Application Guidelines Symptom and Urgent Review Clinic (SURC) Initiative 2018 Grants Scheme - health.vic

 
Application Guidelines
Symptom and Urgent Review Clinic
(SURC) Initiative
2018 Grants Scheme
Application Guidelines
Symptom and Urgent Review Clinic (SURC) Initiative:
2018 Grants Scheme
Contents
A. Introduction ............................................................................................................................................4
Purpose ........................................................................................................................................................4
Background...................................................................................................................................................4

B. Grants Scheme Overview......................................................................................................................6
Objectives .....................................................................................................................................................6
Proposed Outcomes .....................................................................................................................................6
Expectations of pilot sites .............................................................................................................................7
Scope ............................................................................................................................................................7
Project Governance ......................................................................................................................................8
Key dates and information ............................................................................................................................8

C. Application Process ..............................................................................................................................9
Funding available..........................................................................................................................................9
Submission of applications ...........................................................................................................................9

D. Eligibility criteria ..................................................................................................................................10
Applicant requirements ...............................................................................................................................10
Project requirements ..................................................................................................................................10
Exclusions ...................................................................................................................................................10
Participating organisation requirements .....................................................................................................10

E. Assessment Process ...........................................................................................................................11
Selection criteria and requirements ............................................................................................................11
Evaluation process .....................................................................................................................................11
Privacy ........................................................................................................................................................11
Conflict of interest .......................................................................................................................................12

F. Administration and reporting requirements ......................................................................................13
Applicant .....................................................................................................................................................13
Administering organisation .........................................................................................................................13
Funding .......................................................................................................................................................13
Goods and services tax ..............................................................................................................................13
Public Liability .............................................................................................................................................13
Proposed Reporting ....................................................................................................................................14

G. References............................................................................................................................................14
A. Introduction
Purpose
This document provides an overview of the Symptom and Urgent Review Clinic (SURC) Initiative 2018
Grants Scheme.
The 2018 Grants Scheme includes two grant types and will provide up to $440,000 to fund a maximum of
five projects over the next 12 months.
Grant Type 1: Start up Grants will support services that do not already have an existing model of care to
set up a SURC program
Grant Type 2: Capacity Building Grants will support services that wish to leverage existing funding or
initiatives to build on the existing capacity to provide a SURC service
Applications are invited from Victorian Public Health Services in metropolitan Melbourne and regional
Victoria that provide more than 1000 occasions of same day chemotherapy services per annum.

Background
For the purposes of this document, the term Systemic Anti-Cancer Therapy (SACT) is used to refer to all
drugs with direct anti-tumour activity including conventional cytotoxic drugs, monoclonal antibodies,
targeted therapies and immunotherapies.
There is increasing demand on services that deliver SACTs. The number of SACT episodes in Victoria
has grown in recent years in both the public and private sectors. There is an increasing trend for SACT to
be administered in the ambulatory environment, shifting the burden of managing treatment related
toxicities onto the patient, carers and primary care providers. Patients are often unaware of the
significance of their side effects, and lack the confidence to manage their symptoms at home. Under-
reporting and under-treatment of SACT side effects is well described within the literature and is a
common scenario, despite the link between effective management of SACT side effects and improved
patient outcomes.
Emergency Departments (ED) provide the key interface between the community and the acute setting,
resulting in unplanned ED presentations for many patients experiencing treatment related side effects.
Unplanned ED presentations may pose significant risk to the patient including:
• presentation with non-specific symptoms related to the disease, the treatment, or combination of both
  impacting the assessment and identification of seriously ill oncology patients
• unnecessary investigations and interventions
• unnecessary hospital admissions

This in turn may have the following impacts:
• lengthy waiting times
• interrupted continuity of care
• costs and inconvenience associated with hospital presentations

The Victorian Cancer Plan 2016 – 2020 identifies within the treatment action area that cancer treatment
has evolved to be more complex for patients to navigate. It highlights the priority to improve patient
experience of treatment and care by empowering patients to be active partners in their care.

