The Society and College of Radiographers is pleased to offer our latest news e-zine relating to Cancer - CancerTalk, aimed at bringing the latest Cancer news.
The focus for this edition will primarily relate to radiotherapy service provision for patients within the UK with news items on the latest developments.
Currently, national and local activity planning is gathering pace for the huge expansion in radiotherapy capacity, as recommended by NRAG, and further endorsed in the recommendations from the DH in the Cancer Reform Strategy for England. Similar work is under way within the other UK countries. SHAs, commissioners, cancer network leads and service providers are mapping current local service activity and determining required capacity in order to meet the 31 day target and the 40,000 fractions per million population target by 2010.
Service expansion will be in a variety of forms, in order to both increase access and facilitate easier travelling where possible for patients. Fifty per cent of cancer patients are likely to benefit from radiotherapy at some point in their disease pathway, however, in some areas of the country access rates are low. This is being addressed locally with critical examination of the care pathways, together with the functionality and support of MDTs.
We are likely to see the emergence of satellite centres to existing cancer centres; some being managerially independent and others through independent sector providers.
Availability of more services will be positive for patients, offering greater accessibility whilst also providing different work opportunities for staff. The development of such services will also be challenging as models of service will have to adapt to ensure that local care pathways are clearly defined so that there is continuity of care across cancer networks, and continuity between units and centres.
The recently published radiotherapy commissioning guidance, together with new cancer peer review measures for radiotherapy, should help support and drive change in a co-ordinated manner.
SCoR members have been integral to the development of this work. There is also no doubt that care pathways will require careful and detailed examination for all patient groups across the network. The SCoR believe that radiography professionals and others will have a huge role to play in re-focusing and re-shaping services around patients' needs through the development of integrated care across these radiotherapy care pathways. This is an unprecedented situation for therapeutic radiographers, giving our profession new opportunities for the development of expert practice roles as both advanced and consultant practitioners.
At the national level, the national radiotherapy implementation group, chaired by Michael Williams, is supporting various workstreams to support local services with the implementation of NRAG recommendations, which includes the two measurable targets described previously.
The first technological challenge is the roll out of IMRT for those patients who will benefit, despite a national tariff not being available before 2012. The multiprofessional Radiotherapy Development Board, will be publishing the clinical evidence for IMRT, IMRT standards, and have indentified the education and training requirements to support the implementation of IMRT, for those centres that haven't already done so. NRIG are currently identifying support which can be provided to help the service at the local level to achieve this.
Workforce availability will also be a challenge, mapping and modelling was undertaken as part of the original NRAG work and the workforce subgroup concluded that if student attrition can be reduced from training programmes to around 15% there will be sufficient workforce to meet future need.
There is no doubt this is going to require a concerted effort from all of us and in particular the local HEIs and service providers within the region. Alongside this, it is essential that the skilled workforce is deployed efficiently, thus further driving the need to implement the career progression framework. Where this has been done effectively it is evidenced by clear benefits to patients. So what are the SCoR doing to support this national agenda?
The SCoR has recently published comprehensive guidance around good practice models to assist with student retention (Improving Student Retention: Guidelines and Good Practice May 2009) and we urge everyone to read this.
Our recently published new staffing guidance in response to the Cancer Reform Strategy: Radiotherapy moving forward: Delivering new radiography staffing models in response to the Cancer Reform Strategy, builds upon the recommendation within NRAG and the CRS that the four-tier career progression framework must be implemented. We anticipate this guidance will be valuable to service providers and education commissioners in planning for appropriate posts, and funding for post registration education and training to support advanced and consultant levels of practice.
In June, the SCoR soft-launched the accreditation process for expert practice in order to confirm levels of clinical practices for both advanced and consultant levels of practice. We hope to consult with the Radiotherapy Managers Group at their meeting later this year to debate the practicalities of this process. This will be followed by a launch to the wider radiotherapy community at the SCoR Annual RT weekend conference in January 2010. In response to comments from the community, next year's conference is to be held in Birmingham.
SCoR is contributing fully to all workstreams of NRIG and the associated work in the other countries, ensuring that leaders of our profession are representing the organisation on each and every working party at the strategic level.
Other national work is focusing upon collation and reporting from the radiotherapy data set which was mandatory from April 2009, the introduction of Payment by Results, and the development of the national radiotherapy tariff to ensure effective commissioning and appropriate costing of radiotherapy treatments.
The work undertaken to review the Cancer Peer Review measures (2004) is currently being launched by Tim Cooper at RPORT roadshows. These have been held during the summer and all centres have been invited. The measures will be posted on the DH website imminently for all to comment upon and the SCoR will be compiling a response over the coming months. When the measures are implemented next year, they will help to ensure high quality cancer services for all our patients.
The SCoR has been heavily involved in the work to support the future development of proton therapy in England. This has included the introduction of patient referral pathways to both France and US for patients to receive treatment that would have otherwise not been available to them. So far, 30 patients have been referred. The National Proton Advisory Panel is also due to report at the end of the summer. We understand the intention is to recommend proton therapy services for the UK. This could offer another exciting development which will be directly dependent upon the expertise of radiographers to improve patient care.
We hope this e-zine offers you an insight into the many workstreams focusing upon cancer, and demonstrates the integral role radiographers play in shaping future care for cancer patients.
Charlotte Beardmore and Sarah James
Professional Officers for Radiotherapy, SCoR
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