Northern NSW LHD (NNSW LHD) is the regional pilot site for the Cancer Institute NSW’s collaborative Lung Cancer Pathways project.

2. Stephen Manley
Cancer Systems Innovation Manager
NNSW LHD
Lisa Delaney
Project Officer: Lung Pathway Project
(Mon & Wed)| NNSW LHD
Lung Cancer Pathways Project:
Local referral and diagnostic pathway
implementation for lung cancer
NNSWLHD Pilot site

3. Lung Cancer Pathway Project Overview
 Statewide project
 Project collaborators
– Cancer Service Innovation Managers (CSIMs) Community of Practice (CoP)
– Cancer Institute NSW
– University of Sydney Research in Implementation and eHealth Group (RISe)
– Local Health Districts (LHDs)
– Primary Healthcare Networks (PHNs)
– Lung MDTs

4. Lung Cancer Pathway Project Overview
 Strategic objectives of the NSW Cancer Plan 2011-
2015:
Improving the survival of people with cancer through
the reduction in variations in cancer outcomes across
NSW, reducing the gap between evidence and clinical
practice and reducing the gap between evidence and
policy.
 A Toolkit has been funded and developed

5. Toolkit
 Development
 Application by non-pilot LHDs
 Application to other cancer
sites in the future

6. Optimal Care
 A number of organisations have
developed ‘ideal’ pathways.
 ‘Optimal Cancer Care for People
with Lung Cancer’ pathway is the
‘National work plan for improving
care in Australia.’

7. NNSW LHD role
 Northern NSW LHD, alongside Sydney South
West LHD, has received funding from Cancer
Institute NSW as the regional pilot site to develop
a referral and diagnostic pathway for lung cancer.
 Toolkit: Test and QI .
 Mapping current pathways and identification of
barriers to an optimal pathway.

8. Project Collaborators
 Expert Advisory Group:
 Professor Tim Shaw (co-chair)
 Ms Kahren White (co-chair)
 Mr Paul Bennet (HealthPathways Project)
 Dr Kate George (GP)
 Ms Jill Lack (Newcastle CSIM)
 Professor Jane Phillips
 Dr Nicole Rankin
 Dr Emily Stone (Respiratory Physician, St Vincent’s
Hospital)
 Rise
 Cancer Institute NSW
 University of Sydney
 2 pilot LHDs

9. Project Process
 Obtained from lung cancer
pathways toolkit

10. Current Progress
 Stakeholders have been identified and engaged
 Continual presence at MDT meeting for ongoing
engagement
 Mapping current service is underway
 Patient audit to enhance current pathway mapping has
been completed and patient interviews to follow

11. Stakeholder Engagement
 NNSW LHD contains 2 lung MDT groups – Lismore and
Tweed

12. Mapping Meeting

13. Service Mapping

14. Patient Audit
Case 1 = 88 days to treatment
GP
• 15/6
CXR
Mclean
• 26/6 CT
Grafton
• 30/6
Referred
32d Resp phys
• 17/7
consult
• 30/7
PET CT
EBUS
• CROSS
BORDER
• CG
Hospital
• 3/8
Referred
Resp Phys
• 21/8
consult
with
EBUS
results
• 13/8 DOD
MDT
• 2/9
Treatment
• 11/9 Rad
Onc
consult

15. Patient Audit
Case 1 = 88 days to treatment
GP
• 15/6
CXR
Mclean
• 26/6 CT
Grafton
• 30/6
Referred
32d Resp phys
• 17/7
consult
• 30/7
PET CT
EBUS
• CROSS
BORDER
• CG
Hospital
• 3/8
Referred
Resp Phys
• 21/8
consult
with
EBUS
results
• 13/8 DOD
MDT
• 2/9
Treatment
• 11/9 Rad
Onc
consult
Private
Rooms
Paper
RecordPaper
Record
Paper
Record
Power
Chart
Paper
Record
Power
Chart
Power
Chart

16. Patient Audit
Case 2 = 14 days to treatment (Palliative case)
GP
• 14/8
11d Med Onc
• 25/8
Consult
• 3/9 CT
Biopsy
• 2/9 PET
• 24/8
DOD
1d ED
• 26/8
2d Rad Onc
• 28/8
consult
Treatment
• 28/8
MDT
• 2/9

17. Patient Audit
Case 2 = 14 days to treatment (Palliative case)
GP
• 14/8
11d Med Onc
• 25/8
Consult
• 3/9 CT
Biopsy
• 2/9 PET
• 24/8
DOD
1d ED
• 26/8
2d Rad Onc
• 28/8
consult
Treatment
• 28/8
MDT
• 2/9
Power
Chart
Paper
Record
Private
Rooms
Power
Chart

18. Patient Audit
Case 11 = days
GP
• No record - cross border
MDT
• 27/7
• CT
• PET
Treatment
• Surgery
• No record - cross border
Power
Chart

19. Challenges finding information
 Paper record
 Private practice information
 Information sources

20. End Product
 Establish the preferred pathway utilising information
gathered from stakeholders.
 Gain consensus on the preferred pathway from
stakeholders
 Utilise Health Pathways to promote the established pathway
to GPs in NNSWLHD

21. End Product
 Advantages
– Awareness
– Avoid delays
– Minimise learning curve

22. Further work
 Established tools to be utilized in other LHDs to develop
their local lung cancer pathway
 Utilisation of tools developed to be transferable to other
cancer sites in the future

23. Stephen Manley
Cancer Systems Innovation Manager
NNSW LHD
Locked Mail Bag 11, Lismore 2480
Tel 02 6629 4524 | Fax 02 6620 2355
Mob 0414 662 302
stephen.manley@ncahs.health.nsw.gov.au
Lisa Delaney
Project Officer: Lung Pathway Project
(Mon & Wed)| NNSW LHD
Locked Mail Bag 11, Lismore 2480
Tel 02 6629 4547 | Fax 02 6620 2355
Lisa.delaney@ncahs.health.nsw.gov.au
Lung Cancer Pathways Project
Local referral and diagnostic pathway
implementation for lung cancer
NNSWLHD Pilot site