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Mark Lomax blogs on access to cancer treatment and NHS England's proposed changes to radiotherapy

Why NHS England's Proposed Changes to Radiotherapy Fall Short

Photo courtesy of @annadziubinska

NHS England’s Modernising Radiotherapy consultation looks to centralise ‘specialist services’ for ‘rare and uncommon cancers’, whilst ‘common cancers’ will be treated at local centres.  GenesisCare wholeheartedly supports the need to expand access to radiotherapy and to modernise the way that radiotherapy is delivered but these latest proposals do not take into account some fundamental considerations.

First and foremost, patients should be able to access radiotherapy services close to home. Like most cancer treatments, radiotherapy can leave patients with weakened immune systems and quite frankly, feeling unwell and unfit to travel long distances. The risks of infection posed by using public transport pose an additional burden on patients who may then have to rely on friends and relatives to drive them to and from appointments. Experience and studies have shown that when patients have to travel long distances, often daily, the additional stress can mean that some patients simply opt out of, or do not complete treatment.

We believe that all patients should have fair and equitable access to radiotherapy regardless of where they live or the type of cancer. Widening access to radiotherapy for those patients with ‘common cancers’ such as breast and prostate is incredibly important. Radiotherapy is a highly targeted, effective treatment that is currently used in about 40% of patients. However, what of the patients with cancers that do not fall into the ‘common’ category? The NHSE proposal means that they will need to be treated at one of eleven ‘specialist centres’, something that we feel is not necessary and certainly not in the best interests of patients.

Tim Farron MP has been fighting for access to radiotherapy for his Kendal constituents for many years. He has a vested interest in the NHS England (NHSE) consultation and recently held a Westminster Hall debate, Patient travel times for cancer treatment, complementing his Private Member’s Bill, the Access to Radiotherapy Bill. The debate aimed to garner support to urge the Government to ensure equitable access to radiotherapy, regardless of geography and to encourage NHSE to add a maximum 45minute journey time to their proposal.  A number of MPs, expressed their support for Mr Farron, repeatedly reiterating that patients should not have to travel excessive distances when it has been proven that high-quality treatment can be delivered locally.

NHSE’s case for specialist centres for radiotherapy is undoubtedly influenced by experience in other areas such as stroke care. However, where hands-on specialist on-site care is critical for some conditions, this is not necessarily the case for radiotherapy* which is nearly always a planned day-case treatment and harnesses technology to great effect. Whilst this in no way detracts from the great skill and expertise of radiographers and their teams, the opportunity to harness technology and shared expertise to deliver consistent and effective radiotherapy care is simply greater.

GenesisCare operates 56 cancer care centres in Australia, Spain and the UK and treat thousands of radiotherapy patients with high quality, evidence-based accessible care. We utilise Smart Planning technology in the planning of patients’ radiotherapy treatment. This has enabled us to reduce planning times for treatment to minutes rather than days whilst ensuring consistency of best practice and adherence to the very latest modalities and protocols.

Although it is widely acknowledged that technology is a hugely underutilised resource in cancer treatment, it did not appear in either the NHS Cancer Strategy published in 2015 or the recent radiotherapy consultation. This is, to a certain extent, understandable given the cost implications of implementing technological change in such a huge and complex system. However, when the longer-term gains could create a more sustainable and cost-effective NHS, can the system afford not to implement it?

We at GenesisCare believe we can play a vital part in the sharing of best practice and innovation for the benefit of all of those affected by cancer. We are specialists with a unique expertise that we are more than happy to share to improve outcomes for patients and to help to build a sustainable, more effective NHS.

If you’d like to know more about our approach to radiotherapy or indeed debate the current consultation, then please do contact me, mark.lomax@genesiscare.co.uk.

 *Notwithstanding Paediatric, Brachytherapy and SRS services which will still require treatment in specialist centres.

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