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We were engaged by the Grampians Integrated Cancer Services, in partnership with health strategy consultants from Foresight Lane, to design and facilitate a collaborative design forum.

Cancer is an illness to which nearly all of us hold a connection. Treatment is often marked by tremendous emotional strain as well as being physically taxing.

It is a time of incredible stress as people attempt to maintain professional and family commitments, make significant decisions and stay sane. For cancer patients in rural areas, it is often necessary to drive five or six hours to treatment.

Overview

Chemotherapy outreach services in the Grampians region was under a lot of pressure. Not only did a single clinician provide the majority of chemotherapy in the area, but they also had a high caseload and routinely travel long distances to see patients.

As cancer rates in the region increased, in step with an ageing population, the service provided by this clinician had reached capacity. As a result of limited services, many patients were forced to travel as far as Melbourne to receive care, while others opted for more radical treatments, such as surgery, to avoid treatment further from home.

Patients were suffering, and there was considerable risk in the chemotherapy outreach system – if the current clinician became ill, the region would be without a chemotherapy provider.

Regional Response

We were engaged by the Grampians Integrated Cancer Services, in partnership with health strategy consultants from Foresight Lane, to design and facilitate a collaborative design forum.

Our aim was to enable the region’s public and private hospitals, the Department of Health, the Grampians Medicare local, as well as individual medical practitioners, to come together and design a new chemotherapy outreach model for the region.

Together, providers needed to find a solution that would complement their existing chemotherapy service offering and scale to meet growing demand.

Stakeholders knew a new model was desperately needed, but there was no shared view on how to overcome a range of commercial, political and resource constraints.

In the past, efforts to recruit specialist clinicians has been a temporary solution, as doctors often return to the city or move to other areas. The best case scenario was that public and private providers could work together, distributing capability across the region, while satisfying both government funding requirements and commercial interests.

Designing the event

We brought together a group of sponsors to plan a two-day design forum.

Over a period of six weeks, we designed all aspects of the event - the participant group, the program of activities, individual activities themselves, the knowledge management process, the facilitation approach, the environment for working groups and the participant experience.

As we were bringing together a group of stakeholders – traditionally acting as commercial competitors – it was critical that the each member of the group could protect their personal interests while aligning around a common, system-wide solution to getting cancer patients in the region the services they needed.

Outcomes

Over the course of the two-day event, participants worked through their collective health capabilities and built a deep understanding of the growing demand for chemotherapy within the community.

By the end, service providers had sketched the components of a universally viable chemotherapy service model, that addressed both public and private interests, including a funding and workforce model.

After the event, we produced the new, integrated model of care, workforce model and funding model that was designed by the group.

Together, we had designed the first regional, integrated approach to chemotherapy services in Victoria.

Implementation

Each hospital and clinician in the system took away from the event a preliminary business case and proposal for the areas of their own practice or capability they needed to build.

Eight months after the event, the new integrated chemotherapy model was formally launched in the Grampians region. A new clinic opened at Horsham Base Hospital in partnership with Ballarat Base Hospital, the local oncologist and a newly recruited oncologist.

The first day the clinic opened it was fully booked with three new local patients and eight transfers from the private system, demonstrating the uptake of demand in the region and the desire for both public and private options. Both public and private providers exist in harmony, and the model has been used as a statewide example of public/ private partnership.

The Prime Minister travelled to Horsham to announce a one million dollar federal contribution to the chemotherapy program and a commitment to match community fundraising efforts which have currently reached $500,000.