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Cancer Management


Adult cancer care in the CESPHN region is provided across two local health districts, Sydney Local Health District (SLHD), South Eastern Sydney Local Health District (SESLHD), and one health network, St Vincent’s Hospital Sydney (SVHS), encompassing nine cancer centers supported by 73 multi-disciplinary teams and community palliative care services.


Key priorities for CESPHN are to: improve cancer outcomes, improve the quality of life for people with cancer and enhance the experiences for people with cancer. CESPHN’s work in the cancer management space is focused on supporting the delivery of coordinated patient-centered care and enhancing integration across the primary, community and acute care settings.

GP CanShare

GP CanShare is a collaboration between Central and Eastern Sydney PHN, Sydney Local Health District, South Eastern Sydney Local Health District and St Vincent’s Hospital with the aim of enhancing cancer management in primary care.


The project assists General Practices, community cancer services and specialist cancer services to work together in providing care for patients with cancer and improve their experience of the cancer system.


Integrated Nurse Coordinators facilitate seamless coordination of care for patients and liaise between the patient’s cancer specialist team and their General Practitioner. GPs are provided regular updates on all aspects of their patient’s care via their preferred communication method, including clinical and supportive care.


Additionally, the nurse coordinators encourage patients to see their GP regarding problems that can be managed in the GP setting.


All patients with cancer attending the below cancer centres have the option of having their care provided collaboratively by a recognised GP and the hospital-based services:


GPs and practice nurses wanting to be linked to a GPCanShare nurse coordinator, please see contact direct details below.


Sydney Local Health District (SLHD)

  • Concord Repatriation General Hospital
  • Royal Prince Alfred Hospital


If you would like to hear more about GPCanShare or would like to nominate your patients for shared cancer care at Concord or RPA Hospital, please contact:

Email: SLHD-GPCanShare@health.nsw.gov.au

Phone: 02 9767 6675

Working hours: Monday – Friday (8:00am – 4:30pm)


GPCanShare Social Worker

The GPCanShare Social Worker is a specialist position within SLHD. The Social Worker supports patients referred to SLHD Palliative Care Services for Supportive or Palliative Care management. Early access and intervention of supportive care has shown to improve patient experience and outcomes during a cancer journey. The GPCanShare Social Work brings specialist psychosocial knowledge, skills, intervention, and care planning that is often not shared or provided to General Practice. This role aims to support better integration, communication, and transfer of psychosocial skills.


South Eastern Sydney Health District

  • Prince of Wales Hospital
  • St George and Sutherland Hospitals


If you would like to hear more about GPCanShare or would like to nominate your patients for shared cancer care at St George, Sutherland or Prince of Wales Hospitals, please contact:

Email: SESLHD-GPCanShare@health.nsw.gov.au

Phone: Jeremy – 0408 577 841

Yianna – 0418 428 563

Zahra (PoWH) 0438 636 310

Working hours: Monday – Friday (8:00am – 4:30pm)


St Vincent’s Hospital 

  • Kinghorn Cancer Centre


GPCanShare at The Kinghorn Cancer Centre, St. Vincent’s Hospital Sydney is committed to helping GPs care for their cancer patients in the community. We facilitate the timely transfer of information and offer specialist expertise by providing a direct contact line to cancer services at The Kinghorn Cancer Centre through two experienced and knowledgeable clinical nurse consultants. 


If you would like to hear more about GPCanShare or would like to nominate your patients for shared cancer care at The Kinghorn Cancer Centre, please contact:

Email: gpcanshare@svha.org.au 

Phone: Mary and Lisa- 0407 062 048

Working hours: Monday – Friday (8:00am – 4:30pm)


Shared Cancer Care 

Patients with cancer are faced with complex decisions and care treatment across different settings. Lack of involvement in the cancer care system by primary providers leads to poor care coordination for patients with cancer. Poor care coordination is a significant contributor to poor patient outcomes, including a high proportion of palliative related hospitalizations.


Shared cancer care enhances integration of the care system, service navigation and allows for General Practice to effectively support the needs of their patients with timely access to specialist cancer expertise.


Cancer Australia has developed the following Principles of Shared Care

  • Patient-centred
  • Coordination, communication and continuity of care
  • Support for primary care providers
  • Support for specialist treatment team
  • Care is delivered according to best practice standards


CESPHN has developed the shared care model, GPCanShare as described above, that involves joint responsibility of patient care between both primary and acute care providers.


Resources for General Practice

Canrefer

If a patient is suspected of having a diagnosis of cancer, Canrefer can be used by General Practitioners to find the most appropriate specialist to refer to dependent on cancer type. Canrefer also provides GPs with information on recommended cancer centres that specialise in treating complex cancers. Visit their website at www.canrefer.org.au

EviQ

EviQ is a free resource to aid health professionals in the delivery of cancer treatments. Information fact sheets to assist GPs can be found here: https://www.eviq.org.au/clinical-resources/health-professional-fact-sheets

MULTIDISCIPLINARY CARE (MDC)

Multidisciplinary care (MDC) Is considered best practice In the treatment planning and care for patients with cancer. MDC Involves all relevant health professionals discussing options and making joint decisions about treatment and supportive care plans. Visit https://www.canceraustralia.gov.au/clinical-best-practice/multidisciplinary-care/all-about-multidisciplinary-care/principles-multidisciplinary-care

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