GP CanShare - Enhancing Cancer Management in Primary Care with integrated cancer care

Who? Cancer impacts many peoples’ lives. The number of people living with and beyond, a cancer diagnosis is increasing significantly and they are faced with complex decisions, with treatment occurring across different settings. Shared cancer care can enhance system integration and service navigation for General Practice to better support cancer patients’ and their families’ needs (Cancer Australia, 2020). Engagement with co-design? CESPHN received funding to deliver a new cancer service to provide better integration of care between cancer services and primary-care. In consultation with partner Local Health Districts, St Vincent’s Heath Network, General practice and the patient and carer community, a shared care model was developed that involves integrated patient care between both primary and acute provides. CESPHN engaged Deloitte Access Economics for the evaluation that is occurring in real time alongside program implementation, centered around ongoing consultation with cancer services’, program advisory committee, GPs and community. What did we do? CESPHN commissioned three providers to deliver a co-designed service that aims to: Strengthen integration between cancer and palliative care specialists, community services and general practices. Enhance capability of general practice to effectively manage and care for their cancer patients. The GPCanShare service is being implemented across six major Sydney treatment centres. Specialised Cancer Nurse Coordinators and a Palliative Care Social Worker provide GPs and practice nurses regular updates on all aspects of their patient’s care, including clinical and supportive care, via their preferred communication method. Additionally, they encourage patients to see their GP regarding issues that can be managed in the primary-care setting: Information and support services; Symptom management; Referral pathways; Mental and emotional well-being. The impact? The data indicates CESPHN is currently achieving our goals with: 2000 patients currently enrolled in GPCanShare, with greater access to services based on their specific healthcare needs during cancer treatment, survivorship and palliative care. 800 GPs involved in GPCanShare, providing GPs a direct link to patients’ acute treatment teams. As a result of GPCanShare, patients are experiencing improved access to cancer services, highlighting the value of a novel integrated care approach that brings together clinicians in primary care and cancer services.  Key learnings internationally? The outcomes of co-design and collaborative cancer care demonstrate the value of establishing a shared agenda for integrated care. The achievements of GPCanShare demonstrate that we can improve the links between acute services and the often under-utilised component in a person’s cancer care - their local GP. Next steps? CESPHN will continue to advocate for ongoing funding for primary care to play an enhanced role in cancer management to embed integrated, patient-centered care across the primary, community and acute settings more broadly.  CESPHN will continue to work with local partners to ensure patients continue to benefit from integrated care with GP links to dedicated, specialist staff for information about their cancer treatment, survivorship and palliative care.  A cost benefit analysis of the program and further program enhancements will be implemented to enable GPCanShare to be utllised in cancer services throughout Austral