The report ‘Recommendations for achieving a world-class radiotherapy service in the UK’ was funded by Cancer Research UK.

The report explored a) the barriers to making the UK’s radiotherapy service world-class, b) what international evidence suggested a world class service was like, c) what the likely outlook on radiotherapy services in the UK nations was, and d) our recommendations on how each of the UK nations could create a world-class service.

Our findings were as follows:

• There is insufficient capacity in UK radiotherapy centres to meet demand in the short to medium term. To address this, each national government needs to address variation in access to radiotherapy. The roles of national leadership bodies in England and Scotland should be enhanced and the Welsh Government should consider creating a national leadership body with oversight for radiotherapy services across Wales.
• New radiotherapy techniques are more targeted and reduce side effects for patients. NHS England should build on the success of the Radiotherapy Innovation Fund and continue to promote better access to advanced and innovative radiotherapy, focusing on technology and workforce skills development. NHS England should extend the provisions of the current payment mechanisms to incentivise the provision of specialist technologies and techniques like 4D adaptive technologies, SABR, IGBT, and molecular radiotherapy, where evidence has shown their benefit.
• Sufficient numbers of highly trained staff is crucial to meeting patient demand and ensuring delivery of advanced techniques. Health departments in each UK nation, working with the professional bodies, should develop and implement a strategy to address radiotherapy workforce needs.
• There are concerns that the new funding mechanisms in England will not cover the significant capital costs of new radiotherapy equipment, despite the relative cheapness of radiotherapy in comparison to all other cancer treatments. In England, the Department of Health, NHS England and NHS Trusts should continue to work with the NHS Supply Chain to ensure sufficient numbers of up-to-date linacs across England and capitalise on the economies of scale, which can be delivered through co-ordinated purchasing. Similar mechanisms should be utilised in the devolved nations where needed.
• Research is a key indicator for world-class radiotherapy. All radiotherapy centres should be encouraged to engage with national research and should enter patients in national trials.
• Radiotherapy in the UK currently lacks an ‘evaluation culture’. Radiotherapy centres should create the conditions to make each centre a ‘learning organisation’.
• Pressure on the service, through staffing shortages and increasing demand, means that radiotherapy centres have a culture of over-working. National governments should develop and fund national programmes to provide training in management and leadership skills.

Our full report can be downloaded here. For any comments please contact David Drabble (d.drabble@tavistitute.org ) for further details.