SWS LHD Health Planning: Strategic Cancer Services Development

This report provides a comprehensive overview of health services and facilitates planning for cancer within the Australian South Western Sydney Local Health District (SWS LHD). It begins with an introduction to cancer as a global health concern, highlighting the disparity in treatment outcomes between high and low-income countries. The report includes an environmental scan identifying external factors influencing cancer rates, a needs assessment, and a service profile within the LHD, detailing facilities, services, and role delineation levels. It also discusses the model of care, current inpatient and outpatient activity levels, and catchment profiles. A situational analysis identifies strategic issues and priorities, leading to future service profile recommendations. The report emphasizes the importance of demographic analysis, health determinants, and morbidity/mortality data in developing effective cancer control strategies and concludes with overarching recommendations for improving cancer services within the SWS LHD. Find more solved assignments and resources on Desklib.

Health Services and Facilitates Planning
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Executive summary
Cancer as a global concern, that is captivating the world with its second highest rates of
morbidity, whereas treatments are less active and expensive in regard to general population.
Though higher income countries are still managed to survive from this burning situation with
innovative techniques and methods but whereas people of lower income countries are failed to
deal with the situation. This particular report in the light of the Australian SWS LHD protocol is
about to brings up the course knowledge and experience in demographic overview as well as its
control over the death rates are discussed in this contextual aspect. The approach of thestrategic
and healthcare service plan are discussed in this report and the updated health care guidance are
also discussed in this regard.
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Table of Contents
Introduction......................................................................................................................................4
Environmental Scan / Identification of external factors in Cancer..................................................6
Needs Assessments..........................................................................................................................9
Service profile within LHD.............................................................................................................9
Facilities.........................................................................................................................................10
Services..........................................................................................................................................10
Role delineation levels...................................................................................................................10
Model of care.................................................................................................................................11
Current inpatient and outpatient activity levels.............................................................................11
Catchment and reverse catchment profile......................................................................................12
Situational analysis- strategic issue and priorities.........................................................................12
Future services profile by facility & across the LHD....................................................................13
Overarching recommendations and conclusions...........................................................................13
References......................................................................................................................................14
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Introduction
Abnormal growth or un-necessary growth of cells in a particular region of a physiological system
developstumor and proliferate to the different parts of the body via blood or lymphatic drainage
leads to necrosis followed by metastasis and then cancer. Unwanted proliferation of cells occurs
due to uncontrolled celldivision. The molecular basis implies that sudden failure of the cell cycle
checkpoint proteins leads to cause cell division in an uncontrolled way followed by growth of
tumorsotherwise those unwanted cells will get damaged or destroyed by apoptosis. Cell cycle
inhibition ata certain point may lead to resist the development in cancer. Though there are
several genetic over view hasbeen established for this disease but the actual reason of cancer and
its treatments are still unknown. There are several types of cancer present in vivo which are
given in the following figure.
Figure 1: Types of cancer in Human body
(Source: worldpopulationreview.com, 2018)
These all are very common types of cancer that are prevalent in the world with valid dominance.
Cancer cells are physiologically not irregular from the normal cells but functionally they are
extensively different from the normal cell. Comparative analysis of the cancer as well as normal
cells are given in the under mentioned figure (2).
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Figure 2: Contrast between normal and cancer cells
(Source: website.aub.edu.lb, 2018)
Causative agents or reasons of causing cancer are not that much known by the physiologists and
clinicians but still there are lots of identified factors are in trial of discussion. Amongst all these
reasons mutation in the genetic sequence is forced to be considered as the most dominant one
that initiates the carcinogenesis(Sreeramareddyet al. 2018). There are lots of mutagens or
carcinogens present around all over the world but amongst the few are said to be the popular
ones, which are coined in the following list.
Figure 3: List of dominant carcinogens or mutagens.
Created by researcher.
On the contrary it is not enough to explain cancer in a single context as because of its variety of
reasons. Whether its genetic, external factors like if any person get contaminated with any of the
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external toxins because of profession or habitrelated etc. Whereas, immune suppression can be
another vivid reason of cancer. Epidemiologically it is till date one of the biggest threats to the
mankind, which is still not treatable rather curable completely. This particular report is basically
focused in knowing about the epidemiological aspects of this disease, especially in a nation like
Australia.
