20 Years of the VICS: Milestones so far

In 2004–05, the Victorian Department of Health and Human Services established 9 Integrated Cancer Services (ICS), each a partnership of health services and cancer leaders within an area, to support members in implementing cancer policy and improving quality of cancer service delivery.

All publicly funded health services in the state, that treat or support people affected by cancer, are members of their local ICS. By 2025, the Victorian ICS (VICS) network had a total of 115 member organisations.

The PICS Regional Outreach and Shared Care Program (ROSCP) supports care as close to home as possible, when it is safe and appropriate to do so, for children and adolescents affected by cancer across Victoria.

Around 30% of the children and adolescents with cancer treated by The Royal Children’s Hospital (RCH) and Monash Children’s Hospital (MCH) live in regional areas. Some cancer treatments and supportive care can be delivered across Victoria, without needing to travel to Melbourne. The ROSCP helps to make this happen by linking treating teams at RCH and MCH with participating health services across Victoria, and coordinating shared care clinics at their regional centres.

Since it began in 2006, the ROSCP has supported more than 1,300 patients and their families.

This program impacts lives in a lot of different ways that may not seem that much to some people… [but] it’s so much more to us. Thank you for giving us the chance to breathe again… It’s more appreciated than I think you know.

– Mother of Amy, who was treated for precursor B-cell acute lymphoblastic leukaemia as a baby at the Royal Children’s Hospital in Melbourne and closer to home at Bendigo Health

The Victorian Government Department of Human Services published a policy in 2007 (PDF) to ‘promote development of a multidisciplinary approach in health services providing care to people with cancer’ and ‘promote linkage of multidisciplinary teams to other teams and to individual practitioners within and between the Integrated Cancer Services’. The VICS were a key structure for implementing this policy, responsible for:

• collecting service mapping data to identify gaps and opportunities for new multidisciplinary teams
• examining referral patterns to identify linkage needs
• identifying technology requirements to link team members at distant sites, different teams within an ICS area, and metropolitan ICS to regional ICS.

By 2018, with this support from the VICS, more than 180 different multidisciplinary team meetings (MDMs) were operating across public and private cancer settings in Victoria. At that point, the VICS and the Dept of Health and Human Services codeveloped a Victorian cancer multidisciplinary team meeting quality framework (PDF) to enhance and support the quality, effectiveness, and consistency of MDMs.

Victoria’s cancer services performance indicator (CSPI) program was established by the Department of Health in 2007 to measure and monitor alignment with Victorian Government policy. The VICS conduct regular CSPI audits within the patient medical record at our member health services, in collaboration with the Department of Health. Each audit examines more than 3200 patient medical records across Victoria. The information we collect is used to guide service improvement activities across each Integrated Cancer Service (ICS) region.

The Cancer Services Network National Demonstration Program (CanNET) was a national program funded by Cancer Australia from February 2007 to May 2009, to improve outcomes and reduce disparities in outcomes for people affected by cancer by providing high-quality, clinically effective, and coordinated cancer services across Australia. In Victoria, the program was implemented by our Hume Regional Integrated Cancer Service (HRICS) and North Eastern Melbourne Integrated Cancer Service (NEMICS). Their focus was on linking metropolitan and regional services, new strategies for consumer participation, and establishing multidisciplinary lung tumour groups in Melbourne that regional clinicians could join through online meetings.

The project pioneered work to facilitate linkages between multidisciplinary teams and expanded in its fourth year to become a statewide project. Impacts included technology upgrades to facilitate multidisciplinary meetings (MDMs), a revised MDM toolkit, and a new toolkit supporting consumer participation in cancer reform.

Our paediatric Integrated Cancer Service (PICS) established Victoria’s Long-Term Follow-up Program (LTFP) for survivors of childhood cancer in 2008. The program supports monitoring and management of potential long-term impacts of children and adolescents’ cancer diagnosis and treatment. To date, the program has supported more than 2,300 patients and their families.

“Overnight, life went from planning everything around chemo cycles and side-effects, to having more freedom and energy to do so much more, but still feeling so behind everyone else because my body had just been through so much”

– Lucy, who was treated for Stage 3 Anaplastic Large Cell Lymphoma

The VICS informed the development of and supported operationalising the state government’s Supportive Care Policy for Victoria 2009 (PDF), which was designed to promote a strategic, population-based, person-centred approach to the provision and enhancement of supportive care for all Victorians affected by cancer. We used the policy’s supportive care organisational checklist to map health providers’ readiness to implement a systematic approach to supportive care. The VICS also held our first joint Supportive Care Conference in October 2009, with presenters from all 9 ICS.

In 2024, the VICS conducted a statewide self-assessment survey to evaluate supportive care screening practices across Victoria and identify gaps and opportunities to further improve supportive care screening and deliver high-quality, patient-centred care.

