Will the NHS reforms give us a world-class radiotherapy service?

Radiotherapy cures more patients than cancer drugs

Radiotherapy can cure cancer, and we want patients in the UK to have a world-class radiotherapy service which saves more lives.

We have long been championing improvements to the radiotherapy service across the country, with some success – last year the Government earmarked £23 million for more advanced radiotherapy to patients in England.

In April this year, a raft of changes to the structure of the NHS kicked in.

As a result, NHS England is now responsible for buying radiotherapy across the whole of England, rather than different local bodies doing this, while a central group of experts supports NHS England by setting standards.

On top of this, a new national method of payment is replacing local contracts for some radiotherapy services.

The old approach meant that the NHS paid different prices across the country for radiotherapy. Now that NHS England is responsible, it can level the playing field for all radiotherapy centres, so they’re up to the same standard across the country, and paid according to the amount and types of treatment they provide.

We hope these changes will lead to better radiotherapy services. But will they really have the impact we want, and meet Government pledges to help more people than ever to survive cancer?

This was the key question we wanted to answer ahead of the reforms taking effect.

And we decided that the best way to answer this was to ask the professionals what they thought.

We went on the road

We held a series of workshops

In early 2013, we held “Radiotherapy Roadshow” events in London, Oxford, Birmingham and Manchester.

Collectively, these brought together over 100 people from across the radiotherapy community, including service managers, scientists, clinicians and patients.

At each event we asked for our guests’ opinions on the future of the radiotherapy service – and they did not let us down!

Today, we’re publishing a report reflecting the discussions we had at the Roadshows, Improving radiotherapy services to save more lives (PDF).

So what did the radiotherapy community think?

Cautious optimism

Experts have made a series of recommedations

Most participants felt that it was too soon to tell how well the new system will work in practice, or whether this would be better for patients – but they shared some useful predictions for the future.

Fortunately, many said that the changes should improve the number of cancer patients able to receive radiotherapy treatment.

In particular, the community felt that the changes will help to remove the “postcode lottery” and level the playing field between specialist cancer hospitals and general hospitals .

Some thought that the changes would mean more financial incentives for the NHS to improve the quality of the treatment patients receive. But more research into radiotherapy and investment in new technologies would help the service to improve even faster. Some participants were particularly concerned that there are still few incentives to promote research and innovation within NHS radiotherapy services.

Overall, there are promising signs that radiotherapy will improve in England.  But it may be some time before we have a truly exceptional radiotherapy service that helps us to be “among the best in Europe” at tackling cancer, particularly as some experts predicted teething problems as the NHS reforms are rolled out.

The next steps

As well as discussing the potential issues, the radiotherapy community suggested ways to help make sure the changes are successful, and how the Government can support the radiotherapy service even further in future. We explain these in more detail in our report, but here are some of their broader messages:

• Firstly, NHS England should ensure that doctors across the country are referring enough patients for radiotherapy treatment.
• Secondly, NHS England should support and communicate with the radiotherapy staff and patients effectively to ensure a smooth transition to the new system.
• And the Government must continue to invest in high-quality equipment and staffing, as well as to better monitor how the service is working for patients.

We will be keeping in touch with the community to monitor how the reforms are progressing, and will keep you updated in future blog posts.

Zoë

• Download our report, Improving radiotherapy services to save more lives.
  

Zoë Molyneux is a Policy Adviser at Cancer Research UK