A month ago, the European Commission sent the reference authority in the Cancer Plan in each member country, the Ministry of Health and the coordinator of the Cancer Strategy of the National Health System, Josep M. Borrás, in the case of Spain, a self-assessment survey. The aim of the petition was to ‘map’ existing collaboration across Europe to integrate cancer research with care, education and training and deliver capacity building interventions to strengthen it.
Days later, from the Catalan Institute of Oncology (ICO) – which is not the competent spokesperson for this action, but to which the aforementioned coordinator of the Strategy is linked – this request was sent to all the research institutes in Spain. In the email, to which LA RAZON has had access, it was indicated: “The coordination of the European project CCCI4EU-Comprehensive Cancer Infrastructures 4 Europe asks us to contact you (centers accredited by the Carlos III Health Institute –ISCIII–) to inform you and ask for your collaboration in completing this first survey that is being launched. We want to see the degree of development of the Comprehensive Cancer Infrastructure(s) (ICC) and their contexts in Spain. Institutions that complete (part of) this survey by 31 May 2024 will be eligible for CCI4EU capacity building interventions.
This self-assessment included 8 fundamental areas: the structure of these ICCs – which, ideally, should be made up of comprehensive cancer care centers (CCCs) –, the channels of interaction between them, their capacity to develop translational research and clinical and the results that had been obtained with it, the provision of screening and early detection programs for cancer and the existence of a standardized itinerary for the patient according to the type of tumor they have.
Superspecialization
Given these requirements, The Community of Madrid has found the perfect opportunity to gain muscle and present in Europe, for the first time and in a solid way, the Madrid Oncology Network (ROM), a pioneering project that was presented days before the pandemic and was overshadowed by it, but that resurfaced strongly two years ago. And it is that This model, which addresses cancer in a network with the creation of a single circuit that guarantees super-specialization and equity in treatment, fits perfectly with the premises of Europe.
Let us remember that, broadly speaking, what the European Plan against cancer calls for is that there be comprehensive care networks in all countries that ensure a quality approach for patients suffering from this disease, as well as for their families. These networks should ideally be made up of accredited care centers such as CCC. The goal is that, in 2030, this structure will treat 90% of the population with cancer in each country.
As advocated by oncology professionals and managers from the different regions, the logical way to create them is for the networks to first exist within each autonomous community (connecting the hospitals with each other), and, from there, a national one is created. . Well then, The Community of Madrid already has this structure, which is specified in the ROM.
The Network is made up of 29 healthcare centers that include 8 public reference hospitals (La Paz and Ramón y Cajal, in the north; 12 de Octubre, in the south, the Gregorio Marañón and La Princesa, in the east and the Jiménez Díaz Foundation, the San Carlos Clinic and the Puerta de Hierro Hospital, in the west, with their respective research institutes accredited by the ISCIII), which bring together 50% of cancer patients, and 21 smaller hospitals that serve the other 50% of people with cancer.
A model like that of the ONT
This conglomerate of centers, together with the 4 private centers that operate in the region (Clínica Universitaria de Navarra, Grupo HM Hospitales, Grupo Quirón Hospitales and the MD Anderson Cancer Center) serve 40,000 patients a year, which represents between 35 and 40% of the oncology population of our country. And they serve it in a supportive manner, with a model similar to that of the National Transplant Organization (ONT).
It is specifically this specialization and volume of patients that guarantees that, in the medium term, the region can become the European “Houston.” Another of the strong points of this network is its potential to develop collaborative clinical trials between different hospitals and healthcare centers, since the number of cases and their diversity allows us to obtain representative results. A collaborative clinical trial is one that includes different centers, but under the same contract.
Although some 3,000 of these studies are already carried out in Madrid each year, until the creation of the ROM, none of this type had been carried out. The first one underway is one in which Gregorio Marañón, La Princesa and Infanta Leonor are participating.
Furthermore, networking has also allowed the creation of the ROM of Childhood and Adolescence (Romia) that concentrates in La Paz, on October 12, the Gregorio Marañón and the Niño Jesús Hospital all pediatric oncological care. The main reason why this model meets the expectations of the European Commission is because it creates a single circuit, regardless of which door the patient entered through, both for him and for health professionals and researchers, which translates into more functional and efficient management.
Thus, the idea is that the affected person does not belong to any center, but to the entire network. Even so, the model has some weak points that the Ministry of Health of the regional executive has committed to improving, such as the specialization of hospitals in different types of tumors, the creation of a preferential circuit for patients who need urgent assistance , and integration with health centers, which are the gateway for people with cancer into the health system.
Accreditation as cancer centers
After what happened at the beginning of this year with the irregularities of the Ministry of Health in the selection of future comprehensive cancer centers,and the comparative injury suffered by the CAM, the main hospitals in the region have taken advantage of the first opportunity to begin their process of accreditation as Comprehensive Cancer Centers. The Puerta de Hierro, La Paz, the Ramon y Cajal, the San Carlos Clinic, the public part of the Jiménez Diaz Foundation, on October 12 and the Gregorio Marañón have attended the annual meeting of the European Organization of Comprehensive Centers these days in Cancer (OECI), held in Helsinki, where they have applied to be members of this organization. Other leading Spanish hospitals such as the Clinical Hospital of Valencia or the Barcelona Clinic.
All of them will soon begin their accreditation process, which usually lasts between one and a half to two years. To this end, the OECI carries out a quality program, analyzing how cancer is addressed in each of the centers, with the aim that they end up being part of this management model of excellence. In Spain, only the Valle de Hebron Hospital in Barcelona has this accreditation.