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  1. 1. Dr Jerome Coffey MD FRCPI FRCR FFRRCSI Interim Director, NCCP National Healthcare Conference Dublin, May 28th 2015 Cancer 2020
  2. 2. Challenges Solutions Strategy Action
  3. 3. The Challenge Dr Susan OReilly MB, FRCPC, FRCPI Photo courtesy of David Branigan, Oceansport
  4. 4. Cancer Projections for Ireland 20152040 2015 2020 2025 2030 2035 2040 % increase 2010 -2040 Females 14322 16172 18202 20295 22368 24287 84% Males 17008 19692 22658 25775 28855 31704 107% Total 31330 35864 40860 46070 51223 55991 97% www.ncri.ie
  5. 5. Email: nicr@qub.ac.uk Tel: +44 (0)28 9063 2573 Website: www.qub.ac.uk/nicr 0 5 10 15 20 25 30 1 2 3 4 5 Deprivation QuintileEASRper100,000 least deprived most deprived Lung Cervix Stomach Deprivation & Cancer
  6. 6. Global surveillance of cancer survival 19952009: analysis of individual data for 25676887 patients from 279 population-based registries in 67 countries (CONCORD-2) Claudia Allemani, PhD, Hannah K Weir, PhD, Helena Carreira, MPH, Rhea Harewood, MSc, Devon Spika, MSc, Xiao-Si Wang, PhD, Finian Bannon, PhD, Jane V Ahn, MSc, Christopher J Johnson, MPH, Audrey Bonaventure, MD, Rafael Marcos- Gragera, PhD, Charles Stiller, MSc, Gulnar Azevedo e Silva, ProfMD, Wan-Qing Chen, PhD, Olufemi J Ogunbiyi, ProfFWACP, Bernard Rachet, FFPH, Matthew J Soeberg, PhD, Hui You, MAppStats, Tomohiro Matsuda, PhD, Magdalena Bielska-Lasota, ProfMD, Hans Storm, MD, Thomas C Tucker, ProfPhD, Michel P Coleman, ProfFFPH The Lancet Volume 385, Issue 9972, Pages 977-1010 (March 2015) DOI: 10.1016/S0140-6736(14)62038-9 Copyright 2015 Allemani et al.
  7. 7. Revealed: Irish cancer survival rates lowest in Europe 03:55, 19 April 2015 by Susan Mitchell Cancer survival rates in Ireland are amongst the lowest in Europe, new figures show. The figures were laid bare in a major global report that represents the most comprehensive international comparison of cancer survival to date. Cancer survival rates for common cancers including breast cancer, cervical cancer, ovarian cancer and rectal cancer were the lowest of all comparable 16 countries examined by this newspaper. http://www.businesspost.ie
  8. 8. The unsolvable mystery of our low cancer survival rates 03:55, 19 April 2015 by Susan Mitchell Millions have been invested in cancer care in Ireland, but we continue to lag behind the rest of Europe on survival rates. Despite the efforts made by successive governments, the National Cancer Control Programme and the HSE to raise cancer survival rates, Ireland has failed to catch up with other European countries http://www.businesspost.ie
  9. 9. Irish government deficit compared to other European countries and the US wikipedia.org/wiki/European_debt_crisis
  10. 10. http://www.tradingeconomics.com/ireland/government-debt-to-gdp
  11. 11. Cancer Drug Expenditure 0 50,000,000 100,000,000 150,000,000 200,000,000 250,000,000 2009 2010 2011 2012 2013 2014* Hospital Community
  12. 12. Solutions
  13. 13. Cell 161, 1215-1228, May 21, 2015
  14. 14. Slide 18Copyright Evinance Innovation Inc. 2015 Our platform reduces costs & improves quality by enabling evidence-based decision making May 2015 contact: chad.armstrong@evinance.com
  15. 15. Slide 19Copyright Evinance Innovation Inc. 2015 Evinance Workflow Adherence Decision Support Clinical Trials Guidelines Patient Data EHR CIS
  16. 16. Slide 20Copyright Evinance Innovation Inc. 2015 Clinical Consult Note
  17. 17. Slide 21Copyright Evinance Innovation Inc. 2015 Prompts
  18. 18. Slide 22Copyright Evinance Innovation Inc. 2015 Recommendations
  19. 19. Slide 23Copyright Evinance Innovation Inc. 2015 Real-Time Dashboards
  20. 20. Slide 24Copyright Evinance Innovation Inc. 2015 Patient Paths Pt. X
  21. 21. Strategy
  22. 22. Cancer surgery delivered in 32 hospitals Low volumes, poor outcomes, cancer scandals: delayed Dx / Tx Lack of focus on Primary Care and patient pathways No co-ordinated national plan for screening, surgery, radiation, medical oncology Eight Autonomous Health Boards Small health boards did not have the population to support specialist cancer services Some health boards had 3 or more competing hospitals of equal size and status Delays in service developments Prior to 2006 slide courtesy Dr. Marie Laffoy
  23. 23. Ireland will have: A system of cancer control which will reduce cancer incidence, morbidity and mortality rates relative to other EU 15 countries by 2015 A network of equitably accessible state-of-the-art cancer treatment facilities. We will become an internationally recognised location for education and research into all aspects of cancer. Irish people will know and practice health- promoting and cancer preventing behaviours and will have increased awareness of and access to early cancer detection and screening. 2nd National Cancer Strategy slide courtesy Dr. Marie Laffoy
  24. 24. 2015
  25. 25. National Cancer Strategy 2006: A Strategy for Cancer Control in Ireland Evaluation Panel Report Warde et al
  26. 26. The NCCP will continue to implement the strategy for cancer control and to plan, support and monitor the delivery of cancer services nationally. Top 5 in 2015 1. Audit, Quality & Risk Forums: Breast, Lung, Prostate & Pancreas 2. National Medical Oncology Clinical Information System 3. Launch of Breast and Prostate cancer evidence-based clinical practice guidelines 4. Partnership with National Cancer Screening Service 5. Pilot single KPI for wait times for elective cancer surgeries
  27. 27. Developments 2015 Priority posts: 1. National Lead Hereditary Cancer Service, NCCP & SJH 2. Medical Oncologists x 2 3. Specialist Oncology Nurses (CNS/ANP level) x 2 4. Urologist x 1 (S/SW Hospital Group) 5. Second Paediatric Radiation Oncologist, SLRON & OLCHC
  28. 28. Funded Service Developments 2015 (2) Capital: 1. Additional linear accelerators x 2, St. Lukes Hospital 2. Initial planning and design work, St. Lukes Centre at Beaumont 3. Cross-border project in Altnagelvin Community Oncology: 1. Support and deliver cancer education and training programmes. 2. Pilot and Implement a Survivorship Patient Treatment Summary and Long-term Care Plan
  29. 29. Medium & Longer Term Data Culture: Quality & Outcomes Centralisation of Surgical Oncology* Expansion of Medical Oncology Radiation Oncology in Altnagelvin, Cork, Galway & Dublin National Oncology Drug Management System (estd. 2011) Oncology Medication Safety Review (estd. 2014) NCCP Alignment with Clinical Strategy & Programmes Division NCCP Alignment with Hospital Groups, CHOs Molecular Diagnostics Strategy
  30. 30. The Next Ten Years Plan for growth in incidence, prevalence & complexity Resolve the gaps in clinical and allied health staffing Invest in molecular diagnostic and personalised medicine Emphasise research, innovation and productivity Foster prevention and screening Focus on survivorship