Overview
Blood, Cancer and Palliative Care Services in New Zealand
Treatment for cancer services in the New Zealand public health system is delivered from six District Health Boards - Auckland, Waikato, MidCentral, Capital and Coast, Canterbury and Southern.
Most cancer centres operate as integrated departments delivering cancer services across the following disciplines: medical oncology, haematology and radiation oncology. Linkages with hospital and community based palliative care teams are strong in all regions.
A multidisciplinary team approach is taken across all the major tumour types within the New Zealand public health system. Most departments have their own active research units to support participation in clinical trials.
Medical Oncology
The Medical Oncology Departments in New Zealand aim to provide excellence in medical oncology practice. There are generally a number of registrars attached to units, many of whom are advanced trainees in medical oncology. Training centres operate with full accreditation from the Royal Australasian College of Physicians.
Medical Oncology services are supported by a team of expert cancer nurses and allied health professionals. Chemotherapy is administered in both inpatient and outpatient settings for all solid tumour types including lymphoma. Senior Medical Staff also contribute to teaching programmes for both under graduates and those in post-graduate training in medicine and nursing.
Radiation Oncology
Radiation Oncology departments are generally accredited for training Radiation Oncologists, Medical Physicists and Radiation Therapists and are continuously developing their sites as a specialised service to improve patient care and enhanced training.
Facilities consist of a range of highly technical equipment including dual energy Linear Accelerators, kilovoltage units, brachytherapy suites, a simulator, wide-bore planning CT s and utilise up-to-date planning systems. Treatment offered includes prostate and gynaecological high dose rate brachytherapy, and IMAT (RapidArc, VMAT) external beam techniques are rapidly becoming available in most centres.
Nation-wide a national health target of 4 weeks from referral for treatment to start of treatment has been met. Current work continues to focus on shortening the patient journey.
Haematology
Haematology Clinics provide comprehensive haematological care to specific geographical areas. Services include supraregional autologous and allogeneic bone marrow transplant services and also deliver a comprehensive haemophilia care service as well as all of the routine areas of general and malignant haematology. The service is delivered by consultants and haematology registrars, with at least one affiliated with the New Zealand Blood Service. Some registrar positions are certified training posts for college membership.
Palliative Care
Hospital patients with advanced progressive disease are referred in growing numbers to hospital palliative care services for symptom control; psychosocial, emotional, spiritual support (including for family); complex discharge planning; ethical and decision making opinions/perspectives, and end of life care concerns. The majority of such patients have advancing cancer; 30% have non malignant conditions.
Emphasis is placed on appropriate integration of palliative care into all aspects of the acute hospital and community setting. Education and teaching at under and postgraduate level across disciplines is another major focus. Research initiatives add to the progressive and dynamic nature of these services.
