Head and Neck Cancer Service Framework February 2019

Did you know that there has been a review of the head and neck cancer service in the Northland/Auckland region? And that the framework for improvement that came out of this review is going to be a model for the rest of New Zealand? 

An interesting thing about this new Framework, published in February 2019, is that we helped bring it about. Several of us were and still are patient reps on various committees. We tried hard to get our voices heard and … they listened.

Here are some of the changes we helped with

  • The MDM is being humanised. There is a plan underway to “scope” patients in a separate room so that they don’t have to sit on a high chair in front of 20 or so health professionals while they look at the screen behind us. The plan is to have a video link between the separate room and the MDM room with one’s own doctor (or a Fellow) in the room with us. I was initially against this idea because I thought the panel might miss out on opportunities to feel the tumour. However many thought that parading a patient in front of a large group of doctors was no longer acceptable.
  • No more post-code health care. The four DHBs in the region will now provide the same service and consumables. For example, HME filters for laryngectomees are now provided free throughout the region. Previously only CMDHB and Waitemata DHB provided them. It was a proud day when the last of the DHBs, Northland DHB joined the club. We pressed hard for this.
  • There will be one “Level 6” hospital for the very complex cases involving microvascular surgery and flaps etc. So Auckland City hospital will do those cases. Did you know that surgeons carrying out these procedures need to do at least 20 a year to maintain their skills?
  • Radiotherapy for head and neck cancer is likely to stay in Auckland even if a radiation centre is set up in Whangarei.
  • There’s be more investment in Oral Health because patients like us have been complaining about poor follow up after radiotherapy for decades. We have earned this!
  • Better coordination of the many services we need, especially Oral Health as mentioned and gastroenterology for people on feeding tubes.
  • Patients want a contact person or navigator to be their go-to person along the cancer pathway. This is likely to be the clinical nurse specialist. This is a work in progress but it will be done.
  • Open disclosure of our medical notes/letters and consistent information across the four DHBs with the aim of improving health literacy.
  • Follow up after treatment. Better and more consistent rehabilitation and survivorship. This is being worked out in 2019.
  • Better data collection, better feedback, new patient reported outcome measures.