COVID-19 Briefings

Radiotherapy services and COVID-19 weekly update 02/06/20

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis.  These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation. 

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

 

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

 

Professor Pat Price quotes feature in article from The Sun: Experts warn cancer treatment which could save lives is being ‘rationed’ (26 May 2020)

 

Pat Price, chair of Action Radiotherapy, said: "We were at capacity to start with so when we get more patients coming through, we will not be able to deal with it.

 

"We've got some real big solutions here and it's crazy that we've got machinery here that could solve some of the backlog and help improve survival, and yet we're not being allowed to use it. It's madness."

 

Sunday Express article: Putting off cancer treatments is “trading deaths” says experts (31 May 2020)

 

Cancer experts warn a “tsunami” of cancer cases lies ahead, as hospitals “trade deaths” by downgrading referrals to concentrate on coronavirus.

 

Professor Pat Price quoted “This will have a domino effect and we are bracing ourselves for a tsunami of cancer cases. Delays in restarting diagnostic services will lead to delays in diagnosis and more advanced cancer. More patients will no longer be curable by surgery, meaning we will have to deal with our own backlog, as well as these cases which were not treated in a timely way. This will likely be overwhelming.”

 

Open letter from radiotherapy professionals to Secretary of State for Health and Social Care calling for the end of SABR rationing reaches 235 signatures in under a week (1 June 2020)

 

The open letter states: “NHS England must stop rationing Stereotactic Ablative Radiotherapy (SABR). The use of SABR is essential to increase UK radiotherapy capacity, in order to deal with the cancer backlog during the COVID-19 pandemic” 

 

APPG on Cancer share cancer patient and Paralympic gold medallist David Smith’s strategies to combat anxiety video series from Action Radiotherapy YouTube channel (28 May 2020)

 

Radiotherapy Services weekly news updates

1 June 2020: Cancer Research UK data published shows over 2 million people in backlog for cancer care screening with over 2,800 having missed treatment for radiotherapy.

 

26 May 2020: Global coalition for Covid-19 response publishes further resources: Dr Louis Potters presentation from New York & Dr Julie Torode, UICC Director, presentation.

 

Parliamentary update

Parliamentary written questions answered by the minister:

Henry Smith MP’s question on people who have been advised by the Government to shield at home for 12 weeks in response to the covid-19 outbreak – asks for numbers related to conditions including those undergoing radical radiotherapy, have blood disease or having immunotherapy. Answered by Health Minister Jo Churchill: “This data is currently unavailable”

Selaine Saxby MP’s question on steps that are being taken to ensure radiotherapy can continue during Covid-19. Answered by Health Minister Jo Churchill: outlines the letter written to trusts on 29 April detailing the Second Phase of Response to Covid-19 and on radiotherapy specifically says “Treatment, including radiotherapy, must be brought back to pre-pandemic levels at the earliest opportunity to minimise potential harm, and to reduce the scale of the post-pandemic surge in demand.”

Lord Kennedy of Southwark’s question on the percentage of patients awaiting radiotherapy therapy for cancer have experienced delays in their treatment since January. Answered by Health Minister Lord Bethell: “The data requested is not held centrally.”

The All-Party Parliamentary Group for Radiotherapy (APPG RT), Action Radiotherapy and Radiotherapy4Life campaign continue to pursue a debate on  how radiotherapy services are responding to COVID-19 and the potential for our NHS to reduce avoidable cancer deaths by making better use of advanced radiotherapy across the UK. We urge members of the APPG RT to please let us know if they would like to support the debate and receive our briefings.

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Radiotherapy services and COVID-19 weekly update 26/05/20

 

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis.  These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation. 

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

  • A concise overview of how radiotherapy services are responding to COVID-19 based upon Action Radiotherapy’s coverage

  • Weekly updates on actions of the APPGRT and wider campaign

  • The APPG RT and APPG on Cancer meet with Health Minister Jo Churchill and NHS England National Cancer Director, Dame Cally Palmer to discuss radiotherapy, cancer services and the impacts of Covid (20 May 2020)

  • The APPG RT joins a group of cancer APPGs in a letter to Matt Hancock calling for a cancer recovery plan (22 May 2020)

  • Sunday Express article features the letter written by the seven APPGs calling for a national cancer recovery plan to deal with the backlog of cancer cases (24 May 2020)

  • Sky News: Professor Pat Price quotes feature in advanced radiotherapy article: Experts warn cancer treatment which could save lives is being ‘rationed’ (26 May 2020)

  • Action Radiotherapy, Radiotherapy4Life and the APPG RT launch email your MP appeal calling for the removal of restrictions on advanced radiotherapy that would allow patients to be treated, more safely and more quickly (24 May 2020)

