- How many providers are needed?
- What type of providers are needed?
- How to organize and distribute providers?
- How to ensure providers are adequately trained to provide high-quality care.
The World Health Organization (WHO) strategy for optimizing the cancer health workforce includes increasing the number of providers through increased training, decrease provider attrition rates, improve efficiency through service prioritization, intervention efficiencies, and optimization of the workforce through the organizational structure. Beyond the mere increase in the number of health care providers, the WHO recommends supportive supervision, which includes improving performance and building relationships, use local data to monitor performance and solve problems, follow-up regularly, and provide support only.
It is critical to prioritize high-impact cancer services. A good example is a radiologist, which are in desperate need in low-income countries. Training and acquiring enough radiologist, will, among other things, help start and support screening programs for breast cancer for example.
Improving the quality of the health workforce, will eventually empower the people, and develop their full capacities. It also boosts future innovation and development, expands labor market opportunities and reduces social inequalities. The health workforce must be equitably distributed and accessible, competent and motivated, empowered to deliver quality care and adequately supported by the health system.
The WHO workforce survey in partnership with the European Society of Medical Oncologists (ESMO) gathers data for a situational analysis to asses the workforce and determine tailored interventions. It includes seven modules, as seen in Figure 1.
Figure 1 – The modules of the WHO-ESMO workforce survey:
The WHO oncology workforce pilot project includes several important steps with the final goal of improving outcomes of cancer patients (Figure 2).
Figure 2 – WHO oncology workforce pilot project steps:
Dr. Trapani concluded his talk with three important principles. First, “One size does not fit all.” Cancer control planning and workforce should be tailored to the specific epidemiologic burden and health system capacity in each country. Second, “It's not the number, it’s the package.” Workforce strategies require an adequate number of providers, optimization, competencies, and quality. Third, “A strategy without a plan is just a dream.” Rapidly rising cancer burden requires a comprehensive, evidence-based approach that incorporates all needs in cancer care from quality providers, to appropriate technologies and resources. All stakeholders need to be involved, including physicians of all specialties.
Presented By: Dario Trapani, MD, European Institute of Oncology, Milan, Italy
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter:@GoldbergHanan at the 2018 European Society for Medical Oncology Congress (#ESMO18), October 19-23, 2018, Munich Germany