Survival and quality of life depend on early detection and referral to an appropriate multidisciplinary team for diagnosis, and a best practice treatment plan accompanied by supportive care.34
People affected by cancer have multiple complex needs. Multidisciplinary care is increasingly viewed as the optimal standard of care as a range of disciplines are required to achieve optimal outcomes. Multidisciplinary care has been described as 'an integrated team approach to health care in which medical and allied health care professionals consider all relevant treatment options and develop collaboratively an individual treatment plan for the person affected by cancer'.35
A multidisciplinary approach is important not just in the diagnosis and treatment phase, but also in survivorship and end-of-life care. The specific contribution of various disciplines will vary, depending on the health and support needs of the individual over time. Multidisciplinary care is highlighted as a priority area in several national cancer policy documents as well as state and territory cancer plans and discussion papers. Tumour specific clinical practice guidelines also incorporate recommendations for multidisciplinary care.36
Care delivery approaches also need to be responsive to the needs of people living in rural and regional Australia who experience difficulties accessing services and have poorer cancer outcomes reported. Seamless coordination of care is also required to navigate the complex health system across multiple settings in both the private and public sectors.37
In response to identified needs of people affected by cancer in Australia, models of care have been developed at a state wide level to improve care delivery.2 Broad national initiatives include:38
- establishing new infrastructure:
- building integrated cancer centres
- funding for regional cancer centres
- establishing nationally agreed and consistent best practice cancer protocols and pathways of care
- investing in health promotion activities to prevent cancer.
The success of significant investments and initiatives in cancer control is dependent on the availability and effectiveness of a workforce to service them. The National Cancer Workforce Strategic Framework (May 2013)39 provides advice to governments and service providers on the key issues for the cancer workforce and identifies innovation and reform that has the potential for national application. It focuses on enabling the cancer health workforce to provide appropriate, efficient and well-coordinated care for people affected by cancer and their families, from diagnosis, treatment and support to the management of follow-up care and survivorship.
The report and initiatives in its wake will have significant implications for Specialist Cancer Nurses if the vision of the Framework is delivered upon in which the cancer workforce:39
- Operates to its full scope of practice
- Is flexible to changing requirements
- Uses expert clinical staff in the most efficient and effective manner
- Eliminates unnecessary duplication of activities for consumers at all points of care.
Develop a comprehensive list of service providers involved in care of people affected by cancer in your setting.
Describe the strategies used to facilitate multidisciplinary approaches to care in your setting.
Discuss what role a specialist cancer nurse has in facilitating the multidisciplinary approach to care.
Access Ensuring Quality Cancer Care Through the Oncology Workforce40. Discuss how the strategies identified to overcome workforce shortages of the oncology workforce in USA could be relevant at in Australia.