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Shared care key for cancer survivors: RACGP
A new college cancer survivorship position statement highlights the role of GPs in providing holistic and comprehensive care coordination.
Around two thirds of people who have survived cancer report that their ongoing healthcare needs remain unmet.
As Australia’s healthcare system continues to treat a growing population of cancer survivors, the RACGP has released a new position statement to ensure their ongoing and complex needs are met.
The Cancer Survivorship Shared Care position statement shines a light on the role of general practice in offering patient-centred management and care specifically for this cohort.
However, it states their healthcare needs continue to go unmet and that shared care within general practice is not well established for the management of cancer survivors.
‘Legacy models of cancer care are disease-centric and are focused on highly technical specialist care and monitoring for cancer recurrence, rather than whole-of-person centred care that provides ongoing wellness support,’ the position statement says.
‘Cancer survivor experience differs greatly between individuals, requiring tailored support across a wider range of health and community services.
‘Contemporary cancer policy recognises the need for shared care approaches in order to achieve this.’
According to the statement, GPs are well positioned to support cancer survivors through coordinating general medical care, as well as providing psychosocial support and preventive advice following treatment.
The statement goes on to call for:
- a collaborative, shared-care cancer survivorship model between patients, their GP and the general practice team, specialist cancer services, other healthcare providers and required community services
- workforce development and upskilling in cancer survivorship care
- remuneration for assessments, care coordination, and supporting survivors to access rehabilitation services
- IT to allow registries and reminder systems to be accessed by patients and team members
- system-wide evaluation of models of cancer survivorship shared care
- remote monitoring systems and flexible reimbursement for telehealth consultations.
Professor Mark Morgan, Chair of RACGP Expert Committee – Quality Care, worked on the position statement and said GPs have a critical role in providing longitudinal and coordinated care for their patients.
‘GPs don’t just focus on the cancer diagnosis and survivorship, we look after the person through acute illnesses, preventive care, mental health, and ongoing care of chronic diseases,’ he told
newsGP.
‘Once a plan has been established for a person’s cancer follow up, the more that can happen within GP teams, the better.
‘GP care can save patients the cost and inconvenience of travel. Sometimes specialist, follow up care is prohibitively expensive for patients, sometimes there are long delays accessing specialist care.’
The RACGP statement emphasises it does not support any model which results in care fragmentation by increasing the number of community-based health service providers offering initial access, assessment, triage, and diagnosis.
It also outlines specific barriers to this shared care, including time constraints, a lack of guidance for recommended timeframes for follow-up monitoring, workflow constraints, and generalists’ knowledge gaps.
‘Health professionals alone cannot bring about sustainable change without health system improvements to support them,’ the statement said.
It comes amid
evidence that holistic post-cancer care, and improvements in early detection and treatment can result in greater survival rates.
However,
up to two thirds of people who have survived cancer report that their ongoing healthcare needs remain unmet.
In this landscape, the position statement says GPs can also play a key role in the coordination of other medical care and prescribing, and ongoing preventive care, early detection of recurrence and rapid referral to specialist cancer services and managing fear of cancer-related distress.
However, Professor Morgan also offered a note of caution.
‘As a GP, if I am going to take over some of the monitoring of a person’s treatment or post cancer care it is important for me to be able to rapidly access specialist advice or even access a prioritised appointment for my patient when a problem develops,’ he said.
‘I certainly don’t want my patient to be at the back of a queue just because they do not have lifelong follow up appointments with the specialist.’
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