 

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

 

The APPG RT and APPG on Cancer met with Health Minister Jo Churchill and NHS England National Cancer Director, Dame Cally Palmer to discuss radiotherapy, cancer services and the impacts of Covid (20 May 2020)

 

The APPG RT made the case for:

-Radiotherapy to be recognised as a vital solution to the situation cancer services currently face and that advanced radiotherapy national availability be part of a cancer recovery plan

-Called for an update to radiotherapy NICE guidance

-Called for the creation of a National Task Force to deliver world class cancer services by boosting radiotherapy and encompassing the whole NHS radiotherapy sector. 

The APPG RT joins a group of cancer APPGs in a letter to Secretary of State for Health and Social Care Matt Hancock calling for a cancer recovery plan (22 May 2020)

 

The letter was co-signed by the chairs of APPGs including the APPG on Blood Cancer, APPG on Breast Cancer, APPG on Cancer, APPG on Children, Teenagers and Young Adults with Cancer, APPG on Ovarian Cancer, APPG on Pancreatic Cancer, APPG for Radiotherapy and APPG on Stem Cell Transplantation.

Professor Pat Price quotes feature in SABR article on Sky News: Experts warn cancer treatment which could save lives is being ‘rationed’ (26 May 2020)

 

Pat Price, chair of Action Radiotherapy, said: "We were at capacity to start with so when we get more patients coming through, we will not be able to deal with it.

 

"We've got some real big solutions here and it's crazy that we've got machinery here that could solve some of the backlog and help improve survival, and yet we're not being allowed to use it. It's madness."

 

Sunday Express article features the letter written by the seven APPGs calling for a national cancer recovery plan to deal with the backlog of cancer cases (24 May 2020)

 

The print article can be read here.

Action Radiotherapy, Radiotherapy4Life and the APPG RT launch email your MP appeal calling for the removal of restrictions on advanced radiotherapy that would allow patients to be treated, more safely and more quickly (24 May 2020)

The appeal in the form of a letter urges Secretary of State for Health and Social Care Matt Hancock and DHSC to sweep away restrictions on advanced radiotherapy as part of a post Covid cancer recovery plan.

Radiotherapy Services weekly news updates

25 May 2020: Dr Clive Peedell, the oncologist who performed SABR treatment in a single visit,  had an article appear in the Times calling for urgent action to get SABR treatments up and running as an alternative within three months.

25 May 2020: International perspective on Covid-19 Cancer Care webinar

23 May 2020: New Covid-19 protection information for patients published by Royal College of Radiologists

21 May 2020: Radiotherapy lecturer reaches new audience through the internet (ITV)

19 May 2020: Addressing the needs of cancer survivors during the Covid-19 pandemic article

 

Parliamentary update

The All-Party Parliamentary Group for Radiotherapy (APPG RT), Action Radiotherapy and Radiotherapy4Life campaign continue to pursue a debate on  how radiotherapy services are responding to COVID-19 and the potential for our NHS to reduce avoidable cancer deaths by making better use of advanced radiotherapy across the UK. We urge members of the APPG RT to please let us know if they would like to support the debate and receive our briefings.

 

 

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Radiotherapy services and COVID-19 weekly update 19/05/20

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis.  These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation. 

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

  • A concise overview of how radiotherapy services are responding to COVID-19 based upon Action Radiotherapy’s coverage

  • Weekly updates on actions of the APPGRT and wider campaign

  • The APPG RT features in the Mail on Sunday. (17 May 2020)

  • Members of the All-Party Group for Radiotherapy take part in cancer APPG joint meeting (18 May 2020)

  • The APPG RT met on Thursday 14th May 2020 to discuss actions following the inquiry into the impact of Covid-19 on cancer services.

  • Parliamentary questions update on the impact of Covid-19 on radiotherapy treatments

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

 

The APPG RT recommendations to the Health Secretary feature in the Mail on Sunday. (17 May 2020)

A recommendation made by the APPG RT to remove commissioning restrictions on the advanced radiotherapy treatment, SABR (Stereotactic ablative radiotherapy), appeared in the Mail on Sunday in both print and online.

 

The paper outlined how the Health Secretary had been offered the recommendation by MPs and radiotherapy experts. It noted how treatments could now” spare patients dozens of exhausting hospital visits and deliver treatments in as little as three – with one lung cancer sufferer being treated in a breakthrough single session last week”.

