December 2021 update from Te Aho o Te Kahu, Cancer Control Agency New Zealand

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I orea te tautara ka puta ki waho. 
A problem is solved by continuing to find solutions.

This has been a tough year, with both COVID-19 and the health and disability system reforms (HDSR) adding complexity to an already challenging time for whānau living with cancer – and those working tirelessly in the cancer sector.

I want to acknowledge the incredible mahi of everyone involved in the prevention, diagnosis, and treatment of cancer, and all the wonderful people who provide support. Thank you. I hope you get to spend some time with your whānau and friends over the festive season and can rest and recharge your batteries for 2022.

Before the year ends, I wanted to provide you with some brief highlights from our recent work in both planning for the new health system and COVID-19.

Cancer Treatment Services Planning

Work continues to leverage the rare opportunity the HDSR provides to improve the delivery of cancer services and care in the health system.

The Cancer Treatment Services Planning project has delivered a report detailing strategic guidance on recommended approaches to strengthen our cancer treatment services in Aotearoa New Zealand. The report centres on creating services that are whānau-centred, equitable, high-quality and sustainable. Advice from stakeholders has already had significant impact on the shape of the recommendations captured in this project, and we will continue to engage across the sector as we shift our focus to prioritisation, delivery and implementation.

We are working closely with the HDSR Transition Unit to ensure the recommendations from this project are aligned and embedded in the Interim NZ Health Plan. This partnership approach with the Transition Unit will continue into 2022 and enables a strong focus on cancer services with Health New Zealand and the Māori Health Authority as these entities are established.

If you would like to know more about this work, please contact [email protected].

Endemic COVID-19

As a country, and a health system, we are moving into a new phase of our response to the COVID-19 pandemic; one in which COVID-19 may become more prevalent in our communities nationwide, as is currently the case in Auckland. In response to this shift, we have set up a Te Aho o Te Kahu COVID-19 team to work alongside and support the cancer sector.

Current Te Aho o Te Kahu COVID-19 work includes:

  • creating an endemic COVID-19 plan for cancer services
  • responding to growing COVID-19 related queries from the sector
  • preparing/updating guidance for cancer specific services
  • ensuring connectivity with the National Screening Unit and Ministry of Health

The team has recently updated the COVID-19 vaccine advice for clinicians on our website. This includes vaccine advice for those undergoing stem cell transplantation after receiving at least one primary COVID-19 vaccine dose. These patients can now be offered a repeat of the entire primary COVID-19 vaccine course. This advice will continue to be reviewed and updated regularly.

If you would like to know more about our endemic COVID-19 planning, please contact [email protected].

COVID-19 Monitoring

The COVID-19 and Cancer Services Report to end October was released this week. The report found:

  • The dip in cancer registrations seen during August 2021 has resolved.
  • There was some nationwide disruption to bronchoscopy procedures which Te Aho o Te Kahu is currently looking into.
  • Publicly funded cancer treatment – including surgery, chemotherapy, and radiation therapy – continued across the Auckland region from August to October 2021.
  • The disruption to gastrointestinal endoscopy procedures identified in previous reports for the Auckland region has resolved.
  • For the year to date, attendances for radiation oncology first specialist appointments have increased. Radiation therapy volumes in the Auckland region follow a similar pattern to that seen across New Zealand, with an overall decrease in volumes, likely due to the use of hypofractionation where cancers are treated over a shorter time period.  For Māori, there appears to be a greater decrease in radiation therapy volumes between October 2021 and October 2018/19. Te Aho o Te Kahu is actively investigating this.

While we are pleased to see services have largely continued, we acknowledge whānau with cancer may have been impacted in significant ways by COVID-19, including by changes to the way care has been delivered.

The next report will be released in February 2022.

In brief:

  • Congratulations to the Cancer Nurses College on reaching 25 years of commitment to excellence in cancer and haematology nursing. This milestone is a testament to the value of the organisation in connecting, supporting, and amplifying the voices of cancer and haematology nurses around the motu. Thank you for all that you do for people with cancer.

About Author

Professor Diana Sarfati (MBChB, MPH, PhD, FNZCPHM) is National Director of Cancer Control and Chief Executive of Te Aho o Te Kahu, the Cancer Control Agency in New Zealand. Her role is to provide national leadership for, and oversight of cancer control, to provide policy advice to the Government, and to be accountable for ensuring progress towards the goals and outcomes in the New Zealand Cancer Action Plan. Previously Diana was Head of the Department of Public Health and Director of the Cancer and Chronic Conditions (C3) research group at University of Otago, Wellington. She has led a large body of research relating to disparities in cancer outcomes. This work has resulted in the identification of key patient and health system factors that influence cancer survival. It has been used extensively by health policy makers, clinicians and other researchers to develop policies and practices that aim to reduce inequities in cancer outcomes.

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