Developing an Integrated Service Planning Tool: Lessons Learnt from Planning the WSLHD Thoracic Oncology Program

Kylie Smythe; David Greenfield; Anita Calderan; Paul Harnett; Alison Derrett; Adnan Nagrial; Kathy Eljiz

doi:10.5334/ijic.8976

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Table 1

WSLHD Thoracic Oncology Program service plan steering committee and consultation participants and activities.

DETAILS	MEMBER CATEGORIES
DETAILS	DISTRICT EXECUTIVE/MANAGEMENT	HOSPITAL EXECUTIVE/MANAGEMENT	CLINICAL LUNG CANCER CARE	EXTERNAL REPRESENTATIVE
Services represented	Cancer Critical care Imaging Specialty medicine Subacute and ambulatory medicine Surgery Supportive and palliative care Allied health Multicultural health Aboriginal health Clinical innovation and redesign Population health Research and education network Health service planning	General management Medical oncology Radiation oncology Respiratory medicine Intensive care Nursing Allied health	Medical oncology Radiation oncology Thoracic surgery Respiratory medicine Nursing Dietetics Speech pathology Physiotherapy Social work Population health Aboriginal health	General Practitioner Western Sydney Primary Health Network Consumers
Number of steering committee representatives	16	10	7	2
Number of small group/individual interview participants	8	6	15	8
Total number of consultation hours	5	5.5	16	8

The seven stages of the Optimal care pathway for people with lung cancer [36].

Overview of the planning process to develop the WSLHD Thoracic Oncology Program Service Plan.

Table 2

Chronological list of steps taken to develop the WSLHD Thoracic Oncology Program Service Plan.

TIME	ACTION	WHY (RATIONALE)
October 2022	Direction from the chief executive to recommence lung cancer planning	The Chief Executive direction supported the commitment of resources (e.g. health services planning and innovation and redesign services) to the project.
	Small group meeting	The development of the service plan required regular (fortnightly/monthly) review and reflection by the small group guiding the process to ensure ongoing progress.
	Nomination of steering committee membership	A steering committee was required to provide overall leadership, direction, and responsibility for developing recommendations and priority actions [46] for the establishment of a WSLHD Thoracic Oncology Program. Membership nominees were required across specialties, across hospitals, across district executive/management roles, hospital executive/management roles, clinical roles and external roles [46].
	Circulation of a discussion paper	The discussion paper provided a way for steering committee members to develop a shared understanding of what was currently known about lung cancer care in WSLHD.
November 2022	Initial steering committee meeting	The initial meeting set the scene, confirmed the scope of the project, the consultation list and the use of the Optimal care pathway for people with lung cancer as a framework for the plan.
November – May 2023	Detailed consultation interviews	Detail was required from people involved in providing lung cancer care on the availability and function of current services, the challenges and the opportunities for the future.
February 2023	Steering committee meeting: consultation update	The steering committee required awareness of the issues that were being raised through consultation.
May 2023 and June 2023	Workshop 1 and 2: small group discussions about the issues identified in each step of the patient journey and each of the program enablers and development of actions to address the issues	The workshop enabled discussion across specialties and across facilities. The workshop allowed strategies and actions for the issues that had been identified to be developed collaboratively and efficiently.
July 2023	Projections: the methodology used in the planning for the National Lung Cancer Screening Program to project the number of people eligible screening, the number of people diagnosed and the number of people for each treatment pathway was applied to the local WSLHD catchment population	The plan required activity projections to inform future resource needs.
July 2023	Consumer consultation: an expression of interest was circulated at lung cancer clinics for participation in consultation. Individual phone interviews were held with three patients and one carer.	Consumer co-design is a requirement of accreditation for hospitals and ensures awareness and focus on what matters most to consumers [45].
August 2023	Steering committee meeting: tabling of consumer feedback and prioritisation of strategies and actions	Committee members required awareness of the issues raised and suggested areas for improvement from consumers [45]. Prioritisation ensured that the initial areas of focus for implementation were clear.
October 2023	Steering committee meeting: discussion about implementation working groups and a symposium	Preparation for implementation ensured that once the plan was complete, action would be taken to bring the plan to life. The symposium was proposed to communicate details of the plan to a broader audience.
November 2023	Circulation of plan	Steering committee members required the opportunity to review and comment on the detail within the plan.
	Meeting with the Chief Executive to provide an overview of the plan	The Chief Executive required a summarised version of the key features of the plan and the opportunity to ask questions.
	Revision of the plan according to feedback	Refining the plan based on feedback improved the quality and accuracy of the detail that was provided.
	Steering committee meeting: endorsement of the final plan, development of implementation committee membership list, planning for the symposium	Endorsement of the plan was a formality requested by the chairperson (Executive Director of Operations) to confirm the detail that was included in the plan.
December 2023	Chief Executive endorsement	Progressing to implementation and sharing/promoting the plan required endorsement of the plan by the CE.
December 2023	Symposium	The symposium was an opportunity to showcase the work to date and engage stakeholders outside of WSLHD.
February 2024	Publication and distribution of an abridged version of the plan	Communication about the service plan was required beyond the WSLHD Thoracic Oncology Steering Committee to include WSLHD staff and external groups such as General Practitioners, the Cancer Institute NSW and Cancer Australia. Promotion of the service plan raised awareness of the National Lung Cancer Screening Program (to be introduced in July 2025) and the preparation and planning that is taking place within WSLHD. Promotion of the service plan will also generate interest in collaborative and partnership opportunities

WSLHD Thoracic Oncology Program Service Plan components and content overview.

Table 3

The ISPT including five enablers and related actions.

ENABLER	ACTIONS
1. Foster a strong culture of collaboration	Establish a shared vision amongst all involved Facilitate regular collaborative opportunities including small group discussions, meetings and workshops Host a symposium which allows collaboration with external stakeholders Circulate frequent email correspondence summarising progress on the plan and inviting feedback
2. Establish strategic governance	Obtain senior executive endorsement to commence the planning process Identify clinical and executive co-chairs and steering committee membership Convene and minute regular, steering committee meetings to review the collated service planning information and determine an ongoing direction Obtain steering committee endorsement of the service plan
3. Identify a patient journey framework	Review the literature for published patient care pathways and established models of care Identify a patient care pathway or model of care framework to guide the structure of the plan Apply any necessary amendments to the framework Obtain endorsement of the proposed framework by the steering committee
4. Extensive and flexible stakeholder consultation	Include representatives at an organisational, facility and clinical service level in the service planning process Ensure that input is obtained from all relevant clinical specialties and clinical support services Obtain input from external representatives such as primary care clinicians and managers and consumers in the service planning process Allow flexible timing and location (including online options for consultation)
5. Formalise the plan with documentation	Prepare a draft of the service plan for review by the steering committee Amend the draft according to feedback Provide a consolidated list of amendments and the rationale Provide a final draft to the steering committee for endorsement

Developing an Integrated Service Planning Tool: Lessons Learnt from Planning the WSLHD Thoracic Oncology Program

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