Country cancer services
Country cancer services are an integral part of the statewide cancer services, providing access to treatment outside of metropolitan hospitals and facilitating care closer to home for many country patients.
There are 15 chemotherapy units in hospitals across country South Australia. Each unit has between one and six chemotherapy chairs, with 65 chairs in total across country South Australia. Staff are trained and accredited to administer chemotherapy treatment and other supportive services for cancer patients such as chemotherapy education and central venous access device maintenance. The units are also equipped with Digital Telehealth Network facilities so that some medical appointments may be held with specialists based in metropolitan Adelaide without the requirement to travel.
Chemotherapy units in SA Health are classified as low, medium or high complexity based on the services available at that site. Up until recently, the chemotherapy units at Whyalla, Mount Gambier and Port Pirie have been the only country sites classified to provide medium and low complexity chemotherapy for common cancers in stable patients, while those at Ceduna, Clare, Gawler, Kangaroo Island, Mount Barker, Murray Bridge, Naracoorte, Port Augusta, Port Lincoln, Riverland, Victor Harbor and Wallaroo have been classified to provide low complexity chemotherapy for common cancers in stable patients only.
The chemotherapy unit at the Whyalla Regional Cancer Centre
Since the units opened, chemotherapy activity has increased significantly, with a 70% increase in activity in country South Australia reported over the last five years.
In July 2017, Country Health SA engaged Professor Dorothy Keefe, an experienced medical oncologist, to provide advice on how to ensure the country cancer services continue to be accessible, safe, high quality and provided in an efficient and sustainable manner. Professor Keefe undertook a series of site visits and meetings with key stakeholders and staff.
In October 2017, Professor Keefe provided a report to Country Health SA providing a series of recommendations based on the themes that emerged during consultation. These themes included funding, staffing and the complexity level classification of chemotherapy units.
Expanding Country Cancer services
In September 2018, as part of the budget for 2018-19, the State Government announced additional operating funding of $6.9 million over four years for Country Health SA to deliver additional chemotherapy services in regional areas, along with $5 million in funding for SA Health to implement a statewide
chemotherapy prescribing system (ECPS).
Country Health SA has developed a plan to expand country cancer services, which will be implemented in stages over four years, and includes the following actions:
- Employ additional staff to support the operation of the chemotherapy units, including more medical oncologists, clinical pharmacists, cancer care coordinator nurses and administration staff, enabling activity levels to increase.
- Double the number of medium complexity country chemotherapy units, from three to six, by transitioning the units in the South Coast District Hospital in Victor Harbor, the Riverland General Hospital in Berri, and the Port Lincoln Health Service to medium complexity units. This will result in each of the new regional local health networks having a medium complexity unit, ensuring equity of services across regional South Australia.
- Pilot a GP oncologist role in consultation with rural GPs. This will involve a rural GP advanced training program in medical oncology where one or more GPs will support country chemotherapy units, with additional support and supervision from a medical oncologist available via the Digital Telehealth Network.
Building the capacity of staff to support the operation of the country chemotherapy units will require recruitment, training and statewide clinical support, and will be a progressive piece of work. However, significant progress has already been made in achieving the objectives of the plan:
- Country Health SA has employed more medical oncologists, including Professor Sankha Mitra, who has been appointed as Clinical Director of Cancer Services. Professor Mitra spends two days a week working at the regional cancer centre in Whyalla, while Dr Dagmara Poprawski spends two days a week working at the Mount Gambier and Districts Hospital. Previously Dr Poprawski had spent three days a fortnight at each site. Dr Rachael Chang has been employed to provide services in the Port Pirie Regional Health Service and Riverland General Hospital and Dr Anna Mislang has been employed to provide services in the South Coast District Hospital.
- New cancer care coordinator nurses have commenced at the Port Pirie Regional Health Service and South Coast District Hospital, and recruitment is underway for a cancer care coordinator nurse at the Riverland General Hospital.
- Administration staff have commenced at the Whyalla, Mount Gambier and South Coast District Hospital chemotherapy units, and recruitment is underway for administration staff at the Riverland General Hospital and Port Pirie Regional Health Service chemotherapy units.
- A clinical practice consultant has commenced to support country cancer services.
- Additional pharmacy staff will be provided to SA Pharmacy to support country cancer services.
A successful trial of medium complexity chemotherapy has occurred at the South Coast District Hospital in partnership with the Flinders Centre for Innovation in Cancer. This increases the cancer treatments available at the South Coast District Hospital, which is great news for members of the local community.
Former South Coast District Hospital patient Helen (right), with Associate Nursing Unit Manager Belinda Pederick (left)
Helen (pictured above) is one of the people who have already benefited by being able to receive her chemotherapy treatment at the South Coast District Hospital. She shares her story in the video below.
Accessing country cancer services
Like Helen, you may be able to receive all or part of your cancer treatment in a country chemotherapy unit.
A number of country chemotherapy units have a visiting medical oncologist, or have access to a visiting medical oncologist at a site nearby, providing high-quality specialist cancer services.
If you would like to consider this option, please speak with your GP or current specialist about the possibility of being referred to a country medical oncologist.
For more information about the services available near you, call Ellie Seiboth, Manager, Country Cancer Services, on (08) 8226 6603 or email Ellie.Seiboth@sa.gov.au