Radiotherapy Treatment and Beyond - Mapping Radiotherapy Late Effects Service Provision in England

Area of Science:

• Oncology
• Radiotherapy
• Patient Survivorship

Background:

• Radiotherapy is a primary cancer treatment, but patients often experience debilitating acute and late toxicities.
• Radiotherapy Late Effects (RLEs) significantly impact patients' quality of life, necessitating specialized management.
• Current provision of RLE services in England is fragmented, despite service specifications calling for local management.

Purpose of the Study:

• To evaluate the current configuration, funding, and staffing of RLE services across England.
• To identify barriers hindering the development and expansion of RLE services.
• To inform strategies for improving RLE service provision and patient outcomes.

Main Methods:

• An online survey was distributed to all 52 radiotherapy service providers in England.
• Quantitative data were analyzed using descriptive statistics.
• Qualitative data from open-ended responses underwent inductive thematic analysis.

Main Results:

• A 60% response rate (31/52) was achieved, with 55% of respondents having an established RLE service, often led by Therapeutic Radiographers.
• Most services focused on pelvic RLEs, with limited support for other disease sites. Referrals were common from secondary care, but less so from primary care or self-referrals.
• Services were predominantly NHS-funded (71%), with a notable portion relying on charitable funding (24%). Key challenges included insufficient staffing and funding.

Conclusions:

• Significant regional variations exist in RLE service provision across England.
• Equitable access to RLE care requires urgent revisions in workforce modeling and commissioning strategies.
• Addressing identified barriers is essential for enhancing survivorship outcomes nationwide.