Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Development of a Statewide Model of Care for Equitable Access to Cancer Genetic Services in New South Wales (145560)

Meera Warby 1 , Mary Mitchelhill 1 , Fiona Abell 2 , Kristine Barlow-Stewart 3 4 5 , Duffy Jessica 6 , Dunstan Prue 7 , Gunjan Garg 8 , Mike Field 9 , Annabel Goodwin 10 , Lucie Hallenstein 11 , Celia Halliburton 12 , James Harvey 13 , Emilia Ip 14 , Sarah Josephi Taylor 15 16 , Sarah Jordan 17 , Craig Kukard 18 , Robert Lindeman 19 , Louise Lynagh 20 , James Lynam 21 , Cristina Mapagu 22 , Pooshan Navathe 23 , Leonie Noon 24 , Karol Petrovska 25 , Abi Ragunathan 26 , Shelley Rushton 1 , Ingrid Sinnerbrink 27 28 , Michelle Stewart 29 , Sandra Turley 30 , Lesley Andrews 20 31 32 , Tracey O'Brien 33
  1. Cancer Services and Information, Cancer Institute NSW, St Leonards, NSW, Australia
  2. Cancer Services, Hunter New England, John Hunter Hospital, New Lambton Heights, NSW, Australia
  3. School of Clinical Medicine, Randwick Clinical Campus, Discipline of Paediatrics and Child Health, UNSW , Sydney, NSW, Australia
  4. Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
  5. Children's Cancer Institute, Lowy Cancer Research Centre, UNSW, Sydney, NSW, Australia
  6. Hereditary Cancer Clinic, Illawarra Cancer Care Centre, Wollongong, NSW, Australia
  7. Child, Infant and Family Tertiary Service, Southern NSW Local Health District, Goulburn, NSW, Australia
  8. Clinical Genetics, Liverpool Hospital, Liverpool, NSW , Australia
  9. Familial Cancer Service, Royal North Shore Hospital, St Leonards, NSW, Australia
  10. Cancer Genetics Clinic, Royal Prince Alfred Hospital, Camperdown, NSW, Australia
  11. Mid North Coast Cancer Institute, Mid North Coast Local Health District , Coffs Harbour, NSW, Australia
  12. Health System Strategy and Patient Experience Division, NSW Ministry of Health, St Leonards, NSW, Australia
  13. District Wide Services Division, Dubbo Base Hospital, Dubbo, NSW, Australia
  14. Cancer Genetics, Liverpool Hospital, Liverpool, NSW, Australia
  15. Department of Clinical Genetics, Sydney Children's Hospitals Network, Westmead, NSW, Australia
  16. Specialty of Genomic Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  17. Genetic Counselling Service, Northern NSW LHD, Kingscliff Community Health Centre, Kingscliff, NSW, Australia
  18. Department of Medical Oncology, Central Coast Cancer Centre, Gosford Hospital, Gosford, NSW, Australia
  19. Department of Haematology, Prince of Wales Hospital, Randwick, NSW, Australia
  20. Cancer Genetics, The Kinghorn Cancer Centre, Darlinghurst, NSW, Australia
  21. Cancer Institute NSW, St Leonards, NSW, Australia
  22. Department of Medical Oncology, Nepean Cancer Care Centre, Nepean Hospital, Kingswood, NSW, Australia
  23. Executive Director Medical Services, Southern NSW Local Health District, Queanbeyan, NSW, Australia
  24. Dubbo Community Health Centre, Dubbo Hospital , Dubbo, NSW, Australia
  25. Connected Care, System Performance Support, Ministry of Health, St Leonards, NSW, Australia
  26. Familial Cancer Clinic, Westmead Hospital, Westmead, NSW, Australia
  27. Department of Clinical Genetics, Nepean hospital, Kingswood, NSW, Australia
  28. Specialty of Genomic Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  29. Cancer Services, Murrumbidgee Local Health District, Wagga Wagga, NSW, Australia
  30. Rural Cancer Care Coordination Service, Far West Local Health District, Broken Hill, NSW, Australia
  31. Hereditary Cancer Centre, Nelune Comprehensive Cancer Centre, Prince of Wales Hospita, Randwick, NSW, Australia
  32. Hunter Family Cancer Service, John Hunter Hospital, Waratah, NSW, Australia
  33. Chief Executive Officer, Cancer Institute NSW, St Leonards, NSW, Australia

Background:

Demand for cancer genetic services continues to increase due to expanding eligibility criteria and the growing integration of genomics into cancer diagnosis, treatment and prevention. Across New South Wales, increasing demand has placed pressure on specialist genetics workforces, highlighting the need for both innovative and alternate workforce models to improve access, efficiency and sustainability. A statewide project was undertaken to develop a contemporary Model of Care (MoC) for cancer genetic services.

Methods:
The MoC was developed using a co-design approach involving Genetic Counsellors, Genetic Specialists, Oncologists and other key stakeholders. Development activities included an evidence review, analysis of service demand and workforce trends, review of alternative models of care and extensive stakeholder consultation. Key themes and priorities were synthesised and refined through iterative review.

Results:

The resulting MoC outlines a networked statewide approach to cancer genetic services through hub-and-spoke models, enabling coordinated access to specialist expertise while supporting equitable access to care for rural and regional populations. The framework supports greater integration of genomics into routine cancer care through strengthened partnerships between oncology and cancer genetic services, with an emphasis on timely access to testing and risk assessment to inform treatment, prevention and surveillance decisions.

Key service redesign initiatives include streamlined referral pathways, genetic counsellor-initiated testing guidelines, and increased utilisation of mainstreamed genetic testing supported by clear escalation pathways. Evidence-informed, cancer-specific prioritisation criteria were also developed to promote transparent and consistent triage across NSW and support equitable allocation of limited specialist resources.

Conclusions:
This co-designed MoC provides a strategic framework to guide the future delivery of cancer genetic services in NSW, supporting a more coordinated, accessible and sustainable model of care while optimising the specialist genetics workforce.