 

Members of the All-Party Group for Radiotherapy take part in cancer APPG joint meeting (18 May 2020)

In a meeting with other APPG chairs, Tim Farron and APPG members joined the chairs of other APPGs to discuss the impacts of Covid-19 on cancer services and recommendations which could be offered to Government.

 

 

The APPG RT met on Thursday 14th May 2020 to discuss actions following the inquiry into the impact of Covid-19 on cancer services.

In this meeting parliamentarians discussed the actions the group would take to further highlight the case for boosting radiotherapy services following the inquiry and recent media coverage.

 

Radiotherapy Services weekly news updates

18 May 2020: Addressing the needs of cancer survivors during the COVID-19 pandemic

 

16 May 2020: Are we ready? Commissioning and delivering radiotherapy for the long term plan

 

15 May 2020: Clive Peedell delivers the first lung cancer patient treatment with a single fraction of SABR radiosurgery in under 20 minutes.

 

25 May 2020: Upcoming webinar: International Perspective on Covid-19 in cancer care.

 

Parliamentary update

14 May 2020: Health and Social Care Committee - Rosie Cooper MP asks witnesses about the use of advanced radiotherapy where chemotherapy can’t go ahead due to immunosuppression, or surgery cannot go ahead because ICU beds are in demand for Covid patients.

 

18 May 2020: a group of written questions on the subject of radiotherapy which were included in the last bulletin were met with a holding response from Parliamentary Under-Secretary of State for Health and Social Care Jo Churchill:

 

The Department of Health and Social Care has indicated that it will not be possible to answer this question within the usual time period. An answer is being prepared and will be provided as soon as it is available.

 

This bulletin will update once the answers have been received:

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Radiotherapy services and COVID-19 weekly update 12/05/20

 

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis.  These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation. 

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

  • A concise overview of how radiotherapy services are responding to COVID-19 based upon Action Radiotherapy’s coverage

  • Weekly updates on actions of the APPGRT and wider campaign

  • Agenda for next APPG RT Meeting set out Thursday 14th May 2020 10am-11am.

  • Action Radiotherapy present flash survey results at Global Coalition for Radiotherapy meeting (5 May 2020)

  • Further media coverage of APPG RT mini inquiry in trade media (6th May 2020)

  • Parliamentary questions asked on the impact of Covid-19 on radiotherapy treatments

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

Action Radiotherapy present flash survey results at Global Coalition for Radiotherapy meeting (5 May 2020). The charity Action Radiotherapy undertook a flash survey of on the ground radiotherapy professionals, between 24-27th April 2020, following the changes made within the NHS, in response to Covid-19 pandemic. The findings, which were also presented to Parliament, were outlined in a meeting with the group of professionals taking responsibility for finding short and long term solutions for patients during the Covid-19 emergency.

 

Agenda for next APPG RT Meeting set out Thursday 14th May 2020 10am-11am.

 

  1. Introduction from the Chair

  2. Follow up on APPG RT mini-inquiry and media coverage

  3. Response to comments made during the Health and Social Care Committee by NHS National Cancer Director

  4. COVID-19 and Global Coalition for Radiotherapy updates

  5. Agreeing actions and next steps

  6. Date of Next meeting

  7. Any other business 

 

Further media coverage of APPG RT mini-inquiry in the media (6th May 2020). The Hippocratice Post reports on “APPG RT responds to NHS England’s comments”.

Radiotherapy Services weekly updates

7 May 2020: Cancer management in India during Covid-19 - article published

 

6 May 2020: Covid-19 outbreak and cancer radiotherapy disruption in Lombardy Northern Italy – article published

 

6 May 2020: USA radiation oncology perspective during the Covid-19 pandemic: balancing patient care, transmission, migration and resident training – article published

 

Parliamentary update

Grahame Morris MP asks a written question on the steps being taken to reduce the level of unused radiotherapy machine capacity during the Covid-19.

 

Selaine Saxby MP asks a written question on the steps being taken to ensure that radiotherapy services used in cancer treatment continue during the Covid-19 outbreak.

 

Grahame Morris MP asks a written question about the need to establish a covid-19 cancer taskforce to assess the merits of increasing access to radiotherapy during the covid-19 outbreak.

 

Grahame Morris MP asks a written question on how  many patients have had radiotherapy treatments (a) delayed and (b) cancelled since February 2020.

 

Henry Smith MP asks a written question on the number of people advised by the Government to shield at home for 12 weeks in response to the Covid-19 outbreak including the number of patients undergoing cancer treatments.

 

 

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Radiotherapy services and COVID-19 weekly update 5/05/20

 

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis.  These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation. 

