Setting the scene
The Central Region Cancer Alliance (CRCA) is responsible for planning cancer services to six million people across Central Region’s major city and the wider region. The region is facing significant challenges with its radiotherapy provision. Historically, radiotherapy services have been delivered from four separate hospital sites across the conurbation. A severe and growing shortage of specialist radiographers, clinical oncologists, and maintenance engineers has led to increasing waiting lists, particularly for follow-up appointments and less urgent treatments. Equipment maintenance is also becoming a major issue, with ageing machines causing frequent downtime.
The change idea
To address these pressures and ensure sustainable, high-quality service, the Alliance’s Executive Board is thinking about the need for a major reconfiguration. The idea is to consolidate all adult radiotherapy services into two state-of-the-art ‘Radiotherapy Hubs’. These hubs would be located at two existing large acute hospitals, chosen for their strategic locations, existing infrastructure, and potential for future expansion. The aim is to create centres of excellence with better equipment, concentrated specialist staffing, and improved training opportunities, ultimately leading to more efficient and timely treatment delivery.
Initial considerations:
The clinical and operational benefits are clear to the Board. Initial discussions have highlighted that moving from four sites to two will inevitably change travel patterns for many patients. Some patients will find their journey times significantly reduced, especially if they live close to one of the new hubs. Others, particularly those previously attending the two sites that would close, will face longer and potentially more complex journeys. Radiotherapy often requires daily attendance for several weeks, making travel a critical factor.
The Board recognises that this decision, while necessary for service sustainability, has significant implications for patients and their families, particularly concerning access and equity. They need a robust process to ensure that equality and health inequality issues are not just considered but are central to the planning and implementation of this reconfiguration.
