This Clinical Reference Group (CRG) covers radiotherapy. Radiotherapy is the controlled use of high energy x-rays to treat many different types of cancer. In a few cases, radiotherapy can also be used to treat benign (non-cancerous) tumours. Radiotherapy may be used to cure an illness for example, by destroying a tumour (abnormal tissue); to control symptoms e.g. pain relief; to shrink a tumour to make it easier to remove, prior to surgery, and after surgery, to destroy small amounts of tumour that may be left.
Chair: Dr Imogen Locke.
Recruitment to this CRG is in progress and the names of the members will be updated shortly.
A key part of the CRG’s work is the delivery of the ‘products’ of commissioning. These are the tools used by the 10 Hub Commissioning Teams to contract services on an annual basis.
Service specifications are important in clearly defining the standards of care expected from organisations funded by NHS England to provide specialised care. The specifications have been developed by specialised clinicians, commissioners, expert patients and public health representatives to describe both core and developmental service standards. Core standards are those that all funded providers should be able to demonstrate, with developmental standards being those which may require further changes in practice over time to provide excellence in the field.
The following service specifications fall within the scope of this CRG:
- External beam radiotherapy services delivered as part of a radiotherapy network (adults)
- Operational delivery networks for external beam radiotherapy services (adults)
- Stereotactic radiosurgery/radiotherapy – intracranial (all ages)
- Breast Radiotherapy Injury Rehabilitation Service (Adult)
- Brachytherapy and Molecular Radiotherapy (All Ages)
- Proton Beam Therapy NHS Service (All ages)
- Proton Beam Therapy Service – Overseas programme (Adults and children)
A commissioning policy is a document that defines access to a service for a particular group of patients. A NICE Technology Appraisal Guideline on the same topic will replace, or be incorporated into, a commissioning policy as appropriate. These are important documents that are developed to ensure consistency in access to treatments nationwide.
The following policies fall within the scope of this CRG:
- Selective internal radiation therapy for chemotherapy refractory intolerant metastatic colorectal cancer (adults) (effective from 1 April 2019)
- Selective internal radiation therapy (SIRT) for the treatment of chemotherapy refractory or intolerant, unresectable primary intrahepatic cholangiocarcinoma (all ages)
- Stereotactic radiosurgery and radiotherapy for pituitary adenomas (RC)
- Hypofractionated external beam radiotherapy in the treatment of localised prostate cancer (adults)
- Proton Beam Therapy for cancer of the prostate
- The use of Stereotactic Ablative Radiotherapy (SABR) in the treatment of prostate cancer
- The use of Stereotactic Ablative Radiotherapy (SABR) in the treatment of previously irradiated tumours of the pelvis, spine and nasopharynx
- The use of Stereotactic Ablative Radiotherapy (SABR) as a treatment option for patients with Hepatocellular carcinoma or Cholangiocarcinoma
- The use of Stereotactic Ablative Radiotheraly (SABR) as a treatment option for patients with oligometastatic disease
- The use of Stereotactic Ablative Radiotherapy (SABR) as a treatment option for patients with Renal Cancer
- Stereotactic Ablative Body Radiotherapy for Non-Small-Cell Lung Cancer (Adult)
- Proton Beam Therapy for children, teenagers and young adults in the treatment of malignant and nonmalignant tumours
- Proton Beam Radiotherapy (High Energy) for Paediatric Cancer Treatment – NHS Overseas Programme
- Proton Beam Radiotherapy (High Energy) for Teenage and Young Adult Cancer Treatment – NHS Overseas Programme
- Proton Beam Radiotherapy (High Energy) for Skull Base Tumour Treatment – NHS Overseas Programme (Adult)
- Pallative radiotherapy for bone pain
- Radiotherapy after primary surgery for breast cancer
- Stereotactic radiosurgery/radiotherapy for ependymoma, haemangioblastoma, pilocytic astrocytoma and trigeminal schwannoma
Policy statements are brief documents that define the current commissioning position to support service contracting.
The following policy statements fall within the scope of this CRG:
- Selective Internal Radiotherapy (SIRT) (for review from 1 April 2019) | Appendix A – Selective Internal Radiotherapy
- Proton Beam Therapy for Adult Lymphoma
- Proton Beam Therapy for Head and Neck Cancer in Adults
- Proton Beam Therapy for Hepatocellular Carcinoma
- Proton Beam Therapy for Oesophageal Cancer in Adults
Commissioning through Evaluation
NHS England’s Commissioning through Evaluation (CtE) scheme for the use of Selective Internal Radiation Therapy (SIRT) to treat cancerous tumours in the liver is now complete. The independent evaluation of the scheme, led by the National Institute for Health & Care Excellence (NICE) has now been publshed. The evaluation will now be used to support a review of the currently published clinical commissioning policy statement on SIRT, which can be found above.
June 2016: Patients benefiting from advanced brain tumour treatment set to double (article includes a full list of stereotactic radiosurgery and radiotherapy [SRS/SRT] providers)