In 2018 the Victorian Department of Health initiated a project to develop a Home-based cancer care: framework and toolkit to assist Victorian health services establish and deliver a sustainable, safe, high-quality cancer treatment in the home program .
An increasing incidence in cancer diagnoses and scientific developments in Systemic anti-cancer therapies (SACT) has resulted in an increased demand for limited day oncology services. The use of SACT to treat cancer is expected to increase, and exceed capacity of health services to meet on-site demand.
SACT encompass all pharmacological therapies administered intravenously, subcutaneously, intramuscularly or orally to treat cancer and are typically delivered in an ambulatory care setting. An alternative to hospital-based cancer care is delivering SACT in the patient’s home.
In collaboration with key medical, nursing and pharmacy leaders of oncology and Hospital in the Home a comprehensive toolkit was created outlining governance, models of care and funding structures. The framework aligns with Australia’s National Safety and Quality Health Service (NSQHS) Standards. The toolkit contains a set of practical evidence-based, templates and decision making tools to guide the implementation of a HBCC program in both metro and regional Victoria.
In 2020, Northern Health Oncology and Haematology Unit developed a HBCC program utilizing the HBCC framework and toolkit. Since the commencement of NOAH@Home, 865 episodes of HBCC have been delivered. The program has been extremely successful with plans underway to significantly expand the service in the next 12 months.
The Home-based cancer care: framework and toolkit has proven to effectively support the delivery of SACT in the home as a safe and equivalent alternative to the hospital setting. In addition to relieving pressure on ambulatory care services, home based cancer care (HBCC) enhances patient-centredness by offering eligible patients more choice about how, when and where they are treated.1