Cancer Care Services

Last updated: 27 February 2008

The redevelopment of Royal North Shore Hospital will deliver new purpose-built facilities for the care of patients with cancer.

Here are the answers to some frequently asked questions about the service.

• Are there fewer beds for cancer patients?
• Why will the cancer ward and cancer outpatients be separated?
• Will the new RNS facility include a comprehensive cancer centre?
• How is the new cancer service being planned?
• What accommodation is being provided for carers?
• Are breast cancer services moving to Hornsby?
• What is a comprehensive cancer centre?
• What is a multidisciplinary team?
• Why is patient-centred care important?
• What is the NSW Cancer Plan about?

Are there fewer beds for cancer patients?

The existing cancer inpatient beds are made up of 19 oncology beds and 21 combined haematology/ renal (non cancer) beds. The new hospital will provide a minimum of 30 dedicated oncology and haematology beds. There is also capacity to draw on beds in other areas if there is unusually high demand.

Why will the cancer inpatient ward and outpatients area be separated by several floors?

The new hospital design puts the patients' needs first and one of the key planning elements is to reduce travel time in the hospital by locating related services near each other wherever possible. As the new hospital needs to accommodate more than 70 departments, this may mean locating related or shared services on the same floor, or above or below, to create the most efficient design.

The Cancer Care Centre for outpatient treatment will be located on the ground floor (level 3), with easy access for outpatients. A dedicated patient/staff only lift to the inpatient unit will provide easy access for doctors and other staff who need to work in both areas from time to time.

Will the new RNS facility include a comprehensive cancer centre?

Yes. As part of the $732 million redevelopment of Royal North Shore Hospital a Cancer Care Centre will provide a comprehensive range of services including day oncology/haematology and radiation oncology to patients diagnosed with all varieties of cancer including breast cancer. We will continue to provide a patient-centred service with appropriate co-locations and integration of services, whether this is in the current hospital or in the future new hospital building. We are fully committed to ensuring that patients receive the best possible care in facilities which not only comply with Government policy but, more importantly, reflect the needs of our patients and the staff who care for them.

How is the new cancer service being planned?

Providing exemplary care and treatment to cancer patients is at the heart of Northern Sydney Central Coast Health (NSCCH) cancer service planning. The NSCCH Cancer Services Network, a group of senior clinicians who provide cancer services, is working on the design of cancer service provision in the Northern Sydney area as well as across Northern Sydney Central Coast Health. Consultations with doctors, nurses and allied health professionals are ongoing. Final facility options are still being considered.

What accommodation is available for carers of cancer patients?

Carers are now accommodated in nearby budget accommodation, at no additional cost, close to RNS at the Greenwich Inn. Since relocating from Rotary Lodge, many carers have commented on the improved amenity offered in these commercial premises. We recognise that the sort of accommodation Rotary Lodge traditionally provided is a vital part of the acute services at RNS. This type of accommodation will be provided on site in the final redevelopment.

Are breast cancer services moving to Hornsby?

Surgical services across the Area Health Service are currently being reviewed with clinicians. No decision has yet been made on the delivery of breast cancer surgical services, but we will inform all stakeholders as soon as decision is made. An earlier proposal to move breast cancer surgery to Hornsby Kuring-gai Hospital has been ruled out.

What is a comprehensive cancer centre?

A comprehensive cancer centre is usually understood to be a facility offering a comprehensive range of services for cancer assessment, treatment and follow-up care. The latest health planning models advocate a "one stop shop'' approach, with services planned on a model that puts patients' needs first.

Where they can be purpose-built, the ambulatory component of the service may include clinics and rooms for assessment, treatment and follow-up, facilities for day care (for instance, for chemotherapy) and a satellite pharmacy for medications and chemotherapy treatment. Other therapies, such as physiotherapy, occupational therapy and social work, are usually offered within the centre reflecting a team approach to patient care. Diagnostic imaging (such as X-ray, MRI and PET scanning) is usually located as close as possible to the cancer services for easy patient access.

A centre is usually located in a major metropolitan referral or principal referral hospital.

At RNS, the service will include ambulatory and inpatient cancer care, appropriately co-located with associated services such as diagnostic imaging and radiology, in one physical facility - the new main hospital building. Ambulatory services will be located in a welcoming, less clinical environment close to an entry point for easy patient access; in-patient services will be more appropriately located on the highly-serviced acute care floors on the upper levels. It also supports the multidisciplinary model of care by providing an appropriate range of facilities for case conferencing, research, and sharing knowledge and resources.

What is a multidisciplinary team?

A multidisciplinary team is a group of various health professionals who will use a team approach to decision-making regarding treatment planning, and other aspects of care for individual patients. Within the centre, your cancer care team may include a specialist oncologist, surgeon, medical oncologist, radiation oncologist, pathologist, clinical nurse consultant, clinical psychologist, social worker, physiotherapist or social worker, depending on your case. Case conferencing and joint consultations take place to ensure patients get the best possible care. The aim is to bring the latest cancer data, guidelines and research within each multidisciplinary team meeting. The NSW Government's NSW Cancer Plan 2007 - 2010 states that, by 2010, cancer practice in NSW should include wider use of multidisciplinary teams and more comprehensive patient support provided by skilled cancer professionals.

Why is patient-centred care important?

Satisfaction with care has two dimensions - one has to do with technical excellence - the skill and competence of professionals and the ability of equipment, procedures and systems to accomplish what they are meant to accomplish reliably and effectively. The other dimension relates to the subjective experience - the patient's perception of illness or well-being and their interactions with the healthcare system. In health care it is the quality of care provided in this subjective dimension that patients experience most directly. Any health system must address both technical excellence and quality of care. This can be expressed as "patient-centred care". Source: A Clinical Service Framework for Optimising Cancer Care in NSW, NSW Health 2003.

What is the NSW Cancer Plan?

The second NSW Cancer Plan is a clear commitment by the NSW Government to further reduce the devastating effects of cancer in our community. It continues the successful approach of the first NSW Cancer Plan and will consolidate many of the programs already delivering benefits. The NSW Cancer Plan 2007-2010 will focus on five high priorities most likely to improve cancer results.

These are:

· Priority 1 Preventing cancer

· Priority 2 Detecting cancer early

· Priority 3 Improving cancer services and professional education

· Priority 4 Accelerating improvement through research

· Priority 5 Relevant data and information

Planning for cancer services at RNS is informed by the NSW Government's Cancer Plan 2007 - 2010. For more information about the cancer plan, visit http://www.health.nsw.gov.au/cancer_inst/index.html.