Symptom and Urgent Review Clinic (SURC) Initiative – 2018 Grants Scheme - Application Guidelines 10 August
2018
Whilst there is increasing awareness by oncology health professionals of the need to support patients
receiving SACT in the ambulatory setting to self-manage treatment side effects, a number of challenges
remain in achieving a person-centred, flexible and coordinated approach.
These include:
• Engaging and building partnerships with primary care providers to support shared care and follow-up
  of patients throughout treatment.
• Limited information technology solutions to capture information around SACT treatment toxicity.
• Health care provider capacity to identify patient groups most at risk of developing treatment related
  toxicities, and to deliver/refer to support services as appropriate.
• Preparing patients early in their treatment pathway to socialise the concept of being an active
  participant in their care.
• Empowering patients to seek treatment information and support in a manner that suits their individual
  needs.

SURC Model of Care
In 2017, four Victorian public hospitals, Austin Health, Eastern Health (Box Hill campus), Monash Health
(Dandenong campus) and the Royal Children’s Hospital were recipients of a DHHS SURC program
grant. This funding supported the implementation of the SURC model of care within each Chemotherapy
Day Unit (CDU) to support patients who experience treatment related toxicities during the period of active
treatment. This work built on a WCMICS supported Western Health model of care developed in 2013.
A nurse led model was created to:
• Provide consistent education to patient and carers prior to the commencement of chemotherapy
• Provide a point of contact where patients and carers could access support during and throughout
  treatment cycles
• Establish protocols based on previous work undertaken by the United Kingdom Oncology Nursing
  Society including patient assessment and management via telephone or as physical presentations to
  the SURC clinic
• Work collaboratively with existing medical staff within the CDU to manage patients outside the scope
  of the nursing role
• Establish patient pathways to ensure safe management of toxicities.

The Western Health pilot demonstrated high rates of patient participation in the SURC model of care, a
reduction in emergency presentations, improved patient satisfaction throughout treatment and very
favourable clinician support. Preliminary results from the 2017 funded projects indicate that similar
outcomes have been achieved. Deakin University has been engaged to perform an economic evaluation
of the implantation of the SURC model at Austin Health and a final report will be available in March 2019.

Symptom and Urgent Review Clinic Initiative: Grants Scheme 2018                                    Page 5
B. Grants Scheme Overview
Objectives
The 2018 Symptom and Urgent Review Clinic Grants Scheme objectives are to:

     Expand the SURC model to additional sites to increase the capability of Victorian CDU management
      teams to support patients experiencing chemotherapy related toxicities.
     Increase support for patients receiving chemotherapy
     Improve the experience for patients and carers
     Be tailored for the needs of the local environment / clinical model of each organisation
     Include early identification, assessment and management of chemotherapy related toxicities
     Provide an alternative pathway to ED presentations
     Include systems for data collection to collect service activity data and to measure the service impact
      with an aim to develop a sustainable model to continue beyond project completion

This will be through the establishment of SURCs in up to five CDUs in Victoria.

The grants scheme is available to sites within the Melbourne metropolitan and regional Victoria; however
there will be a focus on regional Victorian sites to support the development of the model in patient
populations who are geographically distant from their treating cancer care centre.

This round will include two types of grants:

    Grant          Funding            Description
    Type           Amount
    Type 1         Up to $110,000     Start-up Grants to support services who do not already have an
                                      existing model of care to meet the needs of cancer patients
                                      experiencing treatment related toxicities to fully implement a SURC
                                      model of care
    Type 2         Up to $55,000      Capacity Building Grants to support sites with existing services in
                                      place that partially address the needs of cancer patients experiencing
                                      treatment related toxicities who wish to further develop their service
                                      and capture information in the SURC database

Proposed Outcomes
Patient / Carer Level:
            Increased knowledge and understanding of chemotherapy side-effects, how to manage, when to
             report symptoms and how to access support
            Provision of a specified point of contact for telephone or face to face assistance with
             chemotherapy related toxicities
System / Service level:
            Improved management of adverse events
            Reduced number of chemotherapy patients presenting to ED
            A decrease in day of treatment cancellations (efficiency measure)
            Improved CDU efficiency (impact - waiting times on treatment day, time from scheduled
             appointment time to treatment commencement)
            Improved patient education prior to starting treatment (measurement - percentage of first-time
             patients who had a pre-treatment chemotherapy education session prior to starting treatment)
Symptom and Urgent Review Clinic (SURC) Initiative – 2018 Grants Scheme - Application Guidelines 10 August
2018
Expectations of pilot sites
• Engage with key stakeholders including ED, Bed Management, Pathology, Radiology, Pharmacy,
  Surgery, Radiotherapy, Pharmacy, Allied health to provide appropriate, timely care to patients
  experiencing SACT toxicities. This should be operationalised via local steering committee chaired by
  the executive sponsor of the project
• Implement local governance to ensure the quality and safety of a nurse led model of care that is
  tailored to the local environment, ensuring appropriate representation of the multi-disciplinary team
  and consumers
• Tailor resources to the local area that support patients/carers to self-manage SACT toxicities when
  appropriate and seek advice when required.
• Improve understanding of the needs of specific patient groups, differentiated by age, gender, tumour
  type, nationality or cultural background.
• Deliver targeted interventions to identified groups to optimise self-care strategies
• Evaluate the model for acceptability, effectiveness, and sustainability beyond the project
• Encourage strong engagement with consumers and the role and needs of carers.

