Audit of national care standards, clinical pathways, decision support tools for patients with malignant brain cancer

Background
Brain cancer is the sixth leading cause of cancer burden and there are more than 100 types of brain cancer and other central nervous system cancers. These cancers carry high rates of morbidity and mortality. The five-year relative survival rate for brain cancer is low, at around 22 per cent. The young are disproportionately affected by brain cancer and brain cancer kills more children in Australia than any other disease. Despite improvements in patient care and support, survival rates for brain cancer have remained relatively unchanged for the past 30 years.
The Australian Brain Cancer Mission (the Mission), announced on 29 October 2017, aims to double survival rates and improve the quality of life for patients with brain cancer over ten years to 2027, with the longer term aim of defeating brain cancer. As at April 2019, $124.65M had been committed to the Mission through co-investments from philanthropy, non-government organisations and governments, including $58.35M from the Australian Government through the Medical Research Future Fund (MRFF). Cancer Australia is responsible for administering the Mission, supported by a Strategic Advisory Group (MSAG).

A national Brain Cancer Research Roundtable was convened in 2017 bringing together people affected by brain cancer, leading Australian and international researchers, clinicians, advocacy and philanthropic groups. This Roundtable provided the framework for delivery on the aim of the Mission and developed a Research Roadmap that articulates the Mission’s investment strategies. Conducting an Audit of national care standards, clinical pathways and decision support tools for patients with malignant brain cancer (the Audit) is one of the early and immediate priorities for implementation under the investment strategy ‘Increased patient survival, quality of life and care experiences’ outlined in the Research Roadmap.

The objective of the Audit is to review current national and international care standards, clinical pathways and decision support tools for patients with malignant brain cancer to address unwarranted variation in care and inform future quality care for people with brain cancer.

Scope of the Audit
A comprehensive Audit of current care standards, clinical pathways, and decision support tools for brain cancer patient care will be undertaken. The Audit will identify the availability, level of use and variation in the uptake of existing resources. The Audit will also identify requirements for updating existing resources, any gaps requiring new resources, and approaches to integration and implementation of these resources in the delivery of patient care across sectors and population groups.
The contractor undertaking the Audit will review and utilise existing audits and data sources in the context of this requirement.
The Audit will source and identify resources from:
• Care standards and other forms of clinical guidance including consensus guidelines;
• Clinical pathways; and
• Decision-support tools.

Outcomes and Reporting Requirements
The Audit will identify requirements for delivering best practice clinical guidance and patient decision support tools. The findings of the Audit will also suggest approaches to improve patient experience and outcomes while reducing unwarranted variation and, will identify the costs and benefits of implementing these requirements.
In undertaking this work, the contractor will be required to provide Cancer Australia with monthly updates by teleconference, two progress reports, a draft final report and a final report.

The final report will include:
1. a review of:
a. Australian and international guidance on best practice care standards and models of care, clinical pathways and decision support tools for the management of brain cancer in adults, adolescents and young adults, and children;
b. websites and online material such as from jurisdictions and health services and
c. English language resources from Australia, North America, Europe and Asia identified through correspondence with key Australian and international organisations.
2. An analysis of the extent of use of, and adherence to, available care standards, clinical pathways and decision support tools, including an analysis of variation in uptake, to support the delivery of quality cancer care and patient experience in the Australian healthcare setting; and
3. an analysis of the contribution of research and clinical trials in identifying best practice in cancer care and the enhancement of patient experiences.
4. A synthesis of findings, including gaps, in areas of practice, where clinical guidance is required for the management of brain cancer and approaches to inform future directions and future requirements to address identified critical gaps in the delivery of quality care and patient experiences.
5. A cost-benefit analysis, to inform policy makers and healthcare professionals on the impact of adopting best practice national care standards, clinical pathways and decision support tools for patients with brain cancer including for patients and the healthcare system for the life of the Mission to 2027; and
6. a plan for the development of a system wide approach for routine integration of best practice national care standards, clinical pathways and decision-making support tools for patients into clinical practice.

Partnerships
Cancer Australia encourages the partnering of different organisations or departments to bring together the necessary skills and experiences to provide a Request for Tender to undertake the Audit. The organisational structure and management of staff involved in the partnership should be provided in the Request for Tender.

Timeframe
The project is planned to commence in August 2019 and to be completed within six months of the start date.

Funding of up to $450,000 (GST inclusive) has been provided from the Department of Health to Cancer Australia for the purpose of procuring a suitably qualified organisation to undertake this work.