The world of radiotherapy is undergoing exciting change over the next few years. Behind this is a drive to deliver world class treatment and therefore improve the care and experience of our patients.
Both Scotland and Wales now have representatives on NRIG (the National Radiotherapy Implementation Group). This allows us to align the work plans for each nation to ensure that there is a co-ordinated approach to both policy and delivery.
We are improving access to radiotherapy by setting the 31 day access standard for all patients with cancer. This has been set in radiotherapy for December 2010 to allow the lead-in time for planning and commissioning of sufficient capacity.
Central to developing a world class service is ensuring that all patients who might benefit from radiotherapy have access. This requires commissioners to work with radiotherapy providers to develop plans for expansion. They should be planning for a minimum of 40,000 fractions per million population by 2010, with plans for a more locally appropriate level by 2016 (nationally this is around 54,000 fractions per million).
Delivering this will require commissioners to engage with services and plan service provision. We have been developing tools that will allow commissioners to understand radiotherapy services and to engage with providers in a common dialogue.
There is already discussion on the expansion of radiotherapy through satellite services. Some satellites are already underway, more are being planned. Expansion of radiotherapy must address the access and travel times of some groups. It must also recognise that some radiotherapy can be delivered in centres using different models of care.
Delivering world class radiotherapy is not just about cost and volume. If we are to see the survival advantages that are set in the cancer reform strategy, we must deliver our services in a different way. IMRT must become the standard model of care for all those patients for whom it its clinically appropriate. We will be supporting those services who have not yet managed to develop IMRT capability and allow it to be possible in centres which are able to deliver it.
We must also look in detail at our processes and pathways. Modelling new ways of working and testing scenarios will be an important part of service development. We have developed the R-PORT scenario and capacity planning tool that will allow services to model their service, test new ways of working (on either a large or small scale) and understand the impact on services in a controlled environment. This tool will be available to all radiotherapy services shortly.
The new radiotherapy peer review measures are now undergoing consultation. They are a positive move to support the development of radiotherapy services in England. They will support the development of quality, service delivery and communication within services.
The Radiotherapy Data Set (RTDS) became mandatory on 1 April. This will allow a real understanding of service delivery within England. It will support clinical service planning and service development. Achieving this has not been easy. Many services have had challenges in collecting data and making the returns and some have had to adapt working practices to encompass the new data fields. However, I am sure that these efforts will have been worthwhile as data matures and it contributes to service development.
It is important that we prepare our services to manage change and to integrate it into practice and service delivery. That is why this year's NRAG conference (13 November) will focus on change and supporting changes in clinical practice.
The challenges that lie ahead for all of us will certainly raise opportunities for new models of care and service provision which will allow us to continue to improve care and access for all our patients.
Tim Cooper, associate director - radiotherapy, National Cancer Action Team
Join now
