Welcome to Midland Cancer Network 

Manager's update: 

Kia ora and welcome to the first newsletter of 2012.  The sector is as busy as ever and it is often difficult to keep up to date with all that is happening.

Network team staff changes

It is with regret that I inform you that Dr Charles de Groot has tendered his resignation as Clinical Director of the network.  Charles joined the network team back in June 2008 and seen significant growth in the regional and national cancer control work programme during this period.  I would like to take the opportunity to thank Charles for his support to myself, the team and network members, it has been invaluable.  Charles has made a significant contribution in his Clinical Director role to improving Midland services to cancer patients.  

Charles will still carry on with the roles of chair of the National Lung Cancer Working Group and the chair of the Midland Adolescent and Young Adult Cancer Service Work Group and of course continue with his clinical role in radiation oncology.  Charles and I are working through a process to fill this position, which is essential to providing clinical leadership and direction to improve patient care within Midland.

Jenna and Brent Arnel are expecting their first child in April.  Jenna is taking a years maternity leave from the 29 March and we wish them all the very best.  Shelley O’Sullivan joins the team from Monday 26 March to cover Jenna’s leave. 

Faster Cancer Treatment (FCT)

This is a term that you will hear a lot of in the future.  What does this mean?  I have provided a brief overview within the national section.  The four regional cancer networks (for the regions' DHBs) have been  requested by the Ministry of Health to commence a new work programme – developing national tumour stream standards and patient pathways that support the faster cancer treatment wait time indicators.

  • Cancer treatment multidisciplinary meetings (MDMs)

Cancer treatment MDMs are essential to the management and care of people with cancer.  The infrastructure and management of MDMs (local, regional and supra-regional) is complex and requires more than just video conferencing.  The network has started the process by supporting Tauranga Hospital to upgrade its AV equipment in the radiology room – it looks fantastic.  Waikato is making slow progress on its upgrade.
The good news is that the National Health Board is devolving $2million (sustainable) across the 20 DHBs from 1 July 2012 to continue the development of cancer treatment MDMs.  The Ministry of Health are preparing some MDM guidance for DHBs as we move to make improvements.  The network is working with clinicians to upgrade the current regional lung cancer database used in the Regional Chest Conference.  In addition the network has sourced a UK colorectal cancer database and is working with clinicians to adapt for use locally and regionally.
Waikato is recruiting to its MDT Coordinator vacancy.

Enhanced Recovery After Surgery (ERAS)

ERAS is a new regional initiative.  Bay of Plenty is the lead elective services DHB, with the network as a strategic partner.  The pilot has commenced in Bay of Plenty and Waikato (Hamilton and Thames).  The network is providing project resource for the Waikato ERAS project.

Other notable achievements

• The Midland Adolescent and Young Adult Cancer Service Plan 2012-14 has been completed

• Provision of regional coordination services for the recruitment and retention of Breast Screen Midland priority group women plan (draft) has been developed.

• Bay of Plenty Palliative Care Work Group has been refreshed and had its first meeting in March this year.

You will find more news and updates, so read on.  I hope you find this information helpful to keep up to date with cancer control sector news. 

Jan Smith

Network Manager

Please use the hyperlinks immediately below to quickly access specific topics of interest to you:

Upcoming Events 

Regional Updates

National Updates

Upcoming/events for 2012

Cancer Awareness Campaigns - March

Latest released documents

Regional updates

He Hikoi Hei Manaaki Tāngata - A journey with cancer: a guide for Māori Whānau

This book for Māori with cancer was developed by Te Puna Oranga (Māori Health Service) with one-off funding provided by the Ministry of Health.  It has been created for whānau, with whānau, and by whānau who have been through the cancer journey.  Hui and focus groups initially identified what information they wanted to be included.  We hope that it will prove to be a useful resource for Waikato Māori on their cancer journey.

To download a copy of the book please go to http://www.midlandcancernetwork.org.nz/file/fileid/41890 

Palliative Care update

  • Staff changes

Sandi Haggar previously a clinical nurse specialist in palliative care based at Waikato Hospital has been appointed Nurse Practitioner in Palliative Care.  She has also successfully passed her prescribing exams.  Congratulations Sandi.  Sandi's role will initially be in the South Waikato  including Tokoroa, Te Kuiti and Taumarunui.

Dr Peter Kirk retires at the end of March and we wish him and his wife, Ingrid, many happy travels.  Peter's contribution to palliative care in Waikato and the wider Midland area has been significant across all areas of his work  - patient and family/whānau care, education, training and support of other health professionals, research and planning.    We will miss his expertise and wise counsel.

