Radiotherapy commissioning and tariff—how can we deliver advanced, innovative, and personalised radiotherapy?

TL;DR

This paper discusses how outdated radiotherapy funding in England is limiting access to new treatments and proposes ways to modernize it.

Contribution

The paper proposes updated commissioning and tariff structures to better align with modern radiotherapy practices and promote innovation.

Findings

Outdated radiotherapy tariffs contribute to poor adoption of advanced treatment technologies.

Transferring commissioning to ICBs offers an opportunity to reshape funding structures.

Updating tariffs could drive innovation and equitable access to new treatments.

Abstract

Radiotherapy practices have changed significantly over recent decades with the introduction of increasingly personalised approaches to preparation and treatment and the use of a wider range of imaging technology, treatment techniques and software such as Artificial Intelligence (AI). The lack of development of the radiotherapy tariff, which remunerates services for radiotherapy delivery, has contributed to poor adoption rates and inequitable access for patients to new advanced treatment technologies and software across England. The radiotherapy tariff has a potential to be a lever to drive innovation across the system, if it is routinely updated to respond to latest clinical consensus. The commissioning of radiotherapy services is being transferred from NHS England to Integrated Care Boards (ICBs), in their emerging role as ‘strategic commissioners’. Along with wider reform to funding mechanisms set out in the 10 Year Health Plan, this presents an opportunity to reshape the commissioning and tariff structures for radiotherapy services to better reflect contemporary radiotherapy practice. This paper explores the limitations of current funding arrangements for radiotherapy. It proposes recommendations to ensure that providers are supported to deliver more productive, innovative and value-based radiotherapy.

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