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Organising Radiotherapy Services – what are the lessons from England PowerPoint PPT Presentation


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Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team Organising Radiotherapy Services – what are the lessons from England Tim Cooper Associate Director – Radiotherapy National Cancer Action Team

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Organising Radiotherapy Services – what are the lessons from England

Tim Cooper

Associate Director – Radiotherapy

National Cancer Action Team


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Organising Radiotherapy Services – what are the lessons from England

Tim Cooper

Associate Director – Radiotherapy

National Cancer Action Team


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Vision

Strategy


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  • Workforce

  • Access

  • Capacity

  • Safety

  • Peer Review

  • Clinical Pathways

  • Clinical Trials and Research

  • New Technology

Governance

Service Delivery

NRIG

(NRAG / Cancer Reform Strategy)

  • Survivorship

  • Communication Skills

  • Leadership

  • Engagement

  • Contracting Framework

  • RTDS/RES

  • Tariff / HRG

  • Commissioning Toolkit

Wider World

Commissioning

www.cancer.nhs.uk/radiotherapy


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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


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Headlines

  • Relevant Key issues

  • Investment

  • Engagement

  • Leadership

  • Play to your strengths

  • Toolkits

  • Communication


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Relevant Key Issues

What does World Class look like??

  • Access

    • Performance

    • Productivity

  • Workforce

  • Technology

    • IMRT

    • SBRT

    • IGRT


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  • Workforce

  • Access

  • Capacity

  • Safety

  • Peer Review

  • Clinical Pathways

  • Clinical Trials and Research

  • New Technology

Governance

Service Delivery

NRIG

(NRAG / Cancer Reform Strategy)

  • Survivorship

  • Communication Skills

  • Leadership

  • Engagement

  • Contracting Framework

  • RTDS/RES

  • Tariff / HRG

  • Commissioning Toolkit

Wider World

Commissioning

www.cancer.nhs.uk/radiotherapy


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Relevant Key Issues

What does World Class look like??

  • Access

    • Performance

    • Productivity

  • Workforce

  • Technology

    • IMRT

    • SBRT

    • IGRT


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Workforce

Reconvened 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

VERT

now 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.


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Service Delivery

Access

31 days - analysis of early returns

- data completeness !!

Process and pathways

Capacity

Network led planning in many areas

?? 25 satellites

staged plans- ongoing work

RTDS

Missing patients

Radiotherapy Site Visits

National Purchasing Framework


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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


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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;


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Headlines

  • Relevant Key issues

  • Investment

  • Engagement

  • Leadership

  • Play to your strengths

  • Toolkits

  • Communication


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National Cancer Action Team

Department of Health

Payment by Results

UNIT COST COMPARISONS – AVERAGE OF ALL COSTS PER FRACTIONS

Radiotherapy Costing & Tariff Development


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Leadership & Engagement

  • Clinical Leadership

  • Programme Leadership

  • Progress chaser

  • Engagement

    • Profession

    • Public

    • Political

    • Wider


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Headlines

  • Relevant Key issues

  • Investment

  • Engagement

  • Leadership

  • Play to your strengths

  • Toolkits

  • Communication


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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


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Headlines

  • Relevant Key issues

  • Investment

  • Engagement

  • Leadership

  • Play to your strengths

  • Toolkits

  • Communication


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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


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Commissioning

Contracting

Contracting FrameworkService Specification

Radiotherapy Pathway

www.cancer.nhs.uk/radiotherapy/commissioning

Cancer Commissioning toolkit – radiotherapy section

Radiotherapy Commissioning Pilots x 4


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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


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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?


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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.


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Headlines

  • Relevant Key issues

  • Investment

  • Engagement

  • Leadership

  • Play to your strengths

  • Toolkits

  • Communication


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Achieving a world class radiotherapy service across the UK

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.


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