Background

Outreach services have been provided by a tertiary service over the past 20 years. These services have expanded in response to patient demand and changes to service delivery.

Changes to the national funding model in conjunction with redesign of health services required a change in the way outreach services were administered.

Aims

To establish governance frameworks to support the continued delivery of outreach clinical care and maintain inter-service relationships through improved transparency.

The establishment of a service level agreement (SLA) guaranteed an agreed level of service while clarifying the financial and service expectations of both parties.

Method

Central Integrated Regional Cancer Service (CIRCS) acted as an intermediary between parties as well as legal and funding bodies to ensure the delivery of a comprehensive SLA.

A regional site visit between the business support providers was conducted to establish a mutually agreed baseline for activity and cost recovery (where possible). It was essential that the advice of health funding and allocations was incorporated into these decisions to ensure that any ABF and legal obligations were met.

The SLA was structured in such a way that allowed for flexibility at a facility level using a series of schedules in addition to the standard “head agreement”.

Results

The SLAs for four statutory bodies were first approved for the 2012-14 period with the intention of periodic iterations to address changes in both patient care and service models.

Conclusion

The SLAs have transitioned from a care provision model to offering the additional benefit of supporting activities such as referral triage, participation in MDT meetings and collaborative professional development.

The parties to the SLAs acknowledge that cancer services in QLD are undergoing a transition to greater self-sufficiency and local leadership and as such, SLAs must underpin the delivery of a wider range of specialist cancer services.