Our latest survey of the UK’s radiotherapy cancer workforce, featured in today’s Daily Express, confirms a service in crisis.
The newspaper has campaigned for several years, in support of #CatchUpWithCancer; urging the government to fund modern radiotherapy.
At present, chronic staff shortages, outdated equipment, and an obsolete funding model continue to leave cancer patients at risk.
The Radiotherapy UK Workforce Survey 2024 exposes deep systemic failings and calls for urgent national action and for prioritisation of radiotherapy in the National Cancer Plan – expected to be published soon.
Leading cancer experts say radiotherapy is in a “total crisis” and that “voices in the cancer service are not being heard”. They warn that 8 in 10 responses from the cancer workforce indicate a lack of staff to treat patients. While 6 in 10 say there isn’t enough up-to-date cancer treatment equipment available.
Workforce survey key findings
- Workforce Crisis: 71% of managers say they do not have enough staff to meet current patient needs, rising to 81% for future demand. 59% of the workforce have considered leaving the profession.
- Outdated Cancer Treatment Kit: 61% of the workforce reports not enough machine capacity to meet current needs, with many departments operating machines more than the recommended ten years old.
- Systemic Barriers: 87% of managers warn that the NHS radiotherapy tariff (the system that funds hospitals for cancer treatments) “does not support delivery of world-class radiotherapy.”
About the importance of radiotherapy
Radiotherapy cures cancer and is the most cost-effective cancer treatment. It is needed by 1 in 2 cancer patients and contributes to cure in 40% of cases. In 2021, on average, only 35% of cancer patients in England received radiotherapy as their primary treatment, which is significantly lower than the recommended international consensus of 53%.
Voices from the Frontline
Frontline cancer workforce respondents paint a stark picture:
- “Stressful, nothing seems to get better… radiotherapy treatment machines (linacs) feel like a conveyor belt. I will leave the profession within the next year.”
- “The patient load is rising rapidly and has now reached the staff capacity of the radiotherapy treatment equipment.”
- “Equipment is almost all more than 10 years old… we have no Surface Guided Radiotherapy, no access to MRI for radiotherapy planning. I get told that radiotherapy is too expensive, even though the costs compare very favourably with other cancer therapies.”
- “Recruitment freezes prevent backfilling roles… maternity cover is often delayed or not approved, leading to major staffing gaps.”
- “AI tools (e.g., auto-contouring) and paperless workflow solutions are underfunded.”
- “It is not a cost-effective use of a consultant’s time to wait 20 minutes to log on…”
Leading oncologist and chair of Radiotherapy UK, Professor Pat Price, said:
“Radiotherapy cancer care is in a total crisis, and the workforce is worried that it will be overlooked again, just like it has been for decades. Radiotherapy is one of our most cost-effective and curative cancer treatments, yet we are running a service on threadbare resources. If we don’t fix this, it will have dangerous consequences for cancer patients. The Government has promised a national cancer plan to improve cancer survival, but to make that happen, we need to address the massive equipment and workforce crisis that is preventing patients from getting access to modern radiotherapy treatments on time. As things are, it feels like these voices in the cancer service are not being heard.
“I urge the Secretary of State to look at these findings and engage with us in the radiotherapy community. We want to help, we want to be in the conversation, so that we can ensure solutions to the crisis form part of the cancer plan.”
Recommendations
Radiotherapy UK urges the Government to establish an independent National Radiotherapy Advisory Group to provide strategic oversight and drive a fully funded national plan covering recommendations, including:
- Workforce: Fully funded national radiotherapy workforce plan, pay review, and expanded training capacity.
- Equipment: A ring-fenced, multi-year capital investment plan for radiotherapy machine replacement and modernisation.
- IT & Digital Infrastructure: Dedicated radiotherapy IT teams and investment in AI and patient-focused technologies.
- Remove the bureaucracy that holds back modern care: Overhaul of the outdated NHS radiotherapy payment system (tariff) to reflect modern treatment costs and encourage innovation.
The survey received responses covering nearly 10% of the entire radiotherapy workforce, including the full range of professionals involved in its delivery; therapeutic radiographers, clinical technologists, clinical scientists, healthcare science workforce, clinical engineers and clinical oncologists.
Clive Jones MP on the importance of a workforce plan
Reforming the radiotherapy tariff
In three interlocking articles, radiotherapy professionals in the North West are calling for a new conversation on funding reform to unlock the potential of modern, patient-centred radiotherapy.
If implemented, the reform of radiotherapy tariffs could help many thousands of cancer patients live better and longer.
Each time a department treats a patient with radiotherapy, it receives money to cover the cost of that treatment – from staff time to equipment. This payment is known as a tariff.
But tariffs for radiotherapy have not kept pace with innovation or inflation, leaving departments out of pocket, or with no incentive to adopt new techniques.
Rethinking the tariffs would be a radical, and much needed strategy to make sure the best radiotherapy techniques, including AI, are rolled out properly across the country and in every department.
And if the new National Cancer Plan led to updated radiotherapy tariffs, we could finally cover some ground in catching up with cancer.
Congratulations Imogen Powell Brown, Daniel Hutton, Nicky Thorp, James Thomson, Ran MacKay, Liesl Hacker FCA, Lisa Ashmore, Jon Hayes, John Archer, and Carl Rowbottom for this incredible body of work.
Read the papers here:
Sustainable capital funding for modern and innovative radiotherapy services (here)
Considering late effects costs in radiotherapy funding (here)