Oncology, policy

Report on developing radiotherapy services in England

17 May 2007

London, UK. The National Radiotherapy Advisory Group has published a report on meeting the needs for radiotherapy services in England. The report says current reorganisation needs to be completed, but that there is still a need to increase services to meet current and future demand, there should be greater choice and there is a need for more community based services.

The group was led by Professor Mike Richards, the national cancer director, and Dr Michael Williams the vice president of the Royal College of Radiologists.

The report acknowledges that radiotherapy services have seen improvements, with double the number of staff training to be radiographers and heavy investment in radiotherapy equipment.

However, the report also found that:

  • the need for radiotherapy services was significantly underestimated by planners 15-20 years ago;
  • as a result, despite positive actions the Government has taken over recent years, there is a significant gap in radiotherapy capacity (both in terms of equipment and staff); and
  • cancer incidence will increase further due to a more elderly population over the next 10 years.

The report concludes that to get the best results for cancer patients  reorganisation of services must be completed. Centralisation of specialist services is completed in line with improving outcomes guidance and that patient convenience is improved where possible by making more services available locally.

Patients’ preferences must be respected and high quality care delivered across the country and to all groups within society. However, all services should provide value for money.

The report says that reorganising services is only the first step in cancer reform. Other improvements needed include:

  • get better at raising public awareness of cancer symptoms so that patients come forward as soon as they have concerns about possible symptoms — this will help to identify cancers early when they are more likely to be treatable;
  • increase capacity in areas such as radiotherapy where waits for treatment after surgery can be long;
  • offer patients greater choice based on reliable information;
  • provide more community-based care for patients at the end of their lives so that they have greater choice about where they live and die.

Professor Mike Richards, national cancer director, said: "We have doubled the number of staff training to be radiographers and invested heavily in radiotherapy equipment. However, we need more capacity, both in terms of staff and equipment. This report is very helpful in setting out how this could be achieved both in terms of using what we already have more effectively but also in planning better for the future.

"The problems that we are seeing now with radiotherapy stem from a failure of planning 15-20 years ago. At that time experts predicted that radiotherapy would not have a key role to play in cancer care in the future and that demand would fall. As a result it was not an area prioritised by the NHS for development and expansion.

"I am pleased that Ministers have taken this report seriously. With immediate effect, they have committed £5 million of capital funding to support novel training facilities recommended in the report. They have also asked that I take the broader recommendations into account as I develop the Cancer Reform Strategy, which will map the way forward for cancer services in England, and that I bring the report to the attention of cancer networks so that they can start to consider if the services they are delivering are as productive as they could be."

The report can be downloaded (as a PDF file) from the UK Department of Health website at:


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