Above: Sandi Haggar

  • PalCare

The hospices of the Midland region, led by Waipuna Hospice (Tauranga), have been progressing the introduction of PalCare (electronic patient medical record software) over the past 6 months. The five hospices (Waipuna Hospice, Taupo Hospice, Eastern Bay of Plenty Hospice, Rotorua Hospice and Waikato Hospice) are now working with PalCare in the care of all patients referred to hospice specialist palliative care services. This software allows for secure and mobile access to patient notes in real time and is greatly enhancing interdisciplinary working in the provision of specialist palliative care.

  • Items of interest:

Rotorua Hospice now has it's new website up and running   www.rotoruahospice.co.nz

Waipuna Hospice website upgrade has now been completed and they are back on-line at  www.waipuna-hospice.co.nz

The Palliative Care Education Calendar for nurses and carers for 2012 is now available on the Midland Cancer Network website at http://www.midlandcancernetwork.org.nz/page/pageid/2145868076

Medical oncology challenges

Demand for medical oncology services in New Zealand is projected to nearly double over the next 15 years. This growth coupled with workforce, facility and funding constraints severely compromises future service sustainability.  This requires a new model of care for medical oncology services in New Zealand.

A recent report to the Ministry of Health ‘New Models of Care for Medical Oncology’ outlines how changes  are required to ensure services are effective, equitable and sustainable to meet this future demand.  Within the Midland region, work has already commenced on looking at ways to address some of the issues and stressors that the services are dealing with.

A working group has been set up to review the recommendations from the new models of care report.

Enhanced Recovery after Surgery (ERAS) project

Both Waikato and Bay of Plenty DHBs have embarked on an eighteen month project to improve the pathway for colorectal surgery patients. Currently patients spend longer in hospital than in other hospitals in New Zealand and internationally but thanks to some Ministry of Health funding, this will soon change.

Enhanced recovery programmes have been shown to reduce the length of hospital stay after elective colorectal surgery. The program outlines a number of key elements that must be in place to ensure a good patient experience and improved outcomes.  The team have highlighted a number of areas for improvement including the need for patient information.

Māori Community Health Worker Cancer Education Study Day

This was held in early March at Rauawaawa Kaumātua Charitable Trust and attended by 32 community health workers from Māori health providers across the Midland Cancer Network area.

The three key topics related to lung cancer, palliative care for both adults and children, and the Adolescent and Young Adult Cancer Service.  The format of the day included case studies and group work as well as presentations.

Māori community health workers found the training very useful for supporting their clients with cancer, particularly Māori who experience high levels of respiratory disease and cancer. Māori health providers have indicated that continued cancer education within communities is important especially with whānau requiring support and advocacy services.

A special thank you to Karen Middleton and Leonie Brown (lung cancer clinical nurse specialists), Sandi Haggar (Nurse Practitioner, Palliative Care), Ellyn Proffit (Clinical Nurse Specialist, Adolescent and Young Adult Cancer Service) and Te Puna Oranga (Māori Health Service) who made the day possible. 

Mihi miharo ki a koutou katoa.
Mauri Ora te iwi

Cytotoxic Compounding Unit back at Waikato

From 2 April, Waikato District Health Board Pharmacy will be providing cytotoxic medicines (pharmaceutical products mainly used for the treatment of cancer) from their new Cytotoxic Compounding Unit. 

The unit is based in the old Baxter Healthcare Ltd space in the Lomas Building at Waikato Hospital.

Compounding refers to the process of preparing a medicine, to be ready for administration, from base ingredients.

The area has recently been refurbished as a Class D area for the specific purpose of compounding cytotoxic medicine. Class D means that the area is free from dust, and is kept very clean and free from bugs.

The new supply model says that from 2 April Waikato DHB pharmacy will facilitate the scheduling, ordering, receipting, dispensing and delivery of all cytotoxic products, and provide a limited onsite cytotoxic compounding service for short expiry and urgent products.

While Baxter Healthcare were previously situated onsite at Waikato Hospital, they gave notice of withdrawal from the Waikato campus last year due to financial issues and the increased quality standards required to keep their Waikato facility running,

“Taking over this service has been a challenge for Pharmacy,” said Waikato DHB Pharmacy manager Jan Goddard.

“However, overall bringing the service back onsite will lead to a more coordinated service, increased availability of data, improved ordering and dispensing processes and increased flexibility for future compounding service options.”

