Reducing Inequalities

  • Work in 09/10 involves:
  • Demystifying Cancer Toolkit
  • Addressing inequalities pilot funding 08/09
  • Addressing inequalities pilot funding 09/10
  • Pacific Communities
  • Inequalities Project Forum 27th June 2011 - Wellington


    The Central Cancer Network hosted an inequalities project forum at the Horne auditorium at Wellington hospital on Monday 27th June 2011. This was an opportunity for the network to hear about the outcomes, learning’s, resources and ideas that were developed from each of the local cancer networks inequality project pilot funding. (click here to view the programme)

    The forum was well attended with over 60 in attendance including those from national organisations and other regional cancer networks. Attendees from the central region included the local cancer network managers, Māori providers, primary care providers, consumers, researchers and kaumātua.

    An excellent standard of presentations were disseminated by the presenters. These presentations featured two projects funded under the 2008 competitive process and 7 projects funded in 2009-10 for the Local Cancer Network projects and one Pacific project. Many of these projects were based around the “demystifying cancer workshops” however each of the projects were vastly different and were adapted to suit their local setting, needs and audience.

    The main purpose of the pilot funding was to reduce inequalities in regards to cancer in the central region.

    The strongest theme that ran through all of the presentations was around ‘collaboration’ especially with Māori and community groups. The benefits of providers combining to facilitate their projects echoed the aspirations of Whānau Ora. An outcome from the projects were either established or strengthening current relationships with other providers and Māori communities.

    Many of these projects will continue to be delivered as part of ‘business as usual’ highlighting the effectiveness of their projects to their communities.

    The project leads were asked to discuss whether they achieved the project goals. All of the presentations were unanimous in that they were beneficial to their communities and providers and that had achieved their project goals.

    The projects showed:

    §the benefits of collaboration by linking with other providers and using each others strengths, skills and networks

    • innovation and the ability to adapt to local needs
    • that it was a team effort and involved the local cancer network, Māori and community providers
    • an involvement of Māori in the cancer continuum by providing a forum for Māori to voice their concerns and to gain knowledge in an appropriate setting (i.e. marae)
    • that the learning’s gained from the project would inform and improve any further projects.

    The presentations and forum were summarized at the end of the day by Dr Nina Scott. She was overwhelmed by the projects that were presented. (her notes are included with the presentations). As well as summarizing the projects she also provided data about Māori priorities in regards to cancer as a possible point of focus in regards to any future projects.

    Funding for the next Inequalities projects will be delivered over the 2011-12 period and will focus on the three priorities of the Supportive Care Implementation plan.

    1. Coordination of care and support
    2. Psychological support
    3. Information support

    These projects will once again be led by the various local cancer networks.

    Central Cancer Network would like to acknowledge all of the individuals in the various project teams and to thank the presenters at the 2011 forum. A further thanks and acknowledgement to Ali Hamlin and Caren Rangi for their earlier work for CCN in reducing inequalities for Māori and Pacific and instigating these projects.

    We look forward to the next inequalities projects and to the next inequalities forum in 2012.

    “We have come too far not to go further, we have done too much not to do more”

    Na Sir James Henare

    Mauri Ora

    Reducing inequalities is one of the two dual goals of the NZ Cancer Control Strategy (Ministry of Health, 2003). The Cancer Control Action Plan 2005-2010 (Ministry of Health, 2005) outlines numerous actions with respect to reducing inequalities across the cancer control continuum to be undertaken at national, regional and district levels.

    Planning for the reduction of cancer control inequalities has previously been undertaken in an ad hoc manner based on historical trends, with inadequate coordination of services or funding.

    The need to better plan and to develop strategies to reduce inequalities in cancer control in NZ has been identified by the Cancer Control Council (CCC) in their report, ‘Mapping Progress’. The 2007 report notes that some progress has been made in the area of inequalities; however, it also acknowledges that, on a regional and national level, there is still much work to be done.

    In particular, the report has identified the need to reduce inequalities experienced by both Maori and Pacific people in the area of cancer control, both being populations whose incidence of cancer disease is much higher than that for the rest of the nation.

    The Government’s health policy allows for the expansion of cancer control services to better address the inequalities affecting certain
    demographic groups within the NZ populace. Developing a plan to tackle these inequalities will enable cancer networks to identify and focus on priorities at a regional level.

    In the Central Cancer Network area:

  • Māori have higher rates of cancer than non-Māori
  • the most common cancers for Māori are stomach and lung cancers
  • the most common cancers for Pacific people are breast and prostate cancers
  • there is a higher rate of cancer mortality for Māori in the Central Cancer Network area than for Māori nationally
  • malignant cancer is the highest cause of death for Māori and Pacific people
  • The reducing inequalities work programme objectives are to:

  • ensure programmes and services are accessible to Māori and Pacific people across the cancer care continuum
  • identify and focus on regional inequality priorities and initiatives
  • provide leadership via strategic plan development that will maximise opportunities to address inequalities
  • monitor and evaluate current and new initiatives aimed at reducing inequalities
  • Work in 2009/10 involves:

  • engagement with stakeholders at a district level to identify actions to improve engagement with Iwi/Maori
  • develop an engagement plan for contact with Pacific communities
  • complete and report on a stocktake of breast and cervical screening services in the region
  • work with stakeholders to identify and address issues of cultural competency across the cancer control continuum
  • work with providers of the addressing inequalities pilot funding project
  • work with Cancer Society Divisions and Centres to develop Maori responsiveness plans/frameworks
  • facilitate and support the development of Demystifying Cancer Programmes focussing on the needs of Maori and Pacific
  • assist the cancer Society and cancer service providers to develop processes to support the integration of Cancer Society support services into patient pathways
  • develop a care coordination framework and stocktake tool to assist districts to identify current care coordination coverage and opportunities for improvement.
  • Demystifying Cancer Toolkit

    A Demystifying Cancer approach brings together communities and cancer service providers in a series of workshops delivered in a community setting, to present on and discuss cancer, the cancer journey and cancer services.