As part of a Cancer Australia initiative, the VICS supported development of a network to improve care and outcomes for adolescents and young adults with cancer in Victoria and Tasmania. Parts of the VICS undertook mapping of services available to young people with cancer in their region and audits of the care provided to young patients in 2009. The VICS also worked with the Victorian Assisted Reproductive Treatment Authority (VARTA) to develop a one-hour education program for health professionals on preservation of fertility prior to cancer treatment, which was delivered to at least 10 hospitals in 2011–2012.

As part of the National Cancer Work Plan (2012) for improving cancer care, Victoria led development in 2014−15 of the nation’s first Optimal Care Pathways (OCPs) for cancer care. OCPs for 15 tumour types were developed through a multidisciplinary process drawing on best available evidence and clinical, policy-maker and consumer involvement. A consistent structure was based on similar work developed previously in Victoria. After Australian Government endorsement in 2015, implementation tools and strategies were developed, with tailored rollout in each State and Territory.

As Victoria’s state-funded platform for cancer service improvement, the VICS were instrumental in both designing the original OCPs and implementing them across Victoria. National OCPs are now available for 30 tumour types and two priority populations, with more being launched later this year.

The VICS developed a statewide ‘Victorian Cancer Performance Monitoring Framework (VCPMF) to synchronise ways of identifying and addressing challenges to cancer outcomes and performance. The project identified, tested and piloted a suite of indicators for cancer service performance in Victoria, as well as an overarching framework for evaluating the quality and outcomes of cancer care.

The framework was designed to direct the data collection, reporting, dissemination, review, and analysis of findings as part of a broader effort to ‘close the loop’ with consumers, clinicians, health service executives, administrators, quality personnel and other cancer stakeholders.

Since 2014, the VICS have undertaken 17 statewide, multidisciplinary consultations to identify and examine unwarranted variations in care and outcomes for specific tumour types. The VICS Optimal Care Summits program, formerly known as the Victorian Tumour Summits, delivers strategic consultation, multidisciplinary engagement, data and information analysis, and reporting to examine patterns of cancer care and prioritise improvement activities.

Summit recommendations have driven statewide program redesigns, updates to national Optimal Care Pathways (OCPs), new standards for multidisciplinary meetings (MDMs), and various scoping projects and pilot schemes.

In 2016, the VICS held our first statewide forum on ‘consumers’ – that is, people with lived or living experience of cancer treatment or being carers for someone affected by cancer. Most ICS already had formalised consumer advisory groups, some of which were leading and steering their own initiatives. Each ICS presented a local consumer-related or consumer-initiated project, for attendees to discuss potential to roll out in other ICS areas.

VICS staff and consumer representatives have come together for several consumer forums since – Watch a recording of our 2019 forum on YouTube here. In 2020, we established a standing Consumer Engagement Peer Group to share local ICS consumer-related activities and plan future consumer forums. Those forums (now ‘Consumer Catch-ups’) have been held regularly ever since.

“Any life-threatening condition carries with it deeply personal challenges for the person involved, family, friends, etc. By bringing these personal perspectives to bear, consumer engagement can play a vital part in both humanising and improving the services delivered by the health system.”

– Mike, consumer representative

Symptom and Urgent Review Clinics (SURCs) are a nurse-led model of care used across Victoria to address treatment-related toxicities during active chemotherapy treatment. They fill an important service delivery gap for ambulatory patients by helping to recognise and manage symptoms early, to avoid presentations to the emergency department or rescheduling of treatment.

The SURC model was first developed and piloted at Western Health in 2013. Starting in 2018, the Victorian Dept of Health funded its implementation at 12 sites across Victoria, many of which were supported by the VICS. An evaluation of the pilot implementation at the first four sites in 2018 found the model to be acceptable and feasible.

There are now around 20 SURCs across Victoria. In 2022–23, NEMICS and the Dept of Health co-funded a project at Austin Health that developed quality indicators for SURCs, evaluated the model in 7 hospitals and identified opportunities to strengthen SURC processes.

At the VICS Pancreatic Cancer Summit in 2017, clinicians noted a lack of common criteria for surgical resectability in pancreatic cancer as a barrier to optimal care. To address this, SMICS and NEMICS gathered interested clinicians to agree a common set of guidelines and led facilitated co-design of a new synoptic radiological report template. They piloted the new template in 2 relevant multidisciplinary meetings (MDMs), finding it to be a valuable and useful tool for radiological assessment and surgical decision-making.

Following the VICS’ successful pilot, a grant under the Medical Research Future Fund was awarded to Monash University Chief Investigator A/Prof. Charles Pilgrim (who had chaired the VICS project) to further test and roll out the new report template at 40 pancreatic cancer treatment centres across Australia.

“Well done. Great initiative to improve consistency in reporting and (hopefully) reduce variability in treatment decisions”

– Feedback from a surgeon on the initial VICS pilot

In 2025, the VICS are celebrating 20 years as Victoria’s cancer service improvement network. To mark the occasion, we commissioned a new artwork by Victorian Aboriginal artist Vegas Fitzmaurice. Explore the piece here.