Terms of Reference of the
National Breast Cancer Working Group
Background and context
Timed, effective pathways based on tumour specific quality standards ensure
that:
 patients receive timely and good quality care throughout their cancer journey
 patients receive the same standard of care regardless of where they live
 efficient and sustainable best practice management of specific tumour types
is developed in the New Zealand health system
 a nationally coordinated and consistent approach to service provision for the
tumour type is promoted.
Tumour standards are needed to guide service provision as DHBs work to
implement the Faster Cancer Treatment (FCT) wait time indicators. The primary
purpose for developing these indicators is as a mechanism to inform and drive
service improvement for timely access to health services and ultimately to
improve patient outcomes for:
 patients referred with a high suspicion of cancer
 patients diagnosed with cancer.
The Cancer Treatment Advisory Group (CTAG) agreed at its 16 November 2011
meeting that tumour-standards and pathways were required to mitigate the risk of
patients receiving poor quality care in order for services to meet the timeliness
measures associated with the FCT indicators.
Tumour specific national standards have already been developed for lung cancer
in the Standards of Service Provision for Lung Cancer Patients in New Zealand,
published in August 2011. The lung cancer standards were developed by a
clinical work group, chaired by a clinical chair. This work group and clinical chair
are supported by a lead regional cancer network (RCN). The RCNs have
demonstrated expertise in facilitating and supporting regional DHBs to
collaborate; and supporting clinical work groups to complete national work with
regional representatives. CTAG noted at its meeting on 16 November 2011 that
the lung cancer standards have already made improvements to service delivery
and clinical practice. It also agreed that this success highlights the importance of
nationally developed tumour standards and pathways, and supports the need to
develop these for other tumour types.
The eight national cancer working groups being established for one year to
develop tumour standards, patient pathways and a service framework to support
the FCT approach are:
Breast (Midland Cancer Network); Bowel (Southern Cancer Network); Head and
Neck (Northern Cancer Network); Melanoma (Northern Cancer Network);
Gynaecological (Southern Cancer Network); Upper Gastro-Intestinal (Northern
Cancer Network); Haematological (Central Cancer Network); Sarcoma (Northern
Cancer Network).
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Purpose
1. Develop national breast cancer service standards. Breast cancer service
standards are needed to guide service provision and promote uniform
standards of service provision across New Zealand as DHBs work to
implement the indicators. This will ensure the development of efficient
and sustainable best practice management of specific tumour types in
New Zealand health system, and promote a nationally coordinated and
consistent approach to service provision for the tumour type.
2. Develop breast cancer patient pathway and service framework. The
patient pathway algorithm describes the journey. The service delivery
framework describes the required infrastructure to achieve the standard
e.g. care coordination resources.
Membership
1. The National Clinical Director of Cancer and the regional cancer network
clinical directors have identified the interim chair for the group.
2. The Chair of the National Breast Cancer Working Group (Working Group) will
be confirmed by the members of the Working Group. The Chair will be
appointed for a one year term.
3. Membership of the Working Group will focus on required clinical expertise,
ensuring that professional disciplines, geographical coverage and the
continuum of representatives are included. The following disciplines should
be considered in the membership of the work group:
 Chairs of any regional breast cancer working groups, if established
(who can also be one of the specialties listed below)
 Relevant physicians, surgeons
 Radiation Oncologist
 Medical Oncologist
 Clinical Nurse Specialist
 Radiologist
 Pathologist
 Regional Cancer Network Clinical Director (optional)
 Primary Health representative
 Palliative care
 Research
 Public Health
 Relevant NGO representation
4. Ministry of Health to be ex-officio
5. Membership of the work group will be for one year.
6. To ensure consumers/carers are involved in the process of developing these
guidelines each network will utilise its own regional consumer/carer reference
group to provide input into the process
7. To ensure Māori are involved in the process of developing these guidelines
each network will utilise its own regional Māori reference group to provide
input into the process
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8. To ensure that an equity focus is applied in a uniform way, a Health Equity
Assessment Tool (HEAT) analysis will be undertaken against each of the
standards by the Equity Manager in each network. Networks will engage with
the National Māori Leadership Group through this process.
Meetings
9. The work group will meet as required by the project timelines either face to
face or by teleconference.
Funding
10. Funding for the National Breast Cancer Working Group is for 2012/13. Any
ongoing provision for the group is dependant on MOH prioritisation
11. The National Breast Cancer Working Group is not a fund holding
organisation.
Support
12. The Midland Cancer Network has been contracted by the Ministry of Health to
host this national work group until 30th June 2013. This contract provides
funding for the Clinical Lead, meeting activities and part-time project support.
13. Travel costs and time will be funded through the representative’s employer for
employees. The Midland Cancer Network has a limited budget to support
travel and appropriate costs for unfunded representatives. Approval will be at
the discretion of the cancer network manager. Any expenditure needs to be
approved before it occurs.
14. A national primary breast cancer stakeholder database will be developed and
maintained by the National Breast Cancer Working Group secretariat
(Midland Cancer Network).
15. A communications plan will be developed and maintained to ensure that there
is appropriate and timely communication to stakeholders and strong links with
other national and regional tumour stream work groups.
Reporting
16. The National Breast Cancer Working Group will provide its final drafts to the
Cancer Treatment Advisory Group and via this process to the joint DHB/MoH
Cancer Programme Steering Group.
17. The National Breast Cancer Working Group will also report back to its various
stakeholder groups and organisations on progress.
Conflicts of Interest
18. Members will comply with the Ministry’s Conflicts of Interests Policy; and
perform their functions in good faith, honesty, impartiality, and avoid situations
that may compromise their integrity or otherwise lead to conflicts of interest.
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Members will be required to complete the Ministry Declaration Form prior to
their first meeting (Appendix One). The Ministry will hold the declaration
forms.
19. When members believe they have a conflict of interest on a subject which will
prevent them from reaching an impartial decision or undertaking an activity
consistent with the advisory group functions, then they must declare a conflict
of interest or absent themselves from the discussion and/or activity.
20. Members shall make all reasonable endeavours to support the National
Cancer Programme, with the exception of areas where a conflict of interest
has been noted.
Media
21. The Chair will provide the Ministry with advance notice of any media
statements. Media statements will be made by the Ministry. Interviews are
given only by Ministry authorised media spokespeople. The Chair may be
asked to brief a spokesperson on an issue prior to interview.
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Appendix One
Declaration Form for Candidates on Committees, Boards, Advisory Groups
Name:
Committee / Board / Advisory group: National Breast Cancer Working Group
Responsible Manager: Jan Smith, Midland Cancer Network
To ensure the Ministry of Health can act with integrity and transparency, all members
/ candidates for committees, boards or advisory groups are required to identify and
declare any actual, potential or perceived conflicts of interest that may impact on their
role.
Declaration
If you are aware of any actual, potential or perceived conflicts you must discuss this
with the relevant Chairperson and / or responsible manager and complete a standard
Ministry of Health Conflict of Interest Declaration in addition to this declaration.
Any breach of the Ministry’s Conflicts of Interest rules and guidelines will be a breach
of your obligations to the Ministry.
1
I have read and understand the Ministry of Health Conflicts of Interest
rules and guidelines and related material
Yes/No
2
I have no interests that would potentially impact on my obligations to
the Ministry in the role applied for
Yes/No
3
I will notify the manager of any actual, potential or perceived conflicts
of interest that may arise, or that I become aware of, while I am a
member of the committee, board or advisory group
Yes/No
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