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

 

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

The APPG RT publishes evidence of mini-inquiry and submits as evidence to the Health and Social Care Committee (30 April 2020)

A mini inquiry published by the All-Party Parliamentary Group for Radiotherapy, has found that despite radiotherapy offering potential to prevent avoidable cancer deaths, services are being limited, delayed and cancelled.  The findings, which have been presented to the Health Select Committee, found that unless urgent and co-ordinated action is taken by the Government, in the form of a National Taskforce, the UK will lose more lives from cancer, as a result of the understandable focus on Covid-19, than we are able to save from the virus.

 

Chair of the APPG RT, Tim Farron has an article published on PoliticsHome/ The House Magazine live: Radiotherapy is a vital treatment that can reduce unnecessary cancer deaths during the coronavirus pandemic (4 May 2020)

 

The APPG RT evidence mentioned an article in The Times (30 April 2020): Cancer patients at risk as radiotherapy machines stand idle

 

The APPG RT publishes a flash survey of radiotherapy professionals (30 April 2020) survey findings include:

  • Only 31% of front-line staff felt they had access to full and appropriate levels of PPE

  • 61% reported between 21-60% of patients had their radiotherapy treatment disrupted and 65% of responders were concerned or extremely concerned.

  • 36% were not able to introduce advanced radiotherapy with SABR to shorten treatment and 24% reported poor or very poor IT.

  • Unused machine capacity has increased 5- fold, with some centres reporting 6 hours per day spare machine

  • 97% of respondents said that at least some prostate radiotherapy was cancelled, the average was 56% of patients cancelled, 3% said 0 cancellations and 20% said 100%. The time delay being planned ranged from 2-6 months

  • 24% felt radiotherapy services were severely undervalued and 41% undervalued by senior policy makers in Government and the NHS

  • 38% felt that the Government had no understanding of the effect of the current situation in radiotherapy on cancer patients and 51% no understanding on the effect on the radiotherapy workforce

 

The APPG RT responds to comments made by NHS England’s National Cancer Director during Health and Social Care Select Committee hearing (2 May 2020)

 

The All-Party Parliamentary Group for Radiotherapy have reacted with concern following answers given by NHS England’s National Cancer Director, Dame Cally Palmer, at the Health and Social Care Committee, which appear out of step with the evidence of a mini-inquiry run by the APPG this week. In response APPG RT Chair, Tim Farron MP and Vice-Chair, Grahame Morris, have written to Sir Simon Stevens, Chief Executive, NHS England, to call for an urgent virtual meeting to discuss the findings and set out how boosting radiotherapy services is an unmissable opportunity for the NHS to prevent avoidable cancer deaths during Covid-19.

 

 

Radiotherapy Services weekly updates

29 April 2020: Article: Cancer and Covid-19 – potentially deleterious effects of delaying radiotherapy

 

“Radiotherapy should remain a valid and accessible treatment option during the COVID-19 pandemic, for several reasons. First, radiotherapy generally does not compete for in-demand resources, such as respirators or intensive care unit (ICU) beds and can continue to remain accessible. In certain scenarios, radiotherapy could even safely be used as an alternative to surgery. Second, extensive experience is available in converting many standard fractionation schedules into shorter, hypofractionated ones, which involve fewer visits to the radiotherapy centre, thus reducing the risks of exposing patients to SARS-CoV-2. Third, in contrast to the majority of chemotherapies, most radiotherapy regimens are only moderately immunosuppressive, and this applies particularly to hypofractionated radiotherapy schedules1. Finally, the proper adoption of personal protective equipment (PPE) has been shown to enable the safe delivery of care, despite the presence of many asymptomatic carriers among both patients and clinical and/or nonclinical staff”.

 

29 April 2020: Article: Collateral damage: the impact on cancer outcomes of the Covid-19 pandemic

 

29 April 2020: ULC research: Deaths in people with cancer could rise by at least 20%

 

30 April 2020: VarianVision Interactive Roundtable Webinar – Changing Radiotherapy Practice Patterns In a Covid-19 World.

 

Parliamentary update

Dame Cally Palmer (National Cancer Director for NHS England) responds to a question from Rosie Cooper MP in the Health and Social Care Select Committee hearing on underused radiotherapy machine capacity and appropriate levels of PPE as highlighted by the APPG RT mini-inquiry.

 

During the Health and Social Care Committee, Dame Cally Palmer (National Cancer Director for NHS England) is asked by Taiqo Owatemi MP about offering radiotherapy for some patients where surgery and chemotherapy have been ruled out due to Covid-19.

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Radiotherapy services and COVID-19 weekly update 27/04/20

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis.  These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation. 

