations, localities and sectors of the health system.
Frameworks for high-quality comprehensive health service systems established to deliver better cancer care and improved outcomes.
In achieving this 2-year goal, frameworks that enable and promote high quality, comprehensive, and networked care will be developed for all Australians.
These frameworks will be underpinned by appropriate governance arrangements and planning parameters which will be necessary to progress sustainable, de-centralised, equitable and optimal care across all priority populations, localities and sectors of the health system.
Networked high-quality comprehensive cancer care systems that deliver optimal cancer care and better outcomes.
In achieving this 5-year goal, systems that enable and promote networked care between health service providers will be introduced and operational. This will be done by developing and supporting better linkage of different elements of care. Different elements of cancer care for an individual will be aligned seamlessly into a cancer care plan.
There will be flexibility in different models of care provision to improve access regardless of geographic, cultural or socioeconomic barriers.
Information relevant to care collected at any point will be available throughout the patient journey.
A system of governance will be established to work across jurisdictions and to connect networks. The Comprehensive Cancer Centres will link with each other and also with services across their jurisdictions. This will facilitate sharing of knowledge particularly from centres of excellence to support cancer care providers in regional, rural and remote locations.
Stakeholders raised the issue of equitable and affordable access to supportive care, treatment, palliative care, end-of-life care, advance care planning and VAD, including care and expert advice that is culturally safe and free from racism and discrimination. In addition, they articulated the need for models of care that integrate holistic needs for all Australians.
Continuing to improve access to personalised treatment and palliative care was frequently identified as a key priority for the Australian Cancer Plan by stakeholders, in addition to greater national oversight and standards for optimal care.
Stakeholders suggested that extended access to virtual care models, new and emerging treatments and technologies, and increasing acknowledgment of the importance of accessible, culturally appropriate, responsive, timely, and skilled survivorship and palliative care would contribute to improvements in the delivery of optimal cancer care. The need to better integrate palliative care, end-of-life care including advance care planning and VAD, and supportive care services into multidisciplinary models of care was also identified. Stakeholders raised the need to expand high-quality care services and the consideration of a national network of accredited Comprehensive Cancer Centres as a mechanism to improve integrated, accessible, and high-quality cancer care.
Aboriginal and Torres Strait Islander people are a heterogenous group, and their voices should help guide a system of optimal care. They have poor access to culturally appropriate supportive care, treatment, and palliative care due to systemic barriers, including racism and discrimination.
Aboriginal and Torres Strait Islander people are a heterogenous group, and their voices should help guide a system of optimal care. They have poor access to culturally appropriate supportive care, treatment, and palliative care due to systemic barriers, including racism and discrimination.
People living in rural and remote areas have more limited access to care across the cancer care pathway for reasons including availability of services and infrastructure close to home, and workforce shortages. People living in remote and rural areas also incur additional costs associated with travel because cancer services are more concentrated in metropolitan areas. Stakeholders noted that the ability to receive care from known, trusted health professionals (including via telehealth) can support delivery of optimal, person-centred cancer care for people living in rural and remote areas.
LGBTIQA+ people face discrimination and culturally unsafe or inappropriate interactions in their cancer care. In particular, transgender people and people with intersex variations experience the highest levels of discrimination. Additionally, it was noted that LGBTIQA+ people have many unmet needs in their cancer care experience, including more limited access to follow-up care, and reluctance to discuss sexual health issues.
People from diverse backgrounds do not always receive culturally responsive, sensitive or tailored care due to a lack of understanding of cultural needs and reliance on non-professional interpreters, such as relatives.
People living with disability have a variety of care needs. People living with disability can experience difficulties navigating the cancer care system and are not always supported to participate in conversations and decisions regarding their care. It is important to adopt a person-centred approach, and to understand each person’s disability and their individual needs, throughout their care pathway.
The cost of ongoing cancer treatments can create unnecessary and unmanageable financial burden for those in lower socioeconomic groups. This can be further compounded by the impact of survivorship or caregiving on the ability to fully return to work.
People living with a mental illness may have difficulties in accessing primary care services including Aboriginal Community Controlled Health Services, and in coordinating their cancer care.
Ageism can be a significant barrier for older people in accessing quality cancer care as they often feel spoken down to or not consulted during their care journey.[73] Aged care services, including geriatric medicine, allied health, and community social support services, tend to better serve people with a slower trajectory of decline, therefore many older people may not be prioritised for their care, and waiting lists for specialist outpatient services can be longer.
Concerns were expressed around the safety and efficacy limits to conventional cytotoxic therapies and access to drugs was highlighted as a key challenge for paediatric and young adult oncology.
Children experiencing cancer have unique clinical needs and require specialised assessment and interventions, which can be supported by dedicated care pathways and standards for best practice care.