Environmental Scan / Identification of external factors in Cancer
Though cancer is a global concern now a days so prevention in this regard is highly required at
this part. Different health promotions and awareness programs organized at different parts of the
world, so as in a study of Alberta Parmar & Taylorexpressed that breast, colorectal and cervical
cancer screening and health promotion has been started since 2009. Similarly, in a study of
environmental screening regarding cancer has been done by Ericaet al., (2018), to collaborate
clinical cancer genetic s setting with environmental scanning process for better prevention.So,
there must be policies & planning in respect to demographic analysis, also the health
determinants to be identified, prevalent population who are suffering from this disease must be
analyzed and relevant ratio of mortality and morbidity is also needed to be analyzed.
a) Policy and planning framework (Demographic analysis):Every sixth death in the
world is occurred due to cancer (World in data, 2018). Demographic records imply
that more than half of the population in United States are addicted towards alcohol,
which includes 56% of the adults amongst them 67% increase the level of normal
metrics limit which has been given by APHA (American Public health Association).
So, the budding threat do not get reduced with such terms and policies that are
implemented by the association of America, as a result severe harm used to get occur
in their demography. So as in Australiain in every four males as well as in one
woman in every 6 women are suffering from cancer now these days. Whether it is
creating a substantial effect upon the major populated region of the country. Cancer
council of Australia includes precancerous patients should go for the cervical lesions
if necessaryprimary preventions are given to them by means of changing behavioral
patterns and lifestyle (2018).
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b) Determinants of health: In this case the food habits or the preferred lifestyle which
are needed in concern to prevent the disease has to be considered as the health
determinant of the following disease. Though there are no such assurancefound in
having a specific diet to reduce chances of cancer occurrence but still eating plenty of
fruits and vegetables in basic diet are good to prevent. Whereas whole grains and
beans can be also added as an extra beneficiary diet. Addiction free life may also
reduce the chances of cancer as good health determinant habits.
c) Burden of Disease data for the selected population:Mostly 70% of the low and
middle incomer countries are affected in cancer, according to WHO report 2018. The
most cancer affected countries are shown in figure 4. The reason behind those
occurrences can be anything. Behavioral and dietary risks come at first then 22% of
the total population get dies due to tobacco consumption in those countries. About
26% of affected people dies in late prognosis of the disorder. But in higher income
countries very low cancer can be treated and get diagnosed in a proper stage due to
healthier techniques facility etc.
Figure 4: Shows the cancer prevalent population in global aspects.
Source: worldpopulationreview.com, 2016
d) Relevant morbidity and mortality data: The Institute for Health Metrics and
Evaluation (IHME) ranges the chances of cancer affected people in global figure: the
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lower and upper estimates extend from 8.75 to 9.1 million. Though the rate of
morbidity is growing day by day at least increased 16% than last 15 years.
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Needs Assessments
Cancer at its preliminary stage are not assessed by normal process of diagnosis. Mostly it can be
determined by a brief health historyreviewing, doing physical examinations,Laboratory tests
(blood, urine, etc.), Biopsy, Imaging tests (X-ray, PET/CT, MRI, ultrasound, etc.), Nuclear
medicine scans (bone scans, etc.), Endoscopy and genetic tests are not the only few tests to
determine cancer there much more autoimmune detection methods are implemented to diagnose
it (Bray, 2018). As early as possible it gets detected as early as possible it also started to get
treated. Cancer is best treated with radiation therapies.
Service profile within LHD
Being the largest Local Health Department, it provides an extensive range of health care services
across 15 clinical streams.
 Aged Care and Rehabilitation
 Cancer services
 Cardiovascular Services
 Complex Care and internal Medicine
 Drug Health
 Women’s Health
 Surgical specialties
 Pediatrics and Neonatology
 Mental Health
 Oral Health
 Primary and Community Health
 Medical Imaging
 Critical Care
 Population Health
 Gastroenterology and Liver
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Facilities
SWSLHD is one of the largest healthcare unit in South Western Sydney. It has numerous staffs
who engage themselves in various works. It has a workforce consists of
 15,690 staffs
 10,523 direct patient care staffs
 6,941 nurses and widwives
 1,422 allied health staff
 1,765 doctors
 270 Aboriginal staff
Services
The annual budget of SWSLHD is approximately about $1.8 billion and which provides a wide
spectrum of services and facilities. On an average day the following data has been reported
(Chow et al., 2018).
