A forward-looking strategy to deliver improved radiation oncology services
Importance of planning
- Planning of radiation oncology services must be based upon achieving the agreed optimal target utilisation of radiotherapy for new cases of cancer (currently set at 52.3%).
- The commitment needs to be made now so that the target optimal utilisation rate for radiotherapy can be met by 2022.
- Radiation oncology service planning needs to occur:
- Regularly on a long-term basis and coordinated at a national level.
- With reference to other cancer therapies.
- Ensuring that patients have clinically appropriate and affordable therapies.
Keeping pace with radiotherapy techniques and technologies
- Health technology assessment processes at all levels must be improved so innovations that provide value for both the cancer patient and the health system are effectively implemented.
- There needs to be a sustainable financial model for the introduction of new radiotherapy techniques and technologies based on comparative effectiveness.
- A radiation oncology registry of treatments and outcomes needs to be established to provide data capture and post-market surveillance.
Harmonisation of legislation
- Regulatory legislation and processes should be harmonized across jurisdictions.
Minimum radiation oncology data set
- A minimum radiation oncology dataset must be established, implemented and incorporated into a future national cancer data set.
- All radiation oncology services must comply with the requirements of a radiation oncology national dataset and provide data.
The availability of radiotherapy to all patients for whom it is clinically appropriate which can be accessed in a timely manner
- Planners, decision-makers and service-providers must ensure that radiation oncology services have the capacity for patients to receive radiotherapy within clinically appropriate timeframes.
- National targets for timely access to radiotherapy (as recommended by National Health and Hospital Reform Commission) should be set and services should be reporting against these targets.
Financial impact on patients, families and cares
- The financial impact of accessing cancer treatment should be minimized to ensure that optimal treatment is available to all patients.
- Legislative issues must be resolved to allow out-patient radiation oncology to qualify for private health insurance
A patient-centred, evidence-based and multidisciplinary approach to practice
- Patients, carers and families need to be empowered such that:
- They are provided with current, relevant and evidence-based information regarding radiotherapy.
- Information is available in languages other than English, where appropriate.
- Any costs associated with treatments are clearly described prior to treatment.
- Current radiotherapy waiting times information is made publicly available.
- There needs to be a central information resource on radiation oncology that is:
- Reliable and appropriate
- Readily accessible in all geographic locations
Radiation oncology practice standards
- The Radiation Oncology Practice Standards must be mandatory.
- A mechanism for oversight of compliance with the Standards needs to be established and funded.
- The professions to regularly review and keep the Standards contemporary.
Evidence based multi-disciplinary oncology practice
- Multidisciplinary Team management is the gold-standard of cancer care and must be supported by services, professionals and planners.
Clinical peer-review audit
- Peer-review practices should be supported and increased to minimise process variation and ensure that treatments comply with best practice.
Ongoing evaluation of quality assurance, patient quality of life and survivorship
Quality assurance for safety and quality care
- A national framework for quality assurance should be developed to make radiotherapy more consistent and to ensure patient safety.
- The Australian Clinical Dosimetry Service must be made permanent to ensure safe delivery of radiotherapy.
Quality of life and survivorship
- Patient survivorship must be a focus of cancer management.
Continuous quality improvement
A quality management system for radiation oncology
- There must be a national reporting framework to identify issues associated with quality.
- A formal benchmarking exercise across jurisdictions and radiation oncology facilities must be undertaken, including activity targets, waiting times and clinical patterns of care variation:
- Service and planning benchmarks must be agreed nationally
- Variability between services must be measured and reported
- Individual plans must be developed for services to meet the benchmarks
- A national incident monitoring system specific to radiation oncology must be implemented.
Engendering leadership and fostering a culture of quality
- Quality management and leadership must be included in all professional training programs.