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

  • A concise overview of how radiotherapy services are responding to COVID-19 based upon Action Radiotherapy’s coverage

  • Weekly updates on actions of the APPGRT and wider campaign

  • Sky News appearance from Professor Pat Price, chair of Action Radiotherapy and advisor to the APPG RT (25 April 2020)

  • Virtual meeting with Chair of the Health and Social Care Select Committee (24 April 2020)

  • ITV Central media appearance from Professor Pat Price (23 April 2020)

  • APPG RT meet virtually joined by members of the Cancer APPG (22 April 2020)

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

 

Sky News media coverage: Professor Pat Price, chair of Action Radiotherapy and advisor to the APPG RT appears as a cancer expert on Sky News to highlight the impact of COVID-19 on cancer treatment pathways (25th April 2020).

  • “We will almost certainly going lose more patients unnecessarily from cancer as we do from COVID-19, that is because much of the whole pathway has been disrupted from patients not feeling they can present to their general practitioners, not wanting to disturb the NHS, we know the two week wait is down. And patients having their appointments cancelled.”

 

The APPG for Radiotherapy conduct virtual meeting with the Chair of the Health and Social Care Select Committee, Jeremy Hunt (24 April 2020) to discuss the current crisis in radiotherapy services.

The APPG agreed to produce a body of evidence for the Health Select Committee’s ongoing work in the area of health services disrupted by the COVID-19 pandemic and beyond.

 

The APPG RT were joined in a virtual meeting by members of the Cancer APPG (22 April 2020) to discuss the ongoing need for action to prevent a further epidemic of cancer deaths after the COVID-19 crisis abates.

 

ITV Central media coverage (23 April 2020): Professor Pat Price appears on ITV Central calling for action to avoid the “double tragedy” of losing as many patients from cancer as we do from COVID-19 Full piece: Cancer sufferer feels 'sacrificed' for COVID-19 patients after vital operation cancelled

Action Radiotherapy launch a poll for radiotherapy professions (24 April 2020) to provide further on the ground evidence of what is happening in radiotherapy services and highlight the experiences of staff and patients.

Radiotherapy Services weekly updates

21 April 2020: The Society of Radiographers publishes an urgent PPE update for members. Following media concern over the shortage of PPE and delays to shipments the SoR provided an update to remind members “no one is expected to put their lives at risk because of a shortage of PPE. If a risk assessment demonstrates that you need PPE, then that should dictate its use, not availability”.

 

21 April 2020: Action Radiotherapy produces Radiotherapy & Coronavirus Patient FAQ.

 

21 April 2020: The Lancet publishes multi-centre study during COVID-19 outbreak: Patients with Cancer Appear More Vulnerable to SARS-CoV-2

 

23 April 2020: Cancer Research UK blog on “How coronavirus is impacting cancer services in the UK”.

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Radiotherapy services and COVID-19 weekly update 20/04/20

 

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis. These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation.

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

 

• A concise overview of how radiotherapy services are responding to COVID-19 based upon Action Radiotherapy’s coverage

• Weekly updates on actions of the APPGRT and wider campaign

• The Times Red Box piece from Professor Pat Price - Cancer patients deserve the best treatment despite pressures of coronavirus (16th April)

• Chairs of All Party Parliamentary Groups on Cancer and Radiotherapy Reaction To Matt Hancock’s Comments on Covid/Cancer (17th April)

• Action Radiotherapy joins urgent radiotherapy teleconference with Alex Norris MP (14th April)

 

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

 

Chairs of All Party Parliamentary Groups on Cancer and Radiotherapy Reaction To Matt Hancock’s Comments on Covid/Cancer (17th April)

 

Chairs of All Party Parliamentary Groups on Cancer and Radiotherapy Reaction To Matt Hancock’s Comments on Covid/Cancer

 

Chairs of All Party Parliamentary Groups (APPGs) focussed on cancer, have responded with extreme concern to the comments raised by the Secretary of State for Health and Social Care, Matt Hancock, earlier today when he was challenged over the large number of avoidable cancer deaths that will occur as an inadvertent consequence of the intensity of the overall NHS Covid-19 response.

 

Recent research has indicated that a growing number of people could be lost to cancer due their treatments being unnecessarily delayed, deferred or cancelled. When challenged on this point by Rosie Cooper MP during today’s ‘virtual’ Health and Social Care Select Committee, the Secretary of State failed to engage with, or acknowledge, this problem. His answers suggested that cancer treatments were being disrupted only when clinically justified due to the higher risk of infection during the pandemic, and that the main concern was that cancer patients weren’t coming forward for treatment at this time.

