Aims:
Loddon Mallee Integrated Cancer Service (LMICS) commissioned a Service Plan to guide the development of cancer services in the Loddon Mallee Region over a ten-year period. The process examined the cancer services system in the region and the role of LMICS in responding to service demand and service system requirements.
Methods:
Data were collected, analysed and triangulated data with respect to:
Expressed and Comparative Need, including an examination demographic, socio-demographic, epidemiological and service utilisation data from multiple sources which identified the scale and distribution of population characteristics, service demand and current service provision and made comparison with State and regional data;
Normative Need: including detailed interviews with 92 informants, including clinicians, health administrators, and representatives of key external agencies using a combination of individual interviews and focus groups and
Felt Need: based on a survey and individual and group consultations with consumers over a four-week period. A total of 63 consumer responses were obtained through individual interview or focus group.
Results:
The research produced findings with respect to consumer directed care, service integration, service quality and safety, workforce capability and capacity, and service access. With respect to service and system integration and quality and safety, increased clinical integration of services across the region was supported, with a preference for formal agreements to support shared accountability, standardising care and improved clinical governance of services. Resolution of tensions between individual service provider’s clinical governance responsibility and the requirement for system wide clinical leadership was identified as a priority. Enhanced service linkages between tertiary and regional providers through information exchange, shared care planning and effective referral/discharge arrangements were supported.
Conclusion:
Planning for regional cancer services requires, in addition to consideration of extending service access, consideration of the ways that service systems can be better integrated and quality enhanced through effective clinical leadership.