Faculty of Clinical Oncology position on COVID-19

6 May 2020

From the outset of the COVID-19 pandemic, it was recognised that the continued safe delivery of radiotherapy and Systemic Anti Cancer Therapies (SACT) would be challenging. The manner in which the community collaborated to provide expert consensus guidance, the rapid adoption of new treatment protocols, a focus on making decisions right for each of our patients and dedication to supporting all members of the team has meant that most services have been well-maintained throughout the crisis. For this, we should be very proud and the RCR would like to sincerely thank all Fellows and members for their exceptional work during these unprecedented times.

As we move towards an era of endemic COVID-19, the recovery phase now poses new challenges. The safety of patients and staff remains a priority and departments should continue to take precautions to minimise risk to both. The demand for radiotherapy and chemotherapy may increase considerably to account for known deferrals, altered referral pathways, diagnostic backlogs and an increase in presentation of more advanced stage disease. Staffing levels may continue to fluctuate and contingency plans will be required. Interim RCR guidance will be issued shortly to assist departments with their local recovery plans which should be reviewed in line with current and future NHS guidance.

An area of ongoing concern remains the decline in availability of both diagnostic and surgical oncology services which form crucial parts of the integrated cancer pathway. Work continues at a higher level to drive the development of ‘COVID-19-protected’ cancer hubs with robust isolation and testing protocols, for the safe delivery of surgical and diagnostic services. The successful implementation of these sites has been variable across the UK. We encourage discussion at a regional multi-disciplinary team and cancer alliance level to try and facilitate appropriate local solutions.  

It is important that we capture information on changes to treatment pathways and their impact on the service and patients. It is equally vital that we improve our understanding of the risks of COVID-19 to oncology patients so that modifications to our treatments can be refined accordingly. We encourage centres to submit locally collected data to national initiatives such as COVID RT led by CTRad and the UK Coronavirus Cancer Monitoring Project.

A number of positive changes have taken place within cancer services as a result of the COVID-19 crisis; investment into IT systems has facilitated remote working and robust platforms for virtual MDT meetings. Tele-medicine for selected patients has transformed some out-patient services. We have rapidly adopted changes to protocols and developed more efficient and innovative models of working. These should be built upon, not lost, as circumstances normalise.

The continued safe functioning of our services during this crisis is testament to the way in which the clinical community has pulled together to support each other, our teams and our patients. Continuing with this compassionate, collaborative and adaptable ethos will be important as we negotiate together the new challenges posed by recovery from COVID-19.


Read previous statements about the RCR's position on coronavirus (COVID-19) for clinical oncology

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Published 6 May 2020