 

Tonia Antoniazzi MP, chair of the APPG on Cancer said, ‘Whilst it is true that some cancer treatment is being rightly disrupted because clinicians, in conversation with patients, are making a judgement on whether the treatment is still suitable as it would increase their risk of infection to Covid-19, far too many blanket stoppages of treatment are still occurring. We are talking about a growing number of cancer treatments being disrupted or stopped for a whole range of other Covid related reasons including professionals being deployed away from the cancer frontline. We could be about to see the ‘double tragedy’ of a large loss of life to Covid being followed by further loss of life to cancer. I implore the Minister to meet with us to outline his plan for ensuring people still get the cancer treatment they need.’

 

Tim Farron MP, chair of the APPG for Radiotherapy, said, ‘A catastrophic cancer crisis is unfolding right now. I fear that the Secretary of State is being shielded from this information as if he was aware of it, I’m sure that he would act. The clamour from professionals and experts is getting louder every day. I urge him to meet with myself and Tonia Antoniazzi as a matter of urgency. The majority of these so called ‘collateral’ cancer deaths are avoidable. All it takes is the realisation that they are about to happen and a commitment to some bold simple steps to boost services like radiotherapy. This is a problem with a solution’.

 

The Times, Redbox: Professor Pat Price, Chair of Action Radiotherapy, appeared in The Times Redbox. The APPGRT, Action Radiotherapy and Radiotherapy4Life campaign feel this is an excellent summary of the current challenges faced by radiotherapy services and the solutions needed. Full Article: Cancer patients deserve the best treatment despite pressures of coronavirus (16th April)

 

Action Radiotherapy joins urgent teleconference with other cancer charities and Alex Norris MP, to discuss the radiotherapy emergency (14th April)

 

Former England and Manchester United Football Captain Brian Robson supports the Action Radiotherapy campaign to help cancer patients during the COVID-19 crisis on Instagram on (17th April 2020).

 

Radiotherapy Services weekly updates

 

10th April 2020: Global Radiotherapy response to COVID-19: National Cancer Centre Singapore and Zhongnan Hospital of Wuhan – COVID-19 and Cancer: Experience from Wuhan City, China

 

14th April 2020: Editorial published on the Early appearance of COVID-19 associated pulmonary infiltrates during daily radiotherapy imaging for lung cancer

 

14th April 2020: GenesisCareUK Oncologist: Radiotherapy: a valuable tool in a time of crisis.

 

16th April 2020: Editorial published on prevention and control measures to avoid cross infection during radiotherapy in coronavirus disease 2019 epidemic in Wuhan, China

 

17th April 2020: iNews report: Cancer Treatment cutbacks could lead to 60,000 premature deaths, oncologist warns.

 

Professor Karol Sikora, chief medical officer at Rutherford Health and former head of the World Health Organisation's cancer program: "Let's say the lockdown went on for six months and hospitals couldn't complete cancer surgery, chemotherapy and radiotherapy, we've come to the conclusion that up to 60,000 people in the UK will die if they have to wait that long for treatment.

 

"For a month the figure is very little, about 100 or 200 excess deaths, because there are not that many people who really needed to be treated within a month, which is how long the delay to services has gone on so far. And the urgent cases can be pushed to the front of the queue. But you get a steep curve of excess deaths the longer the lockdown goes on, because the worse it gets.

 

17th April 2020: BMJ article from leading Edinburgh Centre medical professionals responds to NICE advice “We have a real concern that inferences made from these small studies are leading us to under-treat patients with cancer that will lead to an excess cancer mortality following the pandemic that may well outstrip the immediate COVID-related death rate in cancer patients!”

 

17th April 2020: Action Radiotherapy hosted blog from a therapeutic radiographer “Jo Strickland – Behind the mask”

Upcoming (21st April 2020): Webinar with The Radiosurgery Society on SRS/SBRT Radiotherapy in the Time of COVID-19.

 

Parliamentary update

 

Select Committee 17th April 2020: Noting the recent APPG for Radiotherapy virtual meeting, member of the Health and Social Care Select Committee, Rosie Cooper MP questioned the Secretary of State for Health and Social Care at a virtual oral evidence session. Cooper, who is also a member of the APPGRT, asked Matt Hancock about the growing number of people who could lose out on cancer treatments and pressures on radiotherapy services.

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Radiotherapy services and COVID-19 weekly update 14/04/20

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis. These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, one of a series, on how the sector is adapting to the situation.

