Australia needs a unified approach to cancer care, argues medical oncologists Professor John Zalcberg and Clinical Associate Professor Louise Nott.
Cancer outcomes in Australia are among the best in the world, but these outcomes are not experienced equally by all Australians. The issue of navigation in cancer care has been topical among patient communities and clinicians for some time.
It’s time to initiate a cancer-agnostic model to test the potential of a unified approach to cancer care navigation.
All.Can Australia is part of global organisation, All.Can International, which was established to improve patient outcomes throughout the entire cancer continuum, by driving better patient care through improved efficiencies based on the principles of value-based health care.
Its approach is to mobilise people with cancer, healthcare professionals, industry partners and other key stakeholders across health system to enable the collaboration that is required to implement solutions that will lead to meaningful change.
Across Australia, this is being done by representatives from cancer organisations, the biopharmaceutical industry, university faculties, consumer advocates and pharmacists.
All.Can Australia has been advocating for a cancer-agnostic approach to cancer navigation since 2021, when the organisation released Australia’s first pan-cancer care navigation model. The proposal is to use one carefully designed model to transform cancer care delivery for all patients, regardless of cancer type, cancer stage, patient demographic or location.
As clinicians who understand the impact of fragmented cancer care, we believe a deliberate, integrated approach to navigation would make our complex health system easier for patients to navigate and remove some of the biggest pain points they experience in improving or maintaining their quality of life.
Recent insights arising from a recent webinar organised by All.Cam Australia confirmed that we need to work together to overcome the currently siloed nature of cancer care. It is not just about developing new approaches and resources. It is about a collective approach to the delivery of cancer care support, better connecting existing services to improve the disparities in how patients access the resources already available, including dedicated cancer-specific nurses such as breast care nurses.
The current reality is that clinicians are the ones assisting with care navigation and they are not necessarily best resourced and often too time-poor to assist. This leaves patients to their own resources often based on the internet.
Guiding patients through the health system when they are at their most vulnerable can be done better, more efficiently and effectively by trained people and technology.
To make pan-cancer navigation a reality, there will need to be adequate human resourcing, education, leadership and mentoring of appropriately trained healthcare professionals, as well as suitable evaluation processes in order to make informed decisions.
The benefits of a comprehensive cancer care navigation program are likely to be substantial, including improved outcomes for healthcare consumers as well as a more efficient healthcare system.
Positive impacts include reducing emergency department visits, more efficient inpatient services, reduction in duplication of services and, overall, decreased time traversing the cancer treatment pathway. Cancer navigation will improve the healthcare consumer experience by reducing stress and anxiety, reducing barriers to investigations, diagnosis and treatment, and improving continuity of care.
Fortunately, the necessary modelling and cost benefits analyses have already been considered. We estimate that a pan-cancer navigation model in Tasmania run through the Primary Health Network, would generate $2.2 million in net savings per annum, or $724 per patient, delivering a 39% return on required investment (based on the budgeted service cost to fund the pilot for five years). At a peak level of operation, the pilot could provide support to 4913 cancer patients annually.
Increased efficiency in cancer care is about breaking down organisational barriers and silos. It is about optimising the use of existing services already in place at a national, regional or local level, and how these services can be better coordinated and connected.
A unified approach to cancer navigation can help us become a country with not just the best cancer outcomes but the most efficient cancer care system in the world.
ED: Prof Zalcberg is board director of All.Can Australia and a consultant medical oncologist at Alfred Health and Head of the Cancer Research Program at Monash University’s School of Public and Clin. A/Prof Nott is a medical oncologist at Icon Cancer Centre.