Recommendations

Comprehensive, quality cancer care is available to patients, which includes a national patient travel and accommodation scheme

52. Adequately funded and equitable national patient transport and accommodation assistance schemes must be in place
    1. Financial support should demonstrate a relationship between the subsidy and reasonable transport and accommodation expenses;
    2. The transport and accommodation support schemes should be simplified and disparities between jurisdictions should be addressed.
53. A comparative study of costs of providing treatment and out of pocket expenses across various private and public facilities should be developed
    1. To benchmark the costs related to radiotherapy and reimbursements or rebates;
    2. To provide governments with the necessary data to ensure equity.

Models of care are locally tailored and appropriate to rural and regional areas

54. Design models of care appropriate to the regional area and its population needs, including linkage to major radiation oncology centres;
55. Adopt a national planning approach (facilities, workforce and services) with input from regional and rural stakeholders;
56. Regional facility development should focus on patient care outcomes and experiences;
57. Establish access to specialist services through the Cancer Care Network and links between regional and comprehensive metropolitan cancer care services;
58. Accommodate needs for future expansion and uptake of technology in regional facility planning and development.

Planned workforce strategies are developed to support the expansion of radiation oncology services to regional and rural areas.

59. Strategies are developed to recruit trainees and radiotherapy professionals of regional and rural origin;
60. Increased training opportunities in rural and regional centres; increased funding support for prioritisation of rural training placements;
61. Incentives and bonuses to attract and retain rural and regional staff;
62. Staffing models that support professional development, professional collaboration and research activities;
63. Increased flexibility of decision-making and funding responsibilities in regional centres for specific strategies for staff retention;
64. Individual regional facilities should develop areas of expertise, including research, and specific competencies in techniques and technologies to increase competitive attractiveness of rural work.

Strategies in place that recognise and ameliorate the financial and social impact of cancer on patients and carers in rural and regional areas

65. Actions to be taken such that financial consideration by rural and regional patients and carers do not influence decisions regarding treatments:
    1. Where it does not exist already, there should be expansion of arrangements for publicly funded patient access to private regional radiotherapy treatment and review of the eligibility criteria for the same;
    2. Modified billing mechanisms in private facilities where payments and reimbursements are streamlined so that patients are only required to pay the gap payments, while the facility can maintain its operating cash flow;
    3. Costs of developing regional public facilities as opposed to providing publicly-funded access to an existing local private facility need to be considered;
    4. Reimbursement of out of pocket expenses incurred should be an option for those who are forced to pay more because of their place of residence.

Innovative approaches to patient care are implemented, evaluated and supported

66. A planned adoption of telehealth into radiation oncology services for consultation, care planning and follow up of patients
    1. Such adoption should focus on cancer care outcomes and patient experiences;
    2. Clinicians should be consulted to identify clinical needs and the best supporting technology.