Radiation therapy is usually an outpatient treatment, but is centralised because of the technology required. Patients have multiple doses or fractions of treatment over an extended period. Together these two factors require radiation oncology services to have a large population catchment and wide referral network, and to provide support for travel and accommodation of patients and their families/whānau. Because of the large catchment area, the radiation oncology service will usually provide outreach clinics to improve access for patients living in rural and smaller urban areas, and link strongly with local specialist and primary health care services. 2 Operating environment Section 2 describes the context within which radiation oncology services operate in New Zealand, including cancer incidence and impact; the Cancer Control Strategy and Cancer Programme; national health sector agencies with an interest in radiation oncology; national service development initiatives; the regional cancer networks; and radiation therapy service configuration. 2.1 Cancer in New Zealand Cancer is the leading cause of death in New Zealand (30%), and a major cause of hospitalisation. Cancer incidence and mortality rates are higher for Māori than non-Māori. Māori are also more likely to have their cancer detected at a later stage of disease progression. Residents of more socioeconomically deprived areas are more likely to develop cancer, are less likely to have their cancer detected early, and have poorer survival than residents of less deprived areas. While the overall cancer registration rate in New Zealand is generally decreasing, New Zealand has an increasing number of people who are developing cancer, mainly because of population growth and ageing. The total number of cancer registrations is projected to increase by approximately 30% between 2012 and 2022. People with cancer are surviving longer, and being treated for longer. However, Māori are benefitting less than non-Māori from this gain. The Organisation for Economic Cooperation and Development (OECD) Health Care Quality Indicators Data 2009 used three cancers as indicators of how well countries were delivering cancer care (breast, cervical and colorectal cancer). The indicators showed New Zealand’s relative survival ratios for all three cancers were above the OECD average. The OECD data also showed improved survival rates for patients with breast and cervical cancer from 2002 to 2007 compared to 1997 to 2002 (the data was unavailable for colorectal cancer).
use, and their distribution across New Zealand. In this area, ROWG should link with the National Health Committee as noted above support for use of KPI information to understand comparative cancer centre performance, IR monitoring, and encourage spread of effective innovation to improve access and operational efficiency and effectiveness workforce planning and development, including education and training, and opportunities to explore new models of care and workforce roles. In this area, ROWG should link with Health Workforce New Zealand capacity and service planning, including advising the Ministry on updating and enhancement of the Model and Plan capacity and service planning for sub-specialised services such as child cancer treatment consideration of the information base required to support future investment in radiation therapy capacity. The advent of the Plan and should allow ROWG to develop and deliver a more structured work programme that is agreed with the Ministry annually. This work programme should be linked to an annual radiation oncology national implementation plan, as part of the Cancer Programme. Recommendations: National planning and action The Ministry should produce an annual radiation oncology national implementation plan, as part of the Cancer Programme. Appendix 1: Members of the Steering Group and Expert Advisory Group Steering Group Andrew Simpson (Chair) – National Clinical Director, Cancer, Ministry of Health Jo Anson – Central Cancer Network Manager, MidCentral DHB Kate Garland – Senior Advisor, Cancer Services, Ministry of Health Charles De Groot – Radiation Oncologist, Waikato DHB Emmanuel Jo – Principal Technical Specialist, Health Workforce New Zealand, Ministry of Health Lowry – Chief Operating Officer, Capital and Coast DHB Mhairi McHugh – Team Leader, DHB Performance, National Health Board, Ministry of Health Robert Taylor – Group Chief Financial Officer, Mercy Ascot Ricarda Vandervorst – Manager, Cancer Services, Ministry of Health