Scope
 Inclusions                                                         Exclusions
 Sites selected through an EOI process                              Services providing less than 1000
                                                                    treatments per year

 A project manager will provide support to successful individual    Funding beyond the project
 sites and convene a Community of Practice for participating        timeframe for clinical or
 sites and other interested participants                            administrative positions

 Sites provided with documentation templates and toolkit            Private hospital Chemotherapy
                                                                    Day Units

 Use of DHHS SURC ACCESS database for data collection
 Site implementation activities to include:
    Establishment of project governance committee
    Development of local patient pathways
    Appointment of clinic staff
    Measurements at baseline / during and post pilot

 Implementation of SURC model in each project site over a
 minimum six month period
 Evaluation at the local and whole of project levels
 Selected sites must demonstrate organisational readiness
 through:
    Existence of a dedicated clinical space for the delivery of
     the SURC model
    Effective governance and establishment of a working
     group for development of local project documentation and
     pathways
    Ensure continuity of project staff during the funded period
    Be able to participate in data collection using ACCESS
     database

Symptom and Urgent Review Clinic Initiative: Grants Scheme 2018                                     Page 7
Inclusions                                                           Exclusions
    Have sufficient resources for local evaluation of the model

Project Governance

Project Governance Committee (PGC)
Project management oversight will be provided with membership to include:
• DHHS – Cancer Strategy and Development
• Oncology/Haematology medical and nursing representation
• Integrated Cancer Services (secretariat) representation
• Consumer/Carer representatives.

The PGC will provide a framework to support project sites including development of a toolkit to support
local implementation which will include templates for:
• Development of patient pathways
• SURC Assessment and management adapted from the United Kingdom Oncology Nursing Society
  (UKONS) documentation
• SURC Nursing role position description
• SURC Nursing role orientation manual
• Quality Improvement ethics submission preparation for local sites
• User manual for ACCESS database

SURC Community of Practice
A Community of Practice (CoP) will continue to provide support to successful sites throughout the
project.
The CoP will be open to all health services with an interest in the SURC model but attendance is
mandatory for funded sites.

Key dates and information

 Milestone/ Activity                                                     Key Dates
 SURC Initiative Grant process opens                                     Monday 13 August 2018
 Closing date for 2018 SURC Initiative Grants                            Tuesday 11 September 2018 at
                                                                         3pm
 Application assessment process and approval                             Tuesday 11 September –
                                                                         Monday 1 October 2018
 Successful sites advised                                                Tuesday 2 October 2018
 Payments to sites                                                       Tuesday 9 October 2018
 Project commencement                                                    Monday 5 November 2018
 Project completion                                                      Friday 4 November 2019
Submit any questions to cancerplanning@health.vic.gov.au cancerplanning@health.vic.gov.au

Symptom and Urgent Review Clinic (SURC) Initiative – 2018 Grants Scheme - Application Guidelines 10 August
2018
C. Application Process
Funding available
The total funding available for the SURC projects to develop, implement, evaluate and embed the
models is up to $440,000 over 12 months.
The table below outlines the grant’s objective, the funding available per site and funding timeframes.

 Description                                            Proposed     Funding      Funding       Total
                                                        number of    per          timeframe     funding
                                                        projects     project      per grant
 Type 1: Start-up Grants to support services who        3            Up to        1 year        $330,000
 do not already have an existing model of care to                    $110K
 set up a SURC program

 Type 2: Capacity Building Grants to support            2            Up to        1 year        $110,000
 services that wish to leverage existing funding or                  $55,000
 initiatives to build on the existing capacity to
 provide a SURC service

Submission of applications
• All applicants must complete a 2018 SURC Pilot Grants Scheme application form via the Smarty
  Grants application website.
• The department will NOT accept emailed, faxed or hard copies of applications.
• Applications will only be accepted if they are lodged on or before the closing date.
 Applications must be received by Tuesday 11 September 2018, 3pm

Symptom and Urgent Review Clinic Initiative: Grants Scheme 2018                                     Page 9
D. Eligibility criteria
Applications are invited from Victorian operated public health services that provide more than 1000
occasions of same day chemotherapy services per annum.

