Radiotherapy is a core component of cancer treatment and, as such, will play an important role in achieving NHS strategy and policy objectives for cancer. The strategic drivers for radiotherapy include:
- A Vision for Radiotherapy, 2014-2024, NHS England and Cancer Research UK (2014)
- Achieving world-class cancer outcomes – a strategy for England 2015-2020, The Report of the Independent Cancer Taskforce (2015)
- The NHS Long Term Plan, NHS England (2019)
- Capital guidance 2022 to 2025, NHS England (2022)
These policy documents and plans set out ambitions for radiotherapy services, concentrating on:
- Enabling rapid adoption of proven new treatments and technologies across the NHS.
- Using data and improvement science to tackle unwarranted variation in clinical practice, service delivery and equipment utilisation
- Enabling access to holistic care and sub-speciality expertise
- Enabling access to clinical trials and through that to improve participation rates
- Enabling timely replacement of equipment
There are significant tensions facing the planning and delivery of radiotherapy services – including:
- The trend towards fewer fraction treatment protocols – meaning that less equipment/machine capacity is needed to treat the same case volume, though this places increased pressures on dosimetry and treatment planning activities and the delivery of radiotherapy fractions may be increasingly complex and require additional image guidance
- Machine Technology – new treatment machines are often significantly faster, reducing still further the amount of machine capacity needed to treat the same number of cases, though this may be limited by co-morbidity and frailty, as well as by treatment complexity and additional image guidance.
- Networking Technology – it is now possible for sub-specialty expertise to go to the patient rather than vice versa and this is a trend that is likely to continue. This needs to be balanced with the need and benefit of wider team working and learning.
- Workforce and AI – the radiotherapy workforce is not immune from challenges facing the wider NHS workforce, this will likely drive the adoption of workforce innovation and, potentially, AI solutions.
For more details regarding NHS England’s radiotherapy policy, see NHS commissioning » Radiotherapy (england.nhs.uk)