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

• A concise overview of how radiotherapy services are responding to COVID-19 based upon Action Radiotherapy’s coverage

• Weekly updates on actions of the APPGRT and wider campaign

• Actions from the APPG RT virtual meeting 9th April 2020

• Launch of Coalition for Global Radiotherapy Response to Covid-19 8 April

 

APPG RT, Action Radiotherapy and Radiotherapy4Life campaign update

Letter to Secretary of State for Health and Social Care n 4th April 2020: the APPG for Radiotherapy wrote to Matt Hancock urging him to prioritise the supply of Personal Protective Equipment (PPE) for radiotherapy professionals and called on him to take steps to boost radiotherapy capacity to save lives. Letter PDF: https://bit.ly/2V8pP3w

APPG RT Meeting on 9th April 2020: our group met virtually to discuss COVID-19 pressures and how radiotherapy services are responding to them. It was recognised that radiotherapy was quickly becoming the preferred treatment for cancer due to the lower risk of infection but without urgent action there was a risk of avoidable cancer deaths, as a result of unintended consequences of actions to tackle the pandemic, outstripping the numbers saved from COVID-19. Actions needed include:

• Innovative IT, transport and capacity solutions are all needed maximize services ability to function and continue to treat patients

• Vital Personal Protective Equipment (PPE) for clinicians working centimetres from vulnerable cancer patients

• Harnessing private sector capacity to boost radiotherapy, particularly the advanced treatments. We understand from our informal contacts with the private sector (which has around 20 radiotherapy centres around the country) that some of their facilities have significant spare capacity. We believe that this excess private capacity could be, and should be, made available to the NHS.

• Oversee the necessary tariff, commissioning, regulatory and team structure changes that are urgently needed to prevent services collapsing.

 

Sunday Express article on Sunday 12th April 2020: Cancer deaths set to soar amid coronavirus crisis: CANCER deaths caused by the indirect effects of Covid-19 on the NHS will outstrip the number predicted to die from the virus, experts have warned.

The article mentions the APPG RT letter to the Secretary of State for Health and Social Care calling for a refocus on preventing avoidable cancer deaths.

 

Radiotherapy Services weekly updates

30th March 2020: NICE Guidance on COVID-19 rapid guidelines on radiotherapy delivery published. Recommends changes to standard cancer treatment including alternative dose fractionation schedules or radiotherapy techniques where available. NICE recommend the RADS (Remote, Avoid, Defer, Shorten) principle, that is for remote assessments, avoiding or deferring treatment and shortening treatments.

2nd April 2020: COVID-19 Response: The UK Radiographer Workforce Survey published.

2nd April 2020: The Government releases new guidance on the use of personal protective equipment (PPE) emphasising risks treating patients with or suspected cases of COVID-19.

2nd April 2020: The Lancet Oncology editorial – COVID-19: global consequences for oncology, outlines high-risk to cancer patients with huge potential to treatments in England despite additional funding promised at the 2020 budget.

2nd April 2020: International Guidelines on Radiation Therapy for Breast Cancer During the COVID-19 Pandemic editorial published. States there is an “urgent need to share expertise and offer emergency guidance for breast radiation therapy (RT) during the COVID-19 (Coronavirus) pandemic.”

31st March 2020 (updated 3rd April): Latest guidance from the Society of Radiographers calling for a risk assessment to be carried out on every patient not just those suspected of having COVID-19.

9th-10th April: Government issues new PPE guidance and 3 point PPE action plan. A new Coronavirus (COVID-19): personal protective equipment (PPE) hub is launched to collate PPE guidance.

Launch of Coalition for Global Radiotherapy Response to Covid-19 8 April

Action Radiotherapy along with Radiotherapy4Life supporters brought together representative from the international radiotherapy professional community and industry to discuss sharing of experience and data and to find ways to ensure access and delivery of radiotherapy during this challenging time. Radiotherapy professional from Wuhan shared their advice. A range of solutions were being pursued around the world, but the UK were clearly not actively and aggressively tackling the issue as well as other nations. A statement is being produced as well as estimates of how many cancer lives will be lost due to the crisis and how many unnecessary cancer deaths may occur if insufficient action is taken now.

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Radiotherapy services and COVID-19 update - 30.03.2020

The NHS is facing unprecedented pressures as it deals with the COVID-19 crisis. These pressures are affecting nearly every aspect of health provision including radiotherapy services.

The Radiotherapy4Life campaign, Action Radiotherapy and the All-Party Parliamentary Group for Radiotherapy have produced the following briefing, the first of a series, on how the sector is adapting to the situation.

The briefing is primarily for members of the APPG, but it is hoped it will be of value and interest to other stakeholders too:

• An overview of how radiotherapy services are responding to COVID-19

• The role of the APPG RT, Action Radiotherapy and Radiotherapy4Life campaign during this crisis

• It remains the case that 1 in 4 of us will need radiotherapy in our lifetimes and the findings of the APPG RT inquiry are more important than ever

 

How have Radiotherapy Services responded?

