National action - cancer control

The National Cancer Expert Reference Group (NCERG), jointly chaired by the Commonwealth Government and Victoria, was established by COAG in 2011 to develop a National Cancer Work Plan.

Page last updated: 06 April 2018

NCERG background and context

In 2010, the Council of Australian Governments (COAG) noted disparities in cancer outcomes across different groups and recognised the need for more effective cancer diagnosis, treatment and referral protocols. The National Cancer Expert Reference Group (NCERG) was formed to develop a National Cancer Work Plan to address these issues.

NCERG is jointly chaired by the Commonwealth Government and Victoria with representation from all jurisdictions, Cancer Australia, the Cancer Council Australia, the Clinical Oncology Society of Australia and consumer input. It is Australia’s only government endorsed, high-level, expert national cancer forum, including government representation as well as clinical expertise.

In Australia, it is estimated that 1 in 3 males and 1 in 4 females will be diagnosed with cancer by the age of 75. By the age of 85, the risk is estimated to increase to 1 in 2 for both males and females.1 With an ageing population new cancer cases will increase, putting pressure on health services and expenditure as well as patients, families and carers. Cancer survival rates in Australia are, on average, among the world’s best but outcomes differ by tumour type, geography, socioeconomic and Indigenous status and other features. These disparities compromise equitable survival, optimal quality of life and the efficient use of resources.

The National Cancer Work Plan

NCERG developed a National Cancer Work Plan which was endorsed by COAG in 2012 and is guided by three principles:
  • focus on actions requiring national coordination; build on jurisdictional cancer plans and enhance current investments;
  • be underpinned by best-practice research and evidence-based treatment and supportive care; and
  • recognise the tight fiscal environment and the difficulty of funding significant new activity.
The priority action areas include: agreed pathways of cancer care; more efficient and effective cancer services; and better implementation of evidence-based cancer treatment.

The Plan is being implemented in partnership with national, jurisdictional and health professional leadership on specific priority projects with consumer involvement. Australian Health Ministers’ Advisory Council (AHMAC) provided funding of $260,000 in 2017-18 to support implementation activities. Jurisdictions and the Commonwealth have also funded projects. Key projects are outlined below, including web links where available. Links to the complete National Cancer Work Plan and Progress Reports for 2012-13, 2013-14, 2014-15 and 2015-16 have also been provided below.

COAG National Cancer Work Plan Progress Report 2014-15 and 2015-16 (PDF 244 KB)
COAG National Cancer Work Plan Progress Report 2014-15 and 2015-16 (Word 57 KB)

COAG National Cancer Work Plan Progress Report 2013-14 (PDF 163 KB)
COAG National Cancer Work Plan Progress Report 2013-14 (Word 52 KB)

COAG National Cancer Work Plan Progress Report 2012-13 (PDF 431 KB)
COAG National Cancer Work Plan Progress Report 2012-13 (Word 107 KB)

COAG Improving Cancer Care Initiative National Cancer Work Plan (PDF 114 KB)
COAG Improving Cancer Care Initiative National Cancer Work Plan (Word 32 KB)

Further progress reports will be added when available.

Key projects

Initiative 1: Pathways of cancer care

  • establishing best-practice pathways of cancer care with agreed referral protocols
  • improving practical support for patients, their carers and families

How cancer surgery volume affects outcomes

There is evidence that the volume of cancer surgery undertaken at a hospital is a predictor of patient outcomes. Higher volume is associated with better outcomes. The Cancer Institute of NSW is investigating this phenomenon for rare cancers in Australia by examining data on surgical outcomes and hospital volume of complex surgeries. The findings have been a useful catalyst for conversations regarding appropriate surgery volumes and some changes have been made to practice in NSW as a result.

Moving between public and private cancer services

Many cancer patients move between public and private cancer services in the course of their treatment. This project, led by the Commonwealth Department of Health, examined the enablers and barriers to well-coordinated care between the two sectors to improve patient pathways and service provision.

Individual episodes of cancer treatment generally occurred in either a public or private cancer service, however over the course of the entire cancer treatment pathway, many patients had some episodes of their cancer care across both settings.

One significant and overarching finding was that many patients and cancer care providers, including specialists and health professionals in both public and private settings, did not have a shared understanding of the complete cancer treatment pathway and the extent to which public and private cancer services interface.

A copy of the Report is available
National Cancer Expert Reference Group Public and Private Cancer Care Project Final Report (PDF 530 KB)
National Cancer Expert Reference Group Public and Private Cancer Care Project Final Report (Word 421 KB)

Optimal Cancer Care Pathways

Victoria has also led a significant project on Optimal Cancer Care Pathway (OCP) guides for use by health services and professionals. The diagnosis and treatment of cancer is complex and often involves multiple health professionals and services, both public and private. To facilitate consistency of care across the nation the OCPs provide guidance on the specific components of care to be provided at each stage from prevention and early detection through to end-of-life care. OCPs are complete for several tumours and a number of others are in development. Further information is available from the Optimal Cancer Care Pathways website page.