 30 babies born
 74 children admitted to hospital
 120 Operation done
 158 dental cases solved
 194 ambulance arrivals
 582 adults admitted to hospital
 743 presentations to emergency departments
 813 Mental health services
 3,930 out patient department cases
Role delineation levels
The application of delineation in SWSLHD has been used to inform prudent services, capital and
clinical planning at the state and local health level. It outlines the level of organized clinical
services not only with hospitals or health services as a whole. Local Health Department is
responsible for verifying the suitable role delineation level of services at their facilities.
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District Hospitals Emergency
South Western sydney Liverpool Hospital 6
Bankstown Lidcombe
Hospital
5
Campbelltown Hospital 5
Bowral District Hospital 3
FairField hospital 3
Camden Hospital 2
Model of care
Priority plans with relevance to cancer has been implemented across different sites and systems
with keeping in the concept of Telehealth is also implemented. New Role models are likely to be
implemented within for service development and accessibility of new services to meet everyday
demands and diverse healthcare services.(Jootunet al.,2018). It has also been seen that changing
the model of care within SWSLHD has tremendously improved the morbidity and mortality
rates. Altering the models of care and amplification of physical infrastructure would be required
to fit the expected demand for cancer services into the future. New line of services also been
implemented to meet the district’s ageing population and oncology services and assisting the
model of care with home-based care services. The systematic observation and analysis of the
strategies is obligatory to safeguard it is responsive to any changes in the handling environment.
(Delaney et al., (2017).
Current inpatient and outpatient activity levels
As per data, Hospitals under LHD have the following activities:
 Over 152,629 inpatient cases
 Approximately 2 million outpatient care.
Emerging inveterate is also predicted to influence on the demand for sub-acute public hospital
inpatient care. New cases of cancer in SLHD are likely to increase from 2393 in 2011 to 2913 in
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2021 and this request for extra chemotherapy machines and radiotherapy machines. This types of
facilities are provided to the Local health district hospitals only(Foster, Robertson &Robson,
(2018).
Catchment and reverse catchment profile
Knowledge of catchment area is very much important for estimating the health services
implementation, for computing population-based rates of disease and for executing other
principal analyses. Distance is one of the major factors that is responsible for health care facility
and other quality services. In case of health care research, the knowledge of catchment area
defining boundaries is important, the patients close to the hospital get the facilities fast which is
influenced by the attendance and choice of health care facilities (Kohler et al.,2018).
The particular catchment area which is an administrative area defines the patients flow in a
hospital. A number is taken as an arbitrary; if the number of people approaching the hospital
increases then it not being limited by the travelling distance between the hospital and patient’s
residence. A new theory has been proposed which would be used for defining the catchment area
of health care facility and that helps to upgrade on the patient’s point of view. Statistical
measured have been used to define the catchment area.
Situational analysis- strategic issue and priorities
For updating the national policies and master planning of health-based facilities, situation
analysis is most important factor(Soon et al. (2018). The situational analysis is vast area defining
the comprehensive, potential and full range study of present and future health related issues and
their drawbacks. It is an extensive study of the total health of a country and its overall
expectations. Its priorities also describe the demographical structure of a country, the current
health status and also the epidemiology. The following priorities are to be met:
 Projected demands for services and social beliefs
 The overall health system achievements.
 The current advancement in health sector to respond to changing present and future
challenges.
 Expansion of current health system and performances.
The inclusive process should broadly improve resulting guidelines.
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Future services profile by facility & across the LHD
The future services that will lead SWSLHD to prosper:
The healthier communities are the place where families and communities could enjoy the best
quality of health services. SWSLHD is on the way to create a disease-free environment and they
fully engage themselves to improve the health facility across LHD. They pledge to focus on
holistic health and they adopt best techniques. (Dugganet al. (2018).
Overarching recommendations and conclusions
The committee has accepted two overarching recommendations to draw the government’s and
society’s conditions. The investment on current health pattern and policies are important to fight
with future health. Certain laws must be amended pertaining to achieve country’s population
objective. SWSLHD has taken great initiative to achieve the goals in near future. (Lausenet al,
(2018).