Applicant requirements
• The lead applicant must be an employee of the participating organisation.
• The applicant should read through all instructions and guidelines regarding the aims and objectives
  and application processes for this funding round.

Project requirements
• The project must be completed by a Victorian operated health service.
• Projects must have specific aims and outcomes that align with the objectives outlined in Part B and
  are achievable in the designated timeframe.

Exclusions
The SURC Pilot Grants Scheme, 2018 will not fund:
• A service that already provides a SURC model of care
• Projects that are currently funded through other targeted initiatives/grants
• Ongoing operational costs for existing models of care
• Development of IT/ software to support the model of care.

Participating organisation requirements
Applicants must make their application under the auspices of a Victorian operated public hospital.
The administering organisation must:
• Certify in the application form that they meet the requirements for receipt of government funding.
• Have in place policies and procedures for the management of public funds.
• Have in place policies for the proper conduct of projects.
• Provide adequate infrastructure to allow the project to be completed.
• Applicants must demonstrate that there is a suitable clinical area in which the project can be
  undertaken.
• It is expected that the participating organisation will ensure that there is effective governance of the
  project and have in place a process for evaluating the effectiveness of any governance arrangements.
• Applicants must have the approval and endorsement of the Chief Executive of the organisation where
  the project will be carried out.
• Applicants must have the endorsement of a member of the Emergency Department executive team
• Applicants must have the endorsement of an appropriate person from the Information Technology
  department to confirm that the organisation will facilitate the use of MS ACCESS, a requirement for
  data collection.
• The participating organisation will provide the facilities and infrastructure to undertake the project.

Symptom and Urgent Review Clinic (SURC) Initiative – 2018 Grants Scheme - Application Guidelines 10 August
2018
E. Assessment Process
Selection criteria and requirements
 No.     Criteria                                                                          Weighting
 1       Alignment with the SURC model
         In particular:
         • How the project meets the objectives and principles of the SURC
           model.                                                                          10%
         • The project addresses the specific focus criteria including
           interventions that promote self-management, initiatives with an                 10%
           intervention focused on avoiding unplanned ED presentations
         • Identifies how the outcomes of the project will be measured and
           describes what successful implementation looks like.                            10%

 2       Demonstration of need
         • Evidence that the applicant has an identified patient population who            25%
           would benefit from a SURC model of care.
 3       Capacity to undertake the project
         • Evidence of applicant’s satisfactory completion of previous projects            10%
           and compliance with project requirements (track record).
         • Appropriately qualified staff available for the proposed timeframes.            10%
         • Identification of an appropriate geographical location and                      25%
           infrastructure to support a SURC model of care
 Total                                                                                     100%

Evaluation process
A receipt of submission will be sent to applicants via email by Smarty Grants.
Applications will be screened by the Cancer Strategy and Development unit to ensure that selection and
eligibility criteria have been met.
An Evaluation Panel will be convened to assess applications and make recommendations for funding.
The recommendations from the Evaluation Panel will be considered by the department, who will
determine the number of applications it is able to fund, its obligations under government policy, and the
overall strategic objectives of the Cancer Strategy and Development section.
The lodging of an application does not confer any entitlement on the applicant. The making of a
recommendation is totally within the discretion of the assessment panel and the department.
All applicants will be advised in writing of the final outcome of the selection process.

Privacy
All information contained in applications will be regarded as confidential. Documents containing personal
information will be handled and protected in accordance with the provisions of the Privacy and Personal
Information Protection Act 1998. Personal information will only be disclosed with the permission of the
individual to whom it relates, or where the Act allows.

Symptom and Urgent Review Clinic Initiative: Grants Scheme 2018                                        Page 11
Applicants consent to the information supplied as part of their application being disclosed for the
purposes of the evaluation and administration of the grant. Such disclosure includes but is not limited to
members of evaluation panels, independent readers/assessors requested by evaluation panels to
provide advice on the applications, Department of Health and Human Services and Cancer Strategy and
Development staff, and relevant employees of the Victorian Government involved with the grant process.
Applicants acknowledge that announcement of the funded grants will involve the dissemination of
information to the public about the general nature of the funded grants.