Prioritising treatments based on clinical need: Prioritising treatments has become essential during this crisis. The additional risk of a patient contracting the virus needs to be weighed up against the advantage of their radiotherapy treatment. The radiotherapy community has demonstrated commendable effort in producing guidance and collaborative effort on treatments. Tariff constrictions need to be removed immediately so that decisions are based purely on clinical outcome and help Trusts to adhere to COVID-19 radiotherapy guidance. For example, If advanced radiotherapy, SABR, could be performed wherever clinically relevant, this would reduce the number of times that patient needs to visit the department and would relieve pressure on the already stretched workforce.

Maximizing IT infrastructure: Radiotherapy professionals have responded to the epidemic by trying to minimise the risk of their patients and healthcare workers contracting Covid-19. Where possible, follow-up activity is being conducted by telephone and video conferencing. While heroic efforts are being made to ensure treatments are not interrupted, if modern IT infrastructure that has the capability for remote radiotherapy planning is available, this would mean that Consultants could plan treatments from their home, further minimising risk. Future investment in this area is vital.

Workforce planning and protection: As radiotherapy requires a specialised multidisciplinary workforce, and it is expected that there will be further staff shortages over the coming weeks, a temporary Covid-19 register has been set-up. This will include professionals who have voluntarily left the workforce within the last 3 years and final year students who have finished their clinical placements. Adequate Personal Protective Equipment (PPE) needs to be available for front line workers treating cancer patients with radiotherapy as well.

The role of the APPG RT, Action Radiotherapy and Radiotherapy4Life campaign during this crisis

We are producing a series of briefing notes which set out, for those with an interest in the sector, how it is coping with, and contributing to, the COVID-19 response. Our hope is that these briefings will be a useful resource in future radiotherapy policy development once the immediate crisis abates. In addition, we will be: 

 

1. Writing to our members and members of the Health Select Committee to provide valuable information on how this often forgotten, but vital area of cancer treatment, is being impacted

2. Using the future launch of “my radiotherapy story” to monitor how patients are experiencing radiotherapy treatments at this difficult time.

3. Working with the charity Action Radiotherapy to provide daily updates to the radiotherapy community on resources and emerging guidelines on radiotherapy treatment and Covid19 infection and linking with the global community to provide rapid communication of advice and support.

4. Urging Parliamentarians to engage with us though virtual means to update on how the campaign remains at the centre of securing a world class radiotherapy service for everyone.

 

The APPG’s inquiry recommendations are even more important than ever

Advanced radiotherapy treatments being rationed: Stereotactic Ablative Body Radiotherapy (SABR), is restricted by NHS England to half the radiotherapy centres in England, despite weekly publications on its efficacy and safety. Many treatments programmes could be completed in as few as 5 hospital visits with advanced radiotherapy, less advanced techniques could require over 30, significantly increasing the risk of interrupted treatments. Central restrictions on commissioning need to be lifted to allow professional to treat the patients in the best way for their cancer and not in response to slow moving bureaucracy.

• Patients missing treatment: At least 20,000 patients in England a year, are already missing out on radiotherapy. It is essential that radiotherapy is uninterrupted and is also vital in the treatment of early detected cancer. The current crisis means that already under strain services could lead to many more patients missing out on this life saving treatment.

• Radiotherapy Machine replacements: It is concerning that half of NHS Trusts are still operating machines that are older than the recommended 10-year life span and funding was not forthcoming from Government following the existing 2016 funding running out in April 2019. Using up to date machines significantly reduces the amount of downtime of a machine and staff time wasted, which is now needed to increase capacity.

• Travel Times: 3.5 million people in England do not have access to a radiotherapy treatment within the 2012 Department of Health maximum 45-minute travel time recommendation. Travel time is consistently reported as the number one concern of patients accessing radiotherapy and will provide a more significant factor in current circumstances.

• Workforce: Radiotherapy is delivered by a multidisciplinary work force of around 5000 highly skilled professionals. The workforce crisis has disproportionately affected radiotherapy in the UK. The number of unfilled consultant posts in the UK has doubled and is expected to reach 272 in 2023. Whilst the introduction of the grant for trainee therapeutic radiographers is welcomed, it does not go far enough to attract and retain professionals.

 

Cancer patients and the radiotherapy workforce are facing unprecedented challenges. Many of the APPG RT’s findings and COVID-19 related challenges present learning opportunities to develop a truly world class cancer service.

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