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References
Bao, H., Zhang, L., Wang, L., Zhang, M., Zhao, Z., Fang, L., Cong, S., Zhou, M. and Wang, L.,
2018. Significant variations in the cervical cancer screening rate in China by individual‐level and
geographical measures of socioeconomic status: a multilevel model analysis of a nationally
representative survey dataset. Cancer medicine, 7(5), pp.2089-2100.
Bednar, E.M., Walsh, M.T., Baker, E., Muse, K.I., Oakley, H.D., Krukenberg, R.C., Dresbold,
C.S., Jenkinson, S.B., Eppolito, A.L., Teed, K.B. and Klein, M.H., 2018. Creation and
Implementation of an Environmental Scan to Assess Cancer Genetics Services at Three
Oncology Care Settings. Journal of genetic counseling, pp.1-15.
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A. and Jemal, A., 2018. Global
cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36
cancers in 185 countries. CA: a cancer journal for clinicians.
Chow, J., Gonzalez-Arce, V., Knight, A., Kohler, F., Duggan, J., & Sykes, A. (2018).
Transforming Telehealth through Enhanced General Practices Partnerships. International
Journal of Integrated Care, 18(s1).
Delaney, G., Jacob, S., Featherstone, C., & Barton, M. (2005). The role of radiotherapy in cancer
treatment: estimating optimal utilization from a review of evidence‐based clinical
guidelines. Cancer: Interdisciplinary International Journal of the American Cancer
Society, 104(6), 1129-1137.
Duggan, K. J., Wiltshire, J., Strutt, R., Boxer, M. M., Berthelsen, A., Descallar, J., & Vinod, S.
K. (2018). Palliative care and psychosocial care in metastatic non-small cell lung cancer: factors
affecting utilisation of services and impact on patient survival. Supportive Care in Cancer, 1-9.
Foster, L., Robertson, G., & Robson, S. J. (2018). CHANGING PATTERNS OF HOSPITAL
ADMISSION FOR PRIMARY GYNAECOLOGICAL CANCER IN AUSTRALIA 1998 TO
2015. Annals of Cancer Research and Therapy, 26(1), 48-53.
Gopalappa, C., Guo, J., Meckoni, P., Munkhbat, B., Pretorius, C., Lauer, J., ... & Bertram, M.
(2018). A Two-Step Markov Processes Approach for Parameterization of Cancer State-
Page | 14

Transition Models for Low-and Middle-Income Countries. Medical Decision Making, 38(4),
520-530.
Jootun, N., Evans, T., Mak, J., Makin, G., &Platell, C. (2018). Comparing pathological complete
response rate using oral capecitabine versus infusional 5‐fluorouracil with preoperative
radiotherapy in rectal cancer treatment. ANZ journal of surgery, 88(1-2), 62-65.
Kohler, F., McDougall, A., Duggan, J., McDonald, K., Liaw, S. T., Simmons, D., ... & Chow, J.
(2018). Integrating Health Care–Our Journey Continues. International Journal of Integrated
Care, 18(s2).
Kruk, M. E., Gage, A. D., Joseph, N. T., Danaei, G., García-Saisó, S., & Salomon, J. A. (2018).
Mortality due to low-quality health systems in the universal health coverage era: a systematic
analysis of amenable deaths in 137 countries. The Lancet.
Lausen, L. H., Smith, S. K., Cai, A., Meiser, B., Yanes, T., Ahmad, R., & Rowlands, G. (2018).
How is health literacy addressed in primary care? Strategies that general practitioners use to
support patients. Journal of Communication in Healthcare, 1-10.
Seema M. Parmar, Rosanna Taylor” Cancer Screening Health Promotion Environmental Scan
Framework” Alberta Health Services (2010). Cancer Screening Health Promotion Environmental
Scan Framework. Calgary, Alberta: Alberta Health Services.
Soon, P. S., Ruban, S., Mo, H. T. J., Lee, R., Saliba, L., Shah, A., ... & Girgis, A. (2018).
Understanding patient choices regarding breast reconstruction after mastectomy for breast
cancer. Supportive Care in Cancer, 1-8.
Sreeramareddy, C. T., Harper, S., &Ernstsen, L. (2018). Educational and wealth inequalities in
tobacco use among men and women in 54 low-income and middle-income countries. Tobacco
control, 27(1), 26-34.
Stewart, B. W. K. P., & Wild, C. P. (2018). World cancer report 2014. Self.
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