By Dr Julian Singer
THE majority of radiotherapy is delivered by linear accelerators. These are large complex machines costing in the region of £1.5m and housed in lead lined bunkers. These machines are built to a high standard and to be used eight hours per day for ten years before requiring replacement.
Towards the end of their working life, they require more checks and service. This inevitably means “downtime” and patients will be transferred to a paired sister machine.
There is no current national group specifically tasked with the implementation of modern radiotherapy equipment in the UK. Previously the national cancer action team NCAT, and the national radiotherapy implementation group NRIG were responsible for keeping a database of all the hospitals with linear accelerators and the ages of the machines.
These groups have now disbanded and NHS England has formed a few years ago. NHS England have some responsibility to modernize and keep up to date the radiotherapy equipment in England.
But it is down to the individual hospital teams and CEO, to bring forward a business case to apply for modernization money from NHS England.
This means that there will be variations from region to region in the country.
Moreover, NHS England often set a requirement to the CEOs that their Trust should be in the financial black, before the funds are released to the individual hospitals. Since most Trusts are in the red, that seems to be a fairly good way of ensuring that no money is released. Some CEO’s are prepared to gamble and state that they will be in the black in the future to tempt NHS England to release the monies.
The modernisation fund is apparently £130m for new Radiotherapy machines.
When you consider the cost of the NHS is about £120bn then that suggests that about one thousandth of that has been allocated to the radiotherapy machines.
Dr Julian Singer is a specialist in breast and lung malignancies
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