Government Response

The Government responded to this petition on Monday 25th February 2019

NHS England committed £130 million to upgrade or replace radiotherapy machines in England and will use its capital settlement, to be negotiated in 2019 Spending Review, in part to replace equipment.

Cancer survival rates are at their highest level, but we accept that cancer survival in England has historically lagged behind the best performing countries in Europe and the World. However, it is difficult to make meaningful comparisons due to time lag and issues with data completeness. As a result, we should be careful about using these comparisons as a measure of the current performance of the system, although they can be useful as a long-term benchmark.

Modernising radiotherapy services is crucial to improving cancer survival rates, with 55,000 more people surviving 5 years post diagnosis by 2028. Over the last two years, we have invested £130m in modernising radiotherapy equipment, with over 80 machines funded for replacement or upgrade across the country since October 2016. We are also shortly publishing new radiotherapy service specifications to establish 11 radiotherapy networks – ensuring everyone across the country can access high quality care. These networks will be a significant undertaking: we are committed to ensuring their success and therefore intend to provide additional resources over and above the normal funding of radiotherapy services to support their establishment.

Service specification update
Final service specifications setting out the detailed function and requirements of Radiotherapy Networks and Radiotherapy providers are due to be published imminently, following publication of the Long Term Plan. The establishment of Radiotherapy Networks is designed to improve access to high quality, innovative and advanced radiotherapy, as close to home as possible. Alongside the publication of the service specifications, NHS England will also publish a report setting out stakeholders’ feedback during public consultation and NHS England’s response. 45-minute access is not a mandatory requirement in the service specification as Networks will want to consider and balance a range of factors in relation to service configuration. Furthermore, Public Health England’s report in June 2018, on the impact of travel times on rates of radiotherapy treatment found no statistically significant effect. The report is available here: http://www.ncin.org.uk/cancer_type_and_topic_specific_work/topic_specific_work/travel_times

Advanced radiotherapy treatment
Recent advances in radiotherapy using cutting-edge imaging and computing technology have helped target radiation doses at cancer cells more precisely. Enabling better outcomes, with improved quality of life for patients and reduced NHS costs in the long term, through patients experiencing fewer side effects.

NHS England committed £15 million over three years to evaluate treating patients with Stereotactic Ablative Radiotherapy. In April 2012, the Secretary of State announced a £250 million investment to build proton beam therapy (PBT) facilities at The Christie Hospital in Manchester and UCLH in London. The Christie PBT centre became operational from 20th August for patient assessment and treatment planning. The UCLH centre will open in summer 2020.

Long Term Plan
The Long Term Plan reaffirms our ongoing commitment to modernising radiotherapy (para 3.62) – “Faster, smarter and effective radiotherapy, supported by greater networking of specialised expertise, will mean more patients are offered curative treatment, with fewer side effects and shorter treatment times.”

The Plan was not able to cover capital investment, however it states in para 3.60 that, “The NHS will use its capital settlement to be negotiated in the 2019 Spending Review in part to invest in new equipment”.

Radiotherapy funding
The 5% to 6.5% radiotherapy budget increase aim is included within the ‘Manifesto for Radiotherapy’, published during late 2018 by the All Party Parliamentary Group.

It is not clear from the petition’s wording how the percentages quoted have been calculated, however there is a reference to Social and General Statistics available in the House of Commons Library. The document also references the amount of money paid by NHS England to providers for radiotherapy activity and this figure (£383m) is in-line with our internal information. Of relevance to this issue are:

Radiotherapy activity is largely reimbursed through national prices for radiotherapy fractions. The Long Term Plan signalled NHS England’s commitment to reviewing the national tariff to support providers to deliver newer techniques, such as hypofractionation, and also to encourage regular equipment upgrade.

A radiotherapy equipment modernisation programme was established in 2016 with the goal of investing £130million in new equipment. Newer equipment offers a number of benefits including faster treatment times which helps to reduce capacity constraints and improve service efficiency, allowing services to do more within the same revenue envelope.

NHS England is investing in a new national Proton Beam Therapy service, these costs sit outside the £383m figure referenced in the Manifesto.


Department of Health and Social Care (revised response)