Some may have noticed recent articles in the press announcing that the Government have set up a Cancer Radiotherapy Innovation Fund, which will save in the region of 8000 lives per year, and guarantee that anyone who is referred for advanced RT will get it. The Prime Minister has said: “We’re making sure that more people get the drugs and treatments they need. We are making £15 million available straightaway to make sure our NHS staff are trained to give treatments like this. We already have a guarantee for drugs – that if they’re safe, cost-effective and doctors say you need them, you will get them. From April 2013, for the first time ever, we’re extending that guarantee to radiotherapy too. This is going to help thousands of people at one of the hardest times of their lives.”
But what are the facts? Having scrutinized the DOH press release, these are my conclusion:
(1) The £15 Million that is supposedly available straight away will not enable patients who require RT treatments which are not routinely or currently funded get them. Actually, what the £15 million will be spent on straight away is staff training to operate a form of Radiotherapy known as Intensity Modulated Radiotherapy. Even then, it is doubtful where £15, million will come from, in view of the fact that the Government propose to get this money from the under-spending of other NHS budgets, such as the Emergency Drugs Fund. Given the current financial situation, how many of us think these budgets will be under-spent?
(2) Also, while training staff to operate IMRT is a good thing, it is debatable that more IMRT will help the Government meet the claim that,” The Cancer Radiotherapy Innovation Fund will expand the NHS’ capacity to deliver life-saving advanced radiotherapy techniques to those who need them by April 2013”. Because in fact, IMRT has been available within the NHS since 2000 – so hardly revolutionary. Consequently between now and April 2013, all the £15 million could do would be to allow the NHS to offer more IMRT.
(3) The DOH press release also claims that: “From April 2013, we will be able to guarantee access to innovative radiotherapy where clinically appropriate, safe and cost effective. Because cancer treatments will be planned and paid for nationally by the NHS Commissioning Board, for the first time cancer patients will be considered for the most appropriate radiotherapy treatment regardless of where they live. For example, this means that all patients with brain tumours who needed stereotactic radiosurgery would have equal access to this treatment”.
But this does not mean that a cancer patient who was deemed to require stereotactic radiotherapy would be guaranteed to get it? Nowhere does the Fund guarantee that patients will get stereotactic radiotherapy. All it guarantees is that patients will be ‘considered’, and have ‘equal access’ to treatment. What’s more, the only reason people will have equal access, is because local specialised commissioning will be replaced with national commissioning. At the moment applications for specialized funding (that is for treatments like Cyberknife stereotactic radiotherapy, that are not routinely funded), are made to local Specialised Commissioning Groups, and each area has their own policy (hence the postcode lottery). But as from April 2013 decisions about what services should be funded, and what Hospitals should receive for providing these services (the National Tariff), will be decided by a the NHS National Commissioning Board. While that may well end the postcode lottery, it also means that if the National Commissioning Board decide not to fund a treatment, nobody will get it (so it’s debatable how much it will help cancer patients).
Even if the NCB did decide to fund stereotactic RT, for brain tumours, what difference would that make to the current situation? The answer is very little, because although only 29 out of 150 PCT’s currently fund treatments that are called whole body stereotactic treatment (WBRT) such as Cyberknife , most do fund other forms of RT for brain tumours (such as Gamma-knife). Also, as the DOH press release only refers to stereotactic RT in the context of brain tumours there is nothing to suggest that the fund would provide stereotactic treatment for tumours elsewhere in the body.
In conclusion, there is no evidence in my view, that the Cancer Radiotherapy Implementation fund is going to provide patients with access to life-saving radiotherapy, or modernize radiotherapy within the NHS. Instead, my opinion is that it is misleading, and doesn’t stand up to scrutiny. Worse still I fear it will convince some, that the battle ro achieve funding for advanced RT is over.