Clinical oncologists lead the delivery of all types of non-surgical cancer treatment and are the only medical specialty qualified to prescribe radiotherapy.
Radiotherapy is a common, safe and highly effective treatment for cancer and nearly half of cancer patients receive it at some point. Around 40% of patients who are cured of their cancer will have received radiotherapy as part, or the whole, of their treatment. Over half the people in the UK born after 1960 will be diagnosed with cancer at some point in their lives and people are living longer with the disease. Early diagnosis gives people the best chance of curative treatment and long-term survival. In the UK, we currently only diagnose just over half of patients at an early stage.
A fully staffed, adequately funded and well-supported cancer workforce with all available tools at their disposal will:
- Vastly improve patient outcomes and experience.
- Decrease waiting times for treatment
- Improve staff wellbeing
- Reduce early retirement as a result of burn out.
However, the oncology workforce is currently chronically understaffed and needs considerable investment over the coming five years. Adding to this challenge, access to modern equipment is variable; many linear accelerators (LINACs)* are over the recommended age limit of ten years and NHS information technology (IT) infrastructure needs modernising.
Innovations in digital technologies – including the fields of artificial intelligence (AI) and machine learning (ML) – have potential to enhance patient care and service efficiency, but will fail to achieve positive impact unless NHS IT systems are modernised to support emerging digital innovations. Advances in genomics could significantly improve outcomes for patients by making treatment decisions more personalised and treatments better targeted. However, this will necessitate appropriate training so the workforce can use new knowledge effectively for patient benefit. Better data on the effectiveness of all new radiotherapy modalities and more robust and accessible data on cancer prevalence in real time is needed to justify commissioning decisions and to standardise treatment protocols that will help to maximise Radiotherapy Operational Delivery Network (ODN) models and to streamline patient pathways.
This combination of factors means that patient outcomes are subject to stark inequality and this is unlikely to change without significant intervention now. In short, to improve cancer survival rates and provide greater support to those living with and beyond cancer, oncologists should be enabled to offer the best available treatment for any patient, regardless of where they live in the UK. Expanding on the RCR’s Five priorities for radiotherapy 2019–2020 this can be achieved by:
1. Maximising the cancer workforce
- Increase training places and capacity to train
- Facilitate the implementation of skillmix solutions
- Enable overseas recruitment
- Enhance the working environment.
2. Providing the necessary tools for optimum patient care
- Enact a funded, rolling equipment-replacement programme
- Fund and support robust IT infrastructure across the NHS
3. Supporting and nurturing new innovative ways of working
- Fully supported integrated networking solutions
- Enable clinical use of treatment innovations (to include AI and ML)
- Make the best use of data to improve care
- Review patient pathways and systems.
Policy priorities for clinical oncology 2021–2026 report
This report identifies and contextualises priories for clinical radiology and how to make them a reality. All of the priorities are interdependent and equally critical if we are to achieve a clinical radiology service that can provide the best possible treatment and outcomes for people with cancer.
*A medical linear accelerator (LINAC) is the device most commonly used for external-beam radiation treatments for patients with cancer. It delivers high-energy X-rays or electrons to the region of the patient’s tumour.