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Quality of care is dependent on the staff providing that care. The NCS clearly identified the need for more staff dedicated to delivering cancer services, and that further training for existing clinicians was essential. Significant recruitment has since occurred across the healthcare system and has resulted in increased sub-specialization at the physician level, the training of 13 MSc advanced clinical nurse specialist and the introduction of new roles including Patient Pathway coordinators. Secondary and tertiary care recruitment was also complimented with recruitment to support the breast and bowel-screening program.In addition to this, Qatari surgeons have previously and should continue to participate in board certified fellowships programs in overseas centers of excellence.This will support the ongoing work of developing Qatari surgeons.

Over the last five years, significant investment has enabled progress in early detection, rapid diagnosis and treatment of cancer. There is a need to demonstrate how further recruitment and staff development will ensure value for the health sector and continue to improve patient experience.It is therefore recommended that advanced practice programs be considered across all levels of healthcare to help ensure continued professional development
of retained staff and where applicable the further sub specialization of allied health professionals.

In order to support new recommendations around thet ransition of the ongoing care away from specialist acute centers, adequate primary care resources need to be identified, re-deployed and budgeted for to support this multidisciplinary service. Recruitment of healthcare staffis an increasingly globally competitive challenge. Qataris competing with both established systems and those developing in the region. To attract the best talent, Qatar must ensure that the terms and conditions that can be offered to prospective staff are competitive.

  • Continued professional Development
The healthcare professionals event survey from May 2016 asked, Where do you think future investment could be best placed to deliver excellence in cancer care? The results showed that 68% thought that investment would bebest placed in primary care and the community.

To manage the increasing volume and complexity of patients in secondary and tertiary settings, care should,where appropriate, transition to the primary and community setting. A key factor in the successful implementation of this plan will be adequate resourcing of facilities and most importantly the ongoing education of and take on a greater role in caring for cancer patients. These education programs represent a good opportunity to collaborate between providers and could be supported by existing programs, such as those run by the Qatar Cancer Society.

Increasing the scope of primary care physicians places a significant and sometimes added responsibility to be familiar with all types of cancer symptoms, the latest advances in diagnosis, clinical care pathways and the most appropriate specialists for referral. This will become even more important in the future as more cancer services move into the community.

To support the developing role of primary care in the diagnosis and management of cancer patients it is recommended that a Qatar Council for Healthcare
Practitioners (QCHP) accredited professional development program be developed and rolled out to all physicians with a specialist interest in cancer. Currently PHCC have identified and trained 20 Family Physician cancer champions located in centres around Qatar. The aim of this program would be to focus on increasing the role of these family physician champions to be the patients ongoing point of contact, pre- and post-treatment for cancer. The scope of license for key diagnostic roles such as radiologists and ultrasound technicians should also be reviewed and expanded to develop primary care diagnostic services that would further decrease the burden observed the secondary care setting.

Where possible, further sub-specialization of care continues to ensure delivery of excellent care. Sub-specialization is an ongoing process that reflects the changing perspectives of diagnostic, treatment and management of cancer patients.In support of continual professional development, the oncology fellowship program at NCCCR has received accreditation from the Accreditation Council for Graduate Medical Education International and the Hematology
fellowship program should be next. Upon completion of the program and wherever possible the graduates of this program should be placed into roles within the Qatari health system to ensure these highly skilled physicians are retained in the country. It is also recognised that where appropriate collaborative education programs with international partners should continue to share and develop best practice.

The successes delivered in the NCS from a nursing perspective in the development of the Masters in Nursing program should continue. This will ensure ongoing delivery against the recommendation to develop locally trained clinical nurse specialists and that every patient has access to a nurse who is specialized in their type of cancer. In addition to this, the frontline nursing work forceat NCCCR will continue to be developed as cancer nurses.
Consideration should be given as to how those nurses working with cancer patients across the wider health system can also have their cancer knowledge developed.

Delivering excellent cancer care can only truly be achieved with a specialist cancer workforce. To achieve this there needs to be increased focus in the development of all healthcare professionals working in cancer to enable specialization across the clinical workforce. This program will focus on providing development opportunities for retained staff and will involve a combination of localbespoke training, international development programs as well as one to one (1:1) mentoring programs.

  • Recruiting appropriate workforce
The need to accelerate and prioritize recruitment for specialist staff that can provide comprehensive diagnostic and pathology services is covered in Domain 5. However,these are not the only disciplines where challenges with recruitment pose a risk to development or continued delivery of high quality cancer services. As Qatar is competing in a global market to fulfil these requirement sand must also focus on developing the staff currently in the system, particular attention should be paid to Qatari nationals.To facilitate the improved management of patients living with cancer it is recommended that the skill mix requiredto deliver multi-disciplinary ongoing care be reviewed.Recruitment of hard to fill positions, or where significant staffing gaps exist, should be prioritized, based on projections of future activity. These trends must however take into account the desire to shift the burden of care
towards primary and community settings. There will be opportunities to share expertise across the acute and primary healthcare settings and wherever possible this program of knowledge transfer should be developed.With significant investment, having already occurred in cancer care, there needs to be a transition in focus to retaining and developing the skills already in country by providing the opportunity for more health care professionals across all levels of healthcare to be able to​ grow, develop and assume new roles.

Program Activities:
Continued professional Development
  • ​Undertake an assessment of required staffing and resource to shift balance of care for cancer to primary and community settings
  • ​Support extending the scope of primary care licenses for key diagnostic roles
  • ​Develop training programs, both accredited and non-accredited for all existing staff
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