Grampians Region Colonoscopy Access Project
This project aims to explore timely access to colonoscopy for people after a positive (FOBT) result.
In August 2024, GICS received Federal Government funding to explore timely access to colonoscopy.
The project aim is to explore concordance with Clinical Practice Guidelines for timely access post a positive Faecal Occult Blood Test (FOBT) result within the Grampians region, and to identify priority areas and activities to improve access to timeline colonoscopy.
This project has been dubbed the Colonoscopy Access Project (CAP).
Overview
The project will have focus across three streams Patient, Primary Care, Tertiary Health Services perspectives and aims to:
- Streamline and expand referral pathways to improve equitable and timely access to colonoscopy for National Bowel Cancer Screening Program (NBCSP) participants
- Improve compliance on colonoscopy reporting to the National Cancer Screening Registry
- Reduce the stage of disease for patients at diagnosis through earlier detection of disease enabled by the NBCSP.
Over the duration of the project we will be engaging with key stakeholders across the region to identity current issues across the streams, work through feasible solutions and to increase compliance to the National Cancer Screening Registry.
Project Update
April 2025
Over the past 4 months the Project Leads have undertaken an extensive Diagnostic/Discovery phase of the project focusing on both Primary Care and Tertiary Health Services and to understand the current state of referrals (from GP to Health Service and the Health Service journey), triage and waitlisting for procedure.
Across the Grampians Region there is 8 regional hospitals, with Grampians Health (Ballarat) being the only public theatre list hospital to accept referrals from multiple agencies including Primary Care, Specialist Clinics and internally (from Ward/Emergency Department) for Endoscopy services. All ‘other’ Regional hospitals within the Grampians Region whilst having Endoscopy theatre lists are managed and booked by Private Specialist rooms or funneled through from Grampians Health (Ballarat site). This has led to the Project Leads not being able to capture reliable and accurate data on number of procedures, CRC diagnosis, referral waitlist timeframes completed at the regional hospital sites outside Grampians Health (Ballarat).
Based on this, a deeper dive exercise was conducted for Grampians Health (Ballarat) of which a full mapping exercise of the referral pathway journey from presenting to GP (via NBCSP or presenting symptoms) was completed. This exercise identified pain points and critical issues that impacted and delayed the referral processing for patients to be waitlisted and made ‘ready for care’ for Colonoscopy procedure. These pain points and critical issues were also identified as part of the Discovery co-design workshop.
Overall, for public referrals, it was documented that the Optimal Care Pathway (OCP) timeframe to procedure recommendations were not being met regardless of reason the patient was being referred for Colonoscopy (NBSCP or presenting complaint). It was identified as part of the mapping that the categorisation of referrals were accurate and did meet the Colonoscopy Categorisation Guidelines 2017, however the time from acceptance of referral to triaging of referral did not met the Planned Surgery Access Policy 2024 guidelines.
The Primary Care stream diagnosis review, led by the Western Victoria Primary Health Network (WVPHN), highlighted the challenge of patients accessing a Primary Care professional and the wait periods associated to a high pressurised and stretched system. Primary care clinics in the Grampians region were sent opt in surveys to gather their understanding of the NBSCP and NCSR, the survey identified that GPs regularly discussed opportunistically with patients Bowel Cancer Screening, with some confidence in using the National Cancer Screening Register to access the NBSCP kits under Alternative Access Model to Bowel Screening.
A critical component of the diagnosis phase was to undertake two co-design workshops and bring identified key stakeholders together to discuss current state and future state. The workshops were held in December ’24 and February ’25 and focused on Discovery – pain points and critical issues and Solutions – what does future look like by identifying high value, high impact solutions.
At conclusion of the diagnosis phase and co-design activities, a number of recommended solutions have been proposed and mapped out across Primary Care and Tertiary Health Care with the aim to improve timely care to Colonoscopy:
- System enhancements to software used for Referral management
- Increase to National Cancer Screening Register (NCSR) registrations, usage and reporting
- One accessible data report – compiling a number of data sets to bring into one visual real-time report
- Development of eReferral template (specific to Colonoscopy)
- Management of Surveillance Scopes – Health Services & Primary Care
- Planned Care Navigator model to coordinate and manage referral journey from triage to waitlisting and ready for care.
The third stream of this project, Patient perspective is being undertaken by Deakin University with ethics currently being sought to commence their diagnostic phase of the project. Further updates will be available in the next few months.
