Programme no. 109-SY
Quality Improvement
Pakkeforløb – the Scandinavian way to reduce waiting times for cancer patients and improve cooperation between primary and hospital care.
Gunilla Gunnarsson*1, Staffan Ekedahl*2, Helena Brändström*3, Peter Vedsted *4, Anne Hafstad*5
1Regionala cancercentrum i samverkan,Stockholm,Sweden;Sveriges Kommuner och Landsting,Stockholm,Sweden, 2Sveriges Kommuner och Landsting,Stockholm,Sweden;Region Jönköpings län, ,Sweden, 3Regionalt cancercentrum Uppsala Örebro,Uppsala,Sweden;Regionala cancercentrum i samverkan,Stockholm,Sweden, 4Aarhus University,Aarhus,Denmark, 5Helsedirektoratet,Oslo,Norway
* = Presenting author
Objectives: Introducing the Danish model with “pakkeforløb” even in Norway and Sweden is supposed to reduce waiting times, decrease local and regional differences and make cancer patients more satisfied.
One objective for the symposium is to emphasize the important role primary care physicians play in the work with pakkeforløb in Scandinavia. The experiences of the implementation of standardized care processes so far, will be shared. Challenges and opportunities that pakkeforløb bring for primary care will be discussed.
Background: Cancer patients in the Nordic countries often wait too long for treatment. In Denmark, Norway and Sweden the waiting times for care are way too long from the patient's first health care contact until he or she receives a diagnosis and gets treatment.

In the three countries, it has been a government priority to develop cancer care and to reduce waiting times. Denmark introduced as the first country pakkeforløb as a mean to reduce the lead between the physician´s serious suspicion of cancer and the beginning of treatment. Inspired by the Danish example, Norway and Sweden are planning to introduce standardized care processes in several cancer diagnoses in 2015.

Content: Even though primary care is organized differently in the three countries, GPs play a key role in the pakkeforløb model. In the symposium, Denmark will share their experiences of the introduction of pakkeforløb, and how these have affected waiting times and results in the Danish cancer care.

Representatives from the initiative to introduce pakkeforløb in Norway and Sweden will describe their circumstances and the challenges and opportunities that standardized care processes will bring for the relationship between hospital and primary care.
A panel discussion on what we can learn from each other concludes the symposium. How do primary care physician learn from managing pakkeforløb in their daily work? What do primary caregivers know about pakkeforløb in the three countries? And what about alarm symptoms, are they well known? What competencies are needed to refer patients to a standardized care processes – and do primary care physicians in Denmark, Norway and Sweden have these competencies already?

Method: The Danish model with pakkeforløb will soon be used in all the three Scandinavian countries. The symposium presents how this method could be implemented, with similarities and differences, and its impact on cancer care processes in the different countries.
Other considerations: So far, we have not identified any particullar considerations.