Background
Achieving equitable cancer outcomes requires understanding the barriers, enablers and facilitators influencing evidence-based optimal care implementation. The Victorian Integrated Cancer Services (VICS) developed a statewide consultation framework to identify factors contributing to unwarranted variation and inform cancer service improvement.
Aim
To identify barriers and enablers to implementing Optimal Care Pathways (OCPs) across tumour streams and priority populations in Victoria.
Methods
Between 2023 and 2026, the VICS Optimal Care Summits program applied a standardised mixed-methods consultation framework across five priority areas: oesophagogastric, endometrial, colorectal, head and neck cancers, and culturally and linguistically diverse cancer care. Each project was co-designed with multidisciplinary advisory groups representing all VICS. Data sourced from the Department of Health informed unwarranted variations and outcomes, while a statewide survey of clinicians and cancer service providers explored perceived unwarranted variation, barriers, enablers and improvement priorities. Findings were validated through facilitated statewide summit discussions and prioritised improvement initiatives. Quantitative data were analysed descriptively. Qualitative responses underwent inductive thematic analysis.
Results
Five statewide consultations engaged 323 multidisciplinary stakeholders, of which 41% were medical. Perceived unwarranted variations included limited or delayed access to supportive care services (51%), diagnostic procedures/tests (46%), diagnosis (43%), clinical trials (33%), and all treatment (33%).
Barriers across tumour streams included fragmented care pathways, workforce and resource constraints, inequitable access to diagnostic, treatment and supportive care services, communication challenges and inconsistent implementation of OCPs across health services.
Enablers included multidisciplinary collaboration, care coordination, culturally responsive care, workforce capability, consumer partnership, improved data collection and strengthened governance.
Conclusion
The VICS consultation framework provides a scalable stakeholder consultation approach to drive OCP implementation and cancer service improvement. Priorities include improving access to a multidisciplinary and culturally responsive workforce, diagnostic services, diagnosis, clinical trials, all treatment commencement, care coordination, and data and quality monitoring for Victorians affected by cancer.