An overhaul of specialist radiotherapy nationwide could see the number of sites commissioned by NHS England reduced as the body seeks to improve efficiency and access to the service.

The national commissioning body’s proposals for stereotactic radiotherapy and stereotactic radiosurgery, released this week, call for the service to be run seven days a week and a doubling of activity by 2016-17. Such services use focused beams of radiation to treat brain tumours, reducing the risk of damage to healthy tissue compared to other types of radiotherapy.

Radiotherapy treatment

The North West and Sheffield have high concentrations of radiotherapy services

Sean Duffy, national clinical director for cancer, said NHS England’s role as the single commissioner of the services meant that “for the first time ever” it had the opportunity to develop a “truly national service”.

According to its consultation paper, NHS England holds contracts with 12 providers including Sheffield Teaching Hospitals, University Hospital Birmingham and Cambridge University Hospitals foundation trusts.

Poor “strategic placement” of contracts has however left 45 per cent of the population without access to services within a one hour drive, it adds.

Alongside patchy geographical access, NHS England points to an excess of suitable radiotherapy machines across the country.

The total activity of roughly 2,500 treatments in 2013-14 could have been carried out with just three machines, the paper adds.

To improve value for money, NHS England’s preferred option is to cut idle capacity by moving to seven day working.

The paper says this option would “require fewer centres to meet patient need”, resulting in poorer geographical accessibility compared with an alternative option of five day working across more sites.

Between six and 12 machines would be required to deliver the service under the seven day model, it adds.

Thirteen providers with suitable radiotherapy machines are not currently contracted to deliver the service, giving NHS England some scope to change the geographical spread.

Areas that appear to have relatively high concentrations of contracted services include the North West, where the service is delivered at Royal Preston Hospital, the Clatterbridge Cancer Centre and by The Christie at Salford Royal.

The city of Sheffield has three sites delivering the services, according to a map published in the NHS England consultation paper.

The commissioning body’s consultation runs until 26 January.

Further details on its procurement phase are expected to be published later in 2015.

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