Conflict of interest
The Victorian Government requires all Evaluation Panel members to act in an ethical manner, declare
conflicts of interest and withdraw from considering applications where such conflict exists.

Symptom and Urgent Review Clinic (SURC) Initiative – 2018 Grants Scheme - Application Guidelines 10 August
2018
F. Administration and reporting requirements
Applicant
The Applicant will be responsible for guiding and managing the project through to completion. This will
include liaising with collaborators and coordinating reporting requirements of the grant with the
administering organisation.
Where the project involves several sites, the Applicant must obtain written commitment from all Chief
Executive Officers of collaborative partners not within the Administering Organisation or Host
Organisation, and must assume responsibility for undertaking and completing the activities outlined in the
application.
The lead applicant must enter into a funding agreement with the Department of Health and Human
Services that sets out the terms and conditions, including delivery of the funded activity described in the
application form.
A sample copy of the funding agreement is available at the Symptom and Urgent Review Clinic website
https://www2.health.vic.gov.au/about/health-strategies/cancer-care/cancer-projects

Administering organisation
The Administering Organisation will be responsible for administration of the project and funding.
Funds must only be used for the purposes set out in the agreement.

Funding
The total grant amount will be paid in the following instalments:
• Eighty per cent (80%) of the total grant amount is paid after the department receives and accepts the
  signed agreement
• Twenty percent (20%) will be paid upon acceptance of a final report and financial acquittal.

The grant recipient (or funds manager) must spend the grant funds as described in the agreement with
the department, and acquit all purchases funded by this grant.
A written request to vary the approved items of expenditure for approved grant amounts must be
submitted to the department for approval prior to implementation.
All funds must be spent by February 2020.
The department must be notified of any funds unspent by February 2020 and, if requested, these
unspent funds must be returned to the department.

Goods and services tax
GST will be paid on top of grant amounts where appropriate. This will be determined by the administering
organisation’s GST status. This status must be identified by the financial delegate of the Administering
Organisation. Please include the administering organisation’s GST status in the application.

Public Liability
The grant recipient (or funds manager) must ensure it has arranged public liability insurance for at least
$10 million for any one occurrence; such insurance indemnifies the group against personal injury and/or
property damage claims made by third parties in connection with the group's activities.

Symptom and Urgent Review Clinic Initiative: Grants Scheme 2018                                     Page 13
Proposed Reporting
Grant recipients will be required to submit reports on a regular basis.
A proposed reporting schedule is listed below:

 Report                                      Reporting frequency           Due

                                                                           Monday 3 December 2018
 Project plan and risk assessment            Once
                                                                           One month post commencement

                                                                           Monday 4 February 2019
 Progress against milestones, risk
                                             3-monthly                     Monday 6 May 2019
 assessment and/or targets
                                                                           Monday 5 August 2019

                                                                           Monday 2 December 2019

 Final report including sustainability                                     One month post-completion of
                                             Once only                     project; final payment contingent
 plans for pilot sites
                                                                           upon Departmental acceptance
                                                                           of the report

These reports will enable the department to assess whether the project is proceeding satisfactorily, and
that funds are being acquitted in accordance with the original application goals.
The department reserves the right to consider suspending funding if progress is considered
unsatisfactory, or funds have not been utilised in accordance with the grants process, and project’s aims
and objectives.

 G. References

Department of Health (2014) A guide to chemotherapy day unit redesign measures for improvement
https://www.bettercare.vic.gov.au/knowledge-hub/publications/a-guide-to-chemotherapy-day-unit-
redesign

United Kingdom Oncology Nursing Society (UKONS) Oncology/Haematology 24 Hour Triage Rapid
Assessment and Access Toolkit accessed on 10/8/2018
https://az659834.vo.msecnd.net/eventsairwesteuprod/production-succinct-
public/578dfe8d80804d458b365da5efa8fb19

White K, Roydhouse J, O’Riordan L, Wand T. Interventions for reducing the use of adult Emergency
Department services by cancer patients: an Evidence Check rapid review brokered by the Sax Institute
(http://www.saxinstitute.org.au) for the Cancer Institute NSW, 2013.

Symptom and Urgent Review Clinic (SURC) Initiative – 2018 Grants Scheme - Application Guidelines 10 August
2018
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