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Radiotherapy for the Lay

Representative

Tim Cooper

National Cancer Action Team

Radiotherapy

• The role of radiotherapy – wider context

• National radiotherapy strategy

• Commissioning for radiotherapy

• Delivering the challenge

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Radiotherapy contributes to

the cure of cancer

Radiotherapy, 40%

Chemotherapy , 11%

Surgery , 49%

Radiotherapy

Chemotherapy

Surgery IAEA 2010

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Key Message –

Improving Outcomes Strategy

Access to radiotherapy is critical to

improving outcomes.

To improve outcomes from radiotherapy,

there must be equitable access to high

quality, safe, timely, protocol-driven quality-

controlled services focused around patients’

needs.

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Commissioning

• Radiotherapy in specialised commissioning

• Agree

– Standard of care

– Service Specification

– Commissioning dashboard

• Assess local challenges in moving to

standard of care - local trajectories

Standard of Care

• There is access to modern radiotherapy

techniques, e.g. Intensity Modulated

Radiotherapy (IMRT) and Image Guided

Radiotherapy (IGRT). Services not able to offer

this will be expected to have plans in place to

move to routine IGRT over the next 12 months.

• ….. where this is not possible providers, in

consultation with the commissioners, should

offer patients the opportunity to receive this

treatment at an alternative provider.

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0

2000

4000

6000

8000

10000

12000

2008 English Patients 2009 English Patients

2010 English Patients 2011* English Patients

2012 ** English Patients

Inverse Planned IMRT Patients - England

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Equipment Replacement

• The provider should ensure that each

Linear Accelerator is in operation for a

maximum of 10 years and that the

replacements are planned in a timely

manner.

Commissioners may divert activity where

this is breached without agreement.

Tariff

• Mandate National Currency from April

2012

• Publish Non-mandated Tariff

• Intention to Mandate National Tariff from

April 2013

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Service Specification

Cancer Commissioning Toolkit

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Service Profiles map to commissioning dashboard

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Efficiency

Proportion of radiotherapy delivered across the working day

RTDS

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Age Variation - Radical

Age Variation - Palliative

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Radiotherapy National Report

• Update on progress

• Retain and reinforce NRAG

• Refresh metrics

• Re-set the horizon

31 day subsequent Q2 11/12

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31 day waits

• Ahmad and Burnet 2011

• Saves 2,500 lives each year • http://www.bmj.com/content/343/bmj.d4286/reply#bmj_el_268127

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Efficiency

Proportion of radiotherapy delivered across the working day

Uptake of Radiotherapy Access Survey

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Radiotherapy Patient Experience

• When you gave your consent, to what

extent did you understand what the

benefits and side-effects of radiotherapy

were?

• Were you treated with dignity and respect

by the doctor or other health professional

who took your consent for your

radiotherapy?

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Radiotherapy Patient Experience

• Was the information given to you by your

radiographer at the treatment visit the

same as you were told by the doctor /

radiographer in clinic?

• What was the environment of the

radiotherapy department like in respect of:

– Waiting Room

– Treatment room

– Whole Department

Radiotherapy Patient Experience

• Sometimes people with cancer feel they

are treated as “a set of cancer symptoms”,

rather than a whole person. Did you feel

you were treated as a whole person –

• Would you be happy to go back to this

centre again if you were recommended

radiotherapy treatment?

Full survey at

http://ncat.nhs.uk/radiotherapy/rotw-archive

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In 2007 – 48

Radiotherapy centres

New (6)

• Taunton

• Oldham

• Aintree

• Salford

• Bracknell

• Peterborough

• 4 in planning

• 6 in discussion

• 5 New Independent

Information Prescriptions

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Survivorship

• Living with and beyond cancer

• Acute side effects

• Long term side effects

• Profile changes as treatment changes

• Signpost to support and care

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So what is World Class

Recommendation 1: Planning for the future

• a rolling ten-year plan, setting out a vision and strategy for future radiotherapy services,

Recommendation 2: Measuring success

• datasets for the reporting of fractionation, waiting times, access, and patient outcomes.

Recommendation 3: Ensuring equity in access

• demand modelling based on differences in cancer incidence on a region-by-region basis.

Recommendation 4: Training the radiotherapy workforce

• A national career promotion strategy should be introduced across the four nations of the UK

Recommendation 5: Integrating new technologies

• NICE should provide national guidance on novel radiotherapy techniques, such as intensity

modulated radiotherapy (IMRT) and proton therapy.

Recommendation 6: Communicating with the public

• formulate a strategy and proposal for awareness raising about radiotherapy.

Achieving a world class radiotherapy service across the UK 2009

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www.ncat.nhs.uk/radiotherapy

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Date for your Diary

NRAG 12

14th November 2012

Birmingham

Horizon Planning – not Horizon Scanning