    This Toolkit has been developed to support districts to plan, deliver and evaluate Demystifying Cancer workshops as one means of addressing inequalities in cancer control for those communities where there are high incidences of inequalities. In New Zealand, it is often the Maori community, Pacific communities and rural communities who experience such inequalities.

    The Toolkit assists organisations who wish to run a programme of Demystifying Cancer workshops to recognise the distinct needs, issues and approaches that work best for Maori communities, and for Pacific communities. However the principles that underpin the planning, delivery and evaluation of these workshops can be applied to any group that experiences inequalities in cancer control, such as rural communities.

  • Demystifying Cancer Toolkit
  • Recently Completed Activities

  • Hawkes Bay Engagement and Reducing Inequalities Discussion Document
  • Matatuhi Arahi Service Plan for Maori
  • Addressing Inequalities Pilot Funding 08/09

    As part of its Crown Funding Agreement with the Ministry of Health CCN receives funding to investigate and address systemic causes of cancer inequalities. CCN recognises the opportunity to work with organisations/ groups within the region to pilot innovative projects and as part of this work has allocated $73,000 in the 2008/09 budget to support two to three projects in the region that will investigate and/or pilot strategies to address systemic causes of cancer inequalities.

    CCN sought expression of interest from organisations within its area to receive pilot funding for addressing inequalities funding.

    The applications were scored against the published criteria and the following projects were selected to be progressed:

  • HVDHB / CCDHB - Pacific translations for patient information and service directory development
  • The HVDHB and CCDHB together with Wairarapa DHB launched the Cancer Service Directory in August 2010. The service directory has been well received and the work of the project team commended. This link will take you to the document.

  • Te Aitanga a Hauiti Hauora - Targeted approach to support increased BreastScreening rates in Tairawhiti
  • These projects are currently underway and are due to be completed early/mid 2010. It is expected that deliverables and/or learnings from these pilots will be transferable across the region. Overall investment in these three projects totalled $81K.

    One of the criteria of the projects is that the learnings of the project are shared with a wider audience.

    Addressing Inequalities Pilot Funding 09/10

    With respect to 2009/10 funding, the Governance Group have agreed an approach which supports local cancer networks by providing $10K one-off funding per district to identify and coordinate specific activities to address inequalities.

    The following criteria will apply to the funding:

  • The activity/ies is designed to address a clearly identified, existing cancer inequality/ies
  • The activity/ies aligns with existing cancer control policy, guidelines and/or best practice
  • The activity/ies is over and above those that have already been identified for funding in the DAP or service plans for 09/10
  • The local cancer network collectively supports the approach
  • CCN Management Team is satisfied that the proposed activity/ies will contribute to addressing inequalities and add value
  • By devolving this pilot funding to the Local Cancer Networks CCN is seeking to support the following outcomes:

  • Districts are supported to address identified inequalities
  • Local cancer networks are better supported to function effectively
  • Gains are made across the entire CCN region
  • Local cancer networks will be required to provide a brief report on the outcome of the activity/ies at their conclusion.

    More information

  • Reducing Inequalities in Cancer Control Fact Sheet
  • Pacific Communities

    The CCN Pacific Communities Stocktake Report has been completed and is available for your information and consideration in terms of the role that is played in reducing inequalities for Pacific people in cancer control.

    The purposes of this report are :

    1. To determine the make-up of Pacific communities within the Central region in order to identify potential groups, networks and specific communities to be engaged with
    2. To identify the extent of current strategies, programmes and activities in place aimed at reducing inequalities specifically for Pacific communities within health and the cancer control continuum, in order to identify initiatives that could be supported , or where there are gaps
    3. To identify specific information about Pacific peoples’ cancer incidence as one factor for prioritising key issues for Pacific people and cancer in the Central region

    The report makes recommendations regarding possible engagement processes that could be used across the region and in specific DHB areas, to support strong engagement between cancer services and Pacific communities, as well as specific projects for reducing inequalities. A number of Pacific community groups, Pacific health providers and individuals working within health services were identified during the compilation of the report, as potential stakeholders in the work to reduce inequalities for Pacific people in cancer control. One of the next steps from this work will be to have conversations with them to ascertain what roles they wish to play in this work.

    The draft Implementation Plan identifies initiatives for CCN and regional stakeholders to undertake progress the recommendations.

    Recently completed Pacific Activity

  • CCN Pacific Communities Stocktake Report
  • CCN Pacific Communities Projects Draft Implementation Plan
  • Last updated 4th August 2011

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