The Community Oncology Network (CON) is a collaborative voluntary partnership with hospitals in the health authorities and with the BC Cancer regional centres and its systemic and radiation therapy programs.
The CON works with BC health authorities to ensure that cancer care throughout the province meets the standards of BC Cancer.
A CON location must have at a minimum:
- appropriately trained and competent staff (nurses, physicians, pharmacists) to administer and manage the cytotoxic and hazardous products used to treat cancer
- access to clinical diagnostic services, such as haematology, with the capability to provide all of the information required to monitor cancer therapy
- the capability to respond to complications of therapy 24 hours per day.
System planning for outpatient medical oncology services is a major area of focus for BC Cancer, the regional health authorities (Fraser Health, Interior Health, Island Health, Northern Health and Vancouver Coastal Health), First Nations Health and collaborators (Ministry of Health, non-profit organizations, etc.).
Meeting the full range of needs of patients and a community is beyond the capability of one team or organization. As a result, BC Cancer and the regional health authorities partner together to ensure that patients receive high quality cancer care services as close to home as possible.
The Tiers of Service framework provides a tool which is used to define and plan this system of service. Tiers of Service provides a common language and methodology for defining and planning outpatient medical oncology services in BC.
Tiers of Service framework for outpatient medical oncology services recognizes each of the following tiers:
In order to provide safe, sustainable and appropriate outpatient medical oncology services, each tier has responsibilities and requirements that they need to fulfill. These are detailed in the following three focus areas:
- Clinical service,
- Knowledge sharing and transfer / training, and
- Quality improvement / research
A Satellite Centre is staffed by a BC Cancer medical oncologist, and/or a
BC Cancer General Practitioner receiving remote support from a
BC Cancer regional centre.
The Centre also has chemotherapy-certified oncology nurses, oncology-trained pharmacists and pharmacy staff. All chemotherapy in these centres is supervised by a
BC Cancer medical oncologist.
Satellite Centres prepare and deliver oral and parenteral outpatient chemotherapy agents. This includes first-dose treatment and the full spectrum of outpatient chemotherapy protocols as delineated by BC Cancer.
It is also electronically connected to BC Cancer’s Cancer Agency Information System (CAIS) and therefore has full access to electronic patient information.
The service is available from Monday to Friday.
Provides outpatient medical oncology services for patients with
rare and highly specialized cancers (e.g. gynaecologic malignancies, sarcomas).
Capacity to administer
new and / or
uncommon, low to high complexity systemic therapy for
low to high medically complex patients.
Specialized interdisciplinary team includes a Medical Oncology Specialist
assigned to specific tumour sites and provides the full range of medical oncology services.
concurrent outpatient medical oncology services
and radiation oncology services
Facilitates care closer to home by referring patients to Tier 2-4.
Specialized interdisciplinary team includes a Medical Oncology Specialist and provides the full range of medical oncology services.
Medical Oncology Specialist develops the treatment plan and prescribes systemic therapy.
Capacity to administer
low to relatively common, high complexity systemic therapy for low to
high medically complex patients.
Facilitates care closer to home by referring patients to Tier 2-3.
Oncology clinic located in / adjacent to a
health care facility with limited specialty services16.
Oversight provided by a Clinical Practitioner in Oncology under the direction and support of Tier 4-6 Medical Oncology Specialist.
Clinical Practitioner in Oncology writes orders, monitors and manages care as per the established treatment plan.
Capacity to administer
low to moderate complexity systemic therapy for
low to moderate medically complex patients.
Where appropriate and closer to home, makes arrangements for patients to receive some / all of their systemic therapy at Tier 2.
Oversight / care is provided by Tier 3-6.
Upon request from Tier 3-6 Clinical Practitioner in Oncology / Medical Oncology Specialist, provides systemic therapy to patients on a case-by-case basis to facilitate care closer to home.
Oncology Clinic staffing includes an onsite chemotherapy-certified Registered Nurse when providing systemic therapy.
Capacity to administer low complexity systemic therapy for low medically complex patients.
Provides coordinated, comprehensive and quality cancer care services for adults with a cancer diagnosis to stay healthy, get better, live with cancer and cope with end of life. Includes providing first contact access for each new need and long-term comprehensive coordinated care for most health needs and when it must be sought elsewhere.
Thank you to Child Health BC for providing use of their informational video and their support in implementing this framework at BC Cancer.