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![Page 1: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/1.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Organising Radiotherapy Services – what are the lessons from
England
Tim Cooper
Associate Director – Radiotherapy
National Cancer Action Team
![Page 2: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/2.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 3: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/3.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Organising Radiotherapy Services – what are the lessons from
England
Tim Cooper
Associate Director – Radiotherapy
National Cancer Action Team
![Page 4: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/4.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Vision
Strategy
![Page 5: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/5.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 6: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/6.jpg)
Delivering World Class RadiotherapyDelivering World Class RadiotherapyDelivering World Class RadiotherapyDelivering World Class Radiotherapy
NRIG
(NRAG / Cancer Reform Strategy)
Gover
nanc
e
Wide
r Wor
ld
Service Delivery
Comm
issioning
•Safety
•Peer Review
•Clinical Pathways
•Clinical Trials and Research
•New Technology
•Contracting Framework
•RTDS/RES
•Tariff / HRG
•Commissioning Toolkit
•Workforce
•Access
•Capacity
•Survivorship
•Communication Skills
•Leadership
•Engagement
www.cancer.nhs.uk/radiotherapy
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 7: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/7.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
NRIG Subgroups
NRIG - plus ‘press gang’ members
• Workforce• Technology• Protons• Stereotactic• Radiotherapy Clinical Information Group• Raising the profile of radiotherapy
Plus– Tariff (Costing and Coding groups)– R-PORT– Peer Review
![Page 8: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/8.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Headlines
• Relevant Key issues
• Investment
• Engagement
• Leadership
• Play to your strengths
• Toolkits
• Communication
![Page 9: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/9.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Relevant Key Issues
What does World Class look like??
• Access– Performance
– Productivity
• Workforce
• Technology– IMRT
– SBRT
– IGRT
![Page 10: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/10.jpg)
Delivering World Class RadiotherapyDelivering World Class RadiotherapyDelivering World Class RadiotherapyDelivering World Class Radiotherapy
NRIG
(NRAG / Cancer Reform Strategy)
Gover
nanc
e
Wide
r Wor
ld
Service Delivery
Comm
issioning
•Safety
•Peer Review
•Clinical Pathways
•Clinical Trials and Research
•New Technology
•Contracting Framework
•RTDS/RES
•Tariff / HRG
•Commissioning Toolkit
•Workforce
•Access
•Capacity
•Survivorship
•Communication Skills
•Leadership
•Engagement
www.cancer.nhs.uk/radiotherapy
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 11: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/11.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Relevant Key Issues
What does World Class look like??
• Access– Performance
– Productivity
• Workforce
• Technology– IMRT
– SBRT
– IGRT
![Page 12: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/12.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
WorkforceReconvened NRAG workforce subgroup (Jane Barrett chair)
4 tier structure - publishing the learning from the pilot sites
HEI & operational managers – 25th Sept 09 - Developing the radiotherapy workforce– 23rd March 10 - Building on success
VERTnow in 40 clinical centres
Radiotherapy Physics - Modernising Scientific Careers- Meeting 5th March - Developing Solutions
Dosimetrists - secured funding to support national early implementation training
programme. Planned April intake.
![Page 13: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/13.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Service Delivery
Access31 days - analysis of early returns
- data completeness !!Process and pathways
CapacityNetwork led planning in many areas?? 25 satellitesstaged plans - ongoing work
RTDS
Missing patients
Radiotherapy Site Visits
National Purchasing Framework
![Page 14: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/14.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
IMRT
NRIG Technology Group – Chair Michael Williams.
IMRT at least one centre in each Network by 2012
30% of all fractions should be IMRT
Darzi Innovation Metric
•Commissioner guidance•Generic business case•National Training programme•QA audit programme•Consensus document – publishing the evidence
Awarding training support contracts
![Page 15: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/15.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Stereotactic
• SBRT• Intracranial already done• Focus on Technique • Define Technology• National Specification to NRIG by end 2010• Indications and body sites
H&N; Lung; Liver; Pancreas; Kidney; Spine; Prostate; Mets and Oligometastases;
![Page 16: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/16.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Headlines
• Relevant Key issues
• Investment
• Engagement
• Leadership
• Play to your strengths
• Toolkits
• Communication
![Page 17: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/17.jpg)
Delivering World Class RadiotherapyDelivering World Class RadiotherapyR
adio
ther
apy
Co
stin
g &
Tar
iff
Dev
elo
pm
ent
Rad
ioth
erap
y C
ost
ing
& T
arif
f D
evel
op
men
t
UNIT COST COMPARISONS – AVERAGE OF ALL COSTS PER FRACTIONSUNIT COST COMPARISONS – AVERAGE OF ALL COSTS PER FRACTIONS
National Cancer Action TeamNational Cancer Action Team Department of HealthDepartment of HealthPayment by ResultsPayment by Results
RC07
£0
£100
£200
£300
£400
£500
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49
Trust
Un
it c
os
t p
er
fra
cti
on
RC08
£0
£50
£100
£150
£200
£250
£300
£350
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49
Trusts
un
it c
os
t p
er
Fra
cti
on
![Page 18: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/18.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Leadership & Engagement
• Clinical Leadership
• Programme Leadership
• Progress chaser
• Engagement– Profession– Public– Political– Wider
![Page 19: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/19.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Headlines
• Relevant Key issues
• Investment
• Engagement
• Leadership
• Play to your strengths
• Toolkits
• Communication
![Page 20: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/20.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Build on the strengths
• Consensus– 5 centres not 50+
• Commissioning– No Linac fairy – so can push boundaries– Central programme – can move to meet need faster.
• Programmes– NRIG programme already clear, so SRAG can use
this and focus on other areas of importance
• Programme engagement
![Page 21: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/21.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Headlines
• Relevant Key issues
• Investment
• Engagement
• Leadership
• Play to your strengths
• Toolkits
• Communication
![Page 22: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/22.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 23: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/23.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 24: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/24.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
R-PORT
• Roll out underway• Complete by Spring 10• Amanda Travis appointed to secure roll out• Demonstrate efficiency• Available to all HEI’s• Ongoing development• User Group
![Page 25: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/25.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
CommissioningContracting
Contracting FrameworkService SpecificationRadiotherapy Pathway
www.cancer.nhs.uk/radiotherapy/commissioning
Cancer Commissioning toolkit – radiotherapy section
Radiotherapy Commissioning Pilots x 4
![Page 26: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/26.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Configuration:
• Lots of very good work underway
• 4 commissioning pilots– Anglia– Sussex– Merseyside and Cheshire– Lancs and S.Cumbria
• N.Trent, Humber and Yorks
• Greater Midlands
![Page 27: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/27.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Governance
•Peer Review•New Measures …almost complete …..•Completely different•TSR is a recurring theme in peer review
What does a good evidence folder look like?
What information does the Network Radiotherapy Group need?
![Page 28: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/28.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Other work
• NRAG FAQ’s– Demystifying NRAG
• Public profile– Engaging with Public; Patients; Health community
and the wider world
• Developing the evidence base– Supporting the argument
• Enhanced Cross UK working– Working together and supporting each other.
![Page 29: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/29.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
Headlines
• Relevant Key issues
• Investment
• Engagement
• Leadership
• Play to your strengths
• Toolkits
• Communication
![Page 30: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/30.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
![Page 31: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/31.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy
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
![Page 32: Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team.](https://reader030.fdocuments.in/reader030/viewer/2022012918/56649d085503460f949da159/html5/thumbnails/32.jpg)
Delivering World Class RadiotherapyDelivering World Class Radiotherapy