Governance and protocols

The CCCN pilot model in SW Moravia is governed effectively to facilitate the redistribution of care with the aim of providing services as close to patients’ residence as possible. The most common cancers are treated locally in all access points, whereas services for rare cancers, haematological malignancies and childhood cancers are centralised in specialised centres in the City of Brno.

The governance is principally based on a written agreement among the partners, i.e. healthcare providers participating in the CCCN. Starting in 2015, the management structure was built in two basic dimensions:

• managerial leadership, including the representatives of all participating providers of care (network board and governance, financial management)  
• clinical leadership, as the basis for established and continuously optimised multidisciplinary cancer management teams
• independent evaluation team, as a body managing the ICT background of the whole CCCN, quality and performance evaluation, and planning.

The written agreement among the CCCN partners covers all dimensions of the CCCN management, mainly the common governance, cancer management teams, QA/QC evaluation, as well as information shared via a robust information system. The agreement template translated into English is available here (pdf file, 140 kB).

The CCCN structure thus covers all aspects of hospital-based cancer care with respect to the already established and unique position of individual healthcare facilities. This is necessary because these subjects do not provide care to cancer patients only, and the reorganisation of cancer care must not negatively interact with other segments of care.

The standardised clinical leadership is the most important added value in the CCCN functioning. It is based on a written agreement which specifies all important components, namely the mutually shared diagnostic and clinical protocols, standards of multidisciplinary cancer management teams and, finally, the controlled implementation in clinical practice. The cancer management teams (CMT) have been established for given diagnostic categories and are closely interlinked among the participating hospitals – the presentation of the CMT network is available online in the Czech language.

As a cancer-focused collaborative group, the CCCN in the SW Moravia region has also taken responsibility for the collaboration with other complementary segments of care, i.e. diagnostics, screening programmes, follow-up care, palliative care etc. This collaboration is facilitated by a comprehensive information system which makes it possible to quantify patient pathways and to identify the weak points in the organisation of cancer care.