Prof Hui Gan and A/Prof Andrew Danks
The Brain Cancer 2020 Summit was the first summit to be held online during the second COVID-19 lockdown. Despite COVID, this was an extremely well attended event, both by clinicians and consumers, with the second highest attendance of any tumour summit to date. A new hybrid model had to be introduced in response to COVID but most who participated still rated the event very highly.
During the Summit, data and consumer presentations outlined an extensive set of data regarding patient care and outcomes to give a comprehensive picture of how care was delivered across the state. We were pleased that, overall, we found that patients were well cared for across the state with no major variations observed. Nonetheless, we were able to collective identify several areas where we could continue to improve care for patients.
The first area where we felt we could improve patient experience related to palliative care. Access to early palliative care prior to death was identified as of potential benefit. Palliative care offers a number of benefits to consumers beyond end-of-life care, such as better symptom management, respite for carers and consumer autonomy in planning ahead. For consumers with poor prognosis, early palliative care may provide particularly enhanced benefits. If patients are truly 'early', then for many, care will be best delivered in outpatient palliative care, and scoping of these services would be beneficial.
A second area to explore regards time from surgery to post-operative radiotherapy. The optimal care pathway recommends patients’ radiotherapy be received within four-six weeks post-surgery. Variation up to eight weeks post-surgery for patients receiving radiotherapy was evident for patients from regional/rural areas. Action is proposed to look at faster referral for patients repatriated to regional areas for radiotherapy. Further clinical investigation is also needed about whether four-six weeks to radiotherapy impacts patient outcomes.
Thirdly, there was also variation identified in data regarding length of stay for surgery and biopsy admissions. Longer hospital stay impacts bed availability, funding and patient experience. As such, we propose to investigate this variation in length-of-stay with a view to reducing the number of people with brain tumours and a hospital length-of-stay greater than seven days following surgery.
We were particularly pleased at the strong consumer interest in and contribution to the Brain Cancer 2020 Summit. In particular, consumers identified coordination of care as an area for improvement, especially for patients with a mix of public/private and metro/regional service delivery. This is the fourth prioritised variation from the Summit. Regional referrers participation in MDM discussions of their patients, particularly in the context of repatriated regional consumers for post-surgery treatment and care, is recommended to improve coordination of care. Formalisation of referral pathways is recommended.