The COAG National Cancer Work Plan Optimal Cancer Care Pathways Pilot Implementation 2016-17 – National Summary provided to AHMAC out of session provides an overview of the jurisdictional experiences in the early stages of adoption of the OCPs in 2016-17 and identifies a number of key benefits and challenges derived from the use of the OCPs within health care systems.

A copy of the report is available.
PDF version: COAG National Cancer Work Plan Optimal Cancer Care Pathways Pilot Implementation 2016-17 – National Summary (PDF 273 KB)
Word version: COAG National Cancer Work Plan Optimal Cancer Care Pathways Pilot Implementation 2016-17 – National Summary (Word 92 KB)

Supporting Aboriginal and Torres Strait Islander women with breast cancer

Cancer Australia has developed a resource, My breast cancer journey: a guide for Aboriginal and Torres Strait Islander women and their families, to support Indigenous women with breast cancer through their treatment and care.

Initiative 2 – Efficient and effective cancer services

  • innovative use of the cancer workforce
  • agreed capability frameworks for cancer services

Service Capability Framework Project

Victoria led the development of a nationally consistent Service Capability Framework for cancer services to assist them establish clinically safe and effective cancer care pathways. The Service Capability Framework defines the minimum service features (e.g. workforce competency, skills and experience; equipment and infrastructure; and clinical support services) required to provide cancer treatment depending on the type and complexity of the tumour.

Standards for Chemotherapy

This project aimed to develop recommendations on future directions for The Standards for Chemotherapy, developed in 2010, including the potential and value of standards or components of the standards more broadly across Australia. Led by South Australia, this project involved the evaluation of the implementation and impact of the standards on cancer service governance, service delivery, quality and safety and workforce development.

Best Practice Cancer Care in Regional Australia

The Best Practice Cancer Care in Regional Australia project is a continuation of the Profiling of Regional Services project funded by AHMAC in 2013-14. The initial project documented the status of cancer services for a range of cancers, treatments and referrals provided by 34 regional cancer services from across Australia at a point in time (between March and June 2014). This was mapped against relevant Service Capability Frameworks developed by Victoria.

In 2014-15 Cancer Australia reviewed reports from each jurisdiction in accordance with the nationally endorsed OCPs to highlight areas for consideration in enabling best practice cancer care in regional Australia. Eight jurisdictional papers Profiling Regional Cancer Services: Findings and Opportunities were developed, identifying opportunities under each key principle for further consideration by each jurisdiction.

The next phase of work conducted in 2015-16, involved meeting with health department executives and clinical experts in each jurisdiction to discuss the findings and explore opportunities to support the delivery of best practice, evidence-based cancer care in regional areas.

To further strengthen best practice care in regional cancer services through shared learnings across jurisdictions and services, Cancer Australia held a national Regional Cancer Services Forum in late 2016. This was attended by leaders from regional cancer services, people affected by cancer, state and territory health departments, General Practitioners and key national stakeholders, to highlight and address common challenges in delivering best practice cancer care to regional cancer patients.

Initiative 3 – Evidence-based cancer treatment

  • better use of multidisciplinary teams
  • implementation of new research findings and best practice treatment protocols

Multidisciplinary and evidence based care

The use of multi-disciplinary teams in cancer care has been adopted in many countries and is considered best practice in Australia. To increase the use of multidisciplinary teams across the public and private sectors, Cancer Australia has launched an online Multidisciplinary Care Information Hub, which provides a single point of access to evidence-based cancer information for service providers and health professionals.

Supporting evidence-based treatment decisions

The NSW Cancer Institute's eviQ database is an on-line, point-of-care treatment resource for cancer health professionals which all jurisdictions have adopted. It allows clinicians access to online research findings and information on evidence-based cancer treatment and care.

Supporting evidence-based care for lung cancer

Lung cancer is the most common cause of cancer death in Australia. Evidence indicates there are considerable variations in the care, service delivery, and experiences of people affected by lung cancer.

Finalised in November 2017, the most recent project Cancer Australia led built on three previous initiatives to reduce variations in practice with a focus on optimising the delivery of lung cancer care in regional Australia through using data to enhance regional cancer care. The project aimed to improve best practice lung cancer care and improve cancer outcomes for patients with lung cancer in regional Australia.

Contact

Please email the NCERG Secretariat if you have any queries.

Footnotes

1 Australian Institute of Health and Welfare 2017. Cancer in Australia: an overview 2017. Cancer series no. 101. Cat. no. CAN 100. Canberra: AIHW.