The American College of Surgeons’ National Accreditation Program for Breast Centers (NAPBC) has identified the Netcare Milpark Breast Care Centre of Excellence in Johannesburg as one of the top accredited centres of its kind in the world. This month, the centre has been invited to contribute its protocols for the development of an international best practices guideline to help empower other centres to better serve their patients.
“We congratulate renowned specialist surgeon and breast disease specialist, Professor Carol Ann Benn and the dedicated multi-disciplinary team of the Netcare Breast Care Centre of Excellence on all they have achieved in providing the highest standards of care to patients every day, which is freshly affirmed with this outstanding honour,” says Dr Cindy Aitton, head of Netcare’s Cancer Care division.
“We are proud to be a South African centre offering world-class care to all. Meeting and exceeding the standards set out globally have, at times, been a challenging process since our practices have not just been different from other centres in South Africa, but are also in some respects breaking new ground internationally,” comments Professor Benn, who first established the centre with Netcare in 2001.
A South African perspective
Every few years the NAPBC performs an assessment of breast care centres, which are mostly based in the United States, to determine whether they qualify for accreditation, or for renewal of their accreditation. The centre was most recently re-accredited by Professor of Pathology at Harvard Medical School and acting head of NAPBC’S accreditation department, Professor James Connolly. The Netcare Milpark Breast Care Centre of Excellence once again earned top marks scoring a 100% across all 29 standards and 17 recommended points of care that were measured.
Globally, accreditation has been shown to improve patient care by ensuring doctor compliance to high standards of clinical governance. Accredited units have to collect data, as well as feedback, on outcomes while ensuring high standards.
“This recognition shows that not only is there benefit from a patient treatment perspective, but being recognised as one of the flagship centres out of an accreditation system that monitors over 650 other centres internationally, shows the dedication and hard work of the team involved is reaping tremendous rewards,” Dr Aitton says.
“The centre is dynamic in that it is a continually growing and improving systems. We are a team that encourages free thinking and ideas from all members, including allied and navigator teams, ensuring we are constantly building on our own experiences in an African setting combined with international guidelines,” comments Professor Benn.
Building international best practice
“It is most rewarding that from 2022 onwards, new and improving centres around the world will see the Netcare Milpark Breast Care Centre of Excellence as a goalpost to aim for, and our best practice protocols will help guide the development of patient care worldwide.”
The centre has always strived to provide the best standard of care both to patients with access to medical funding and those without medical insurance, who are managed at Helen Joseph Hospital’s breast unit. Personalised inter-disciplinary and multi-disciplinary care is provided for patients with breast cancer, with 35 or more attending professionals giving input on patient treatment options, both within their own disciplines and across other disciplines in oncology.
“The centre uses digital support systems allowing for rapid first contact with concerned patients. Rapid access to best practice care is provided, without the person being rushed into treatment. A full and robust multi-disciplinary review of the patient is conducted within seven days, and our process is geared towards careful selection of the best treatment options for cancer care, taking into consideration each patient and their circumstances in a holistic way,” Professor Benn explains.
More options, better care
“The centre’s approach is that individuals are treated more on the biology of the disease rather than according to the stage of presentation. Time to primary treatment, be it surgical or oncological, occurs within three weeks and patients are kept updated and supported with detailed feedback throughout.”
Each patient is guided by an experienced oncology nurse navigator through all related aspects of diagnosis and treatment for a supportive experience, aligned to our holistic and person centred approach to cancer care. When confronted with a diagnosis, this can have wide-ranging implications for the person’s life. The navigators’ role is to assist in ensuring that patients are well cared for throughout their journey and that their individual needs are supported.
“It is all too often that we see traumatised patients who have spent money and time, and have been rushed through services without even understanding their diagnosis or treatment options, which is particularly sad when funding is limited. Our holistic approach includes navigators advising and coordinating support to assist patients with financial issues, family and fertility care, psychological and complementary oncology services, as well as traditional medicine, geriatric care, and a buddy support system,” Prof Benn says.
Person centred breast care
The ethos of personalised care upheld at the centre is providing more options for cancer care, alongside the international trend in oncology towards a ‘less is more’ approach, personalised to the specific needs of the patient.
“More patients can benefit from options such as intra-operative radiation and cryosurgery, which is the minimally invasive freezing of cancers, often replacing the need for traditional surgery in appropriate cases. There has also been more use of primary endocrine treatment, and some 70% of women have breast saving surgery and immediate reconstruction. We make use of more genetic profiling of cancers and many more options for oncology treatments.”
Prof Benn expressed her appreciation to the dedicated team members at the Netcare Milpark Breast Care Centre of Excellence for their role in its achievements. “It is a privilege working with a dynamic team – from the administrative staff and IT team to the navigators and clinicians – who together provide excellent, personalised care. Contributing to academic best practice and patient centred care is a privilege.”
Her advice for anyone who has been diagnosed with breast cancer is to insist on personalised oncology care. “Do not rush into treatment choices until there has been a full multi-disciplinary assessment of your treatment plan. Go for second opinions, beware of being pushed into who to see and what to do, and make sure you understand the costs involved. It is your body, you deserve the best breast care,” Prof Benn concludes.
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