National updates

Faster Cancer Treatment (FCT)

This is a term that you will hear a lot of in the future.  What does this mean?  The Ministry of Health and the regional cancer networks are in the process of developing formal communications. The FCT work programme is the early phase of start up.
Recently the four regional cancer networks (for the regions DHBs) were requested by the Ministry of Health to commence a new work programme – developing national tumour stream standards and patient pathways that support the faster cancer treatment wait time indicators.  This requires:

  • the establishment of eight national tumour working groups to develop national tumour stream standards by 30 June 2013
  •  a regional DHB stocktake of cancer care coordination roles by 30 June 2012
  •  the development of faster cancer treatment indicators data definitions by end of March 2012
  • undertake a review of DHB systems/processes and ability to capture and report the FCT indicators effective 1 July 2012
  • development of  DHB FCT implementation plans by 30 June 2012.

FCT is a patient pathway approach to ensuring timely clinical cancer care and will be measured by the following agreed indicators, for patients:

• referred urgently with a high suspicion of cancer receive their first cancer treatment (or other management) (best practice timeliness measure of within 62 days)

• referred urgently with a high suspicion of cancer have their first specialist assessment (best practice timeliness measure of within14 days)

• with a confirmed diagnosis of cancer to receive their first cancer treatment (or other management) from decision-to-treat (best practice timeliness measure of within 31 days).


LCP Update

NZ GP Survey on LCP
We are pleased to advise that the National LCP Office NZ with the support of The Royal New Zealand College of General Practitioners has now completed the Technical Report on the survey of general practitioners’ knowledge and perspectives of the Liverpool Care Pathway for the dying patient in NZ.  It has been peer reviewed by Drs Bruce Stewart and Jean Clark. The report is now published on the LCP website

This is a significant milestone as it is the first time in NZ we have sought the knowledge and perception of general practitioners and their use of the LCP in practice. We are very grateful to those who have participated in the survey and The Royal New Zealand College of General Practitioners for their support in this project.

Culturally Appropriate End of Life Care for Māori Study
The technical reports for Phases 1a and 1b are now also available online for download at

Ministry of Health Develops a New Website - www.health.govt.nz/

  • Why has the Ministry developed a new website?

The Ministry of Health is providing a website that is more user-friendly and better meets our users’ needs. Every day, around 4,300 New Zealanders access our website. People want to be able to easily access the information they need, when they need it, in a way that works best for them.

The current website has not undergone any extensive redevelopment for a number of years. We are responding to feedback by providing a better web experience, an improved search function and new design and navigation to make information easier to find.

A new dedicated section (Your Health) contains quality health information for individuals, families and communities.

  •  Why have we changed the website address from moh.govt.nz to health.govt.nz?
Changing the website address to health.govt.nz makes it easier for people to find us on the web as it more clearly represents who we are. The current moh address is not easily recognisable as being about health.
  •  What’s different about the new website?
The new website is quite different from moh.govt.nz. The main improvements are a better search function, design and navigation which will make information easier to find. The site structure is also different, with content more logically organised based on what our users need.

If you need help getting around, check out the Guide to our new website.

The website has a new section called ‘Your Health’ which will provide easy to understand information on common health topics such as influenza and breastfeeding. This has been developed in response to user research which identified that people wanted to access this type of trusted and credible information online.

  • Who can contact if we have any questions about the website?

Contact info@health.govt.nz or use the feedback form on the website.

Feature Organisiation

Child Cancer Foundation - Beads of Courage

Beads of Courage is a unique program designed to honour the challenging journey kids take while receiving care for cancer.

Each collection of Beads of Courage symbolizes the courage and honours the milestones achieved along the treatment path. 

How does the beads program work?
Each child who is a Beads of Courage member firstly receives a string with beads that spell out their first name. Then, colourful beads that visually represent the many challenges they have overcome along the treatment journey are added to the string to tell their unique story of courage.

Every time something from the bead guide is experienced a bead is given by their health professional to add to their Beads of Courage collection. These Beads of Courage are used to tell and show friends and family all of their experiences of courage and they are encouraged to display these proudly and to have fun!

Sibling Beads
The Sibling Beads programme is exclusively for siblings of children with cancer and recognises the impact cancer has on brothers and sisters and the many special ways that these siblings help their family members.  The different beads acknowledge the many brave and courageous acts and caring challenges siblings face during the cancer journey. 

For more information on the Child Cancer Foundation and the work they do in supporting children and thier families with cancer, please go to there website http://www.childcancer.org.nz/