By Grant Smith

TAYSIDE PATIENTS needing radiotherapy should not have to wait much beyond target times for treatment thanks to a recent staff recruitment drive, a cancer specialist at Ninewells Hospital in Dundee said yesterday.

Dr John Dewar, a consultant clinical oncologist, was speaking in the wake of a warning that patients across the UK were potentially being put at risk because of staff shortages.

An article in the British Medical Journal by two Leeds doctors said many radiotherapy units were overstretched, causing long delays for patients waiting for treatment.

The UK was said to be in a worse position even than some much poorer countries.

Consultants Adrian Crellin and David Dodwell said that the delays could lead to a much higher chance of cancer recurring.

For example, patients who had undergone surgery for head and neck cancers and who had to wait more than six weeks for post-operative radiotherapy to begin were three times more likely to see their cancer return.

For breast cancer patients, a wait of more than eight weeks meant a 60% increased chance of recurrence.

The consultants called for a consistent national policy to be developed to ensure there was enough investment to allow hospitals to bring their capacity in line with demand.

Dr Dewar said that Ninewells had also been affected by the national shortage of therapy radiographers. Last year six out of 18 posts had been unfilled. However, the hospital had been successful in recruiting five new members of staff, leaving only one position open.

The job of therapy radiographers is to use special equipment called linear accelerators to shine X-rays into the part of a patient’s body affected by cancer.

Dr Dewar said the service had been hit by a double whammy—not enough staff and a rising demand of about 3% to 4% per year, largely because of the ageing population.

However, efforts by the NHS and the Scottish Executive to cope with these pressures were now showing signs of success.

A joint procurement programme had allowed economies of scale to be achieved in purchasing equipment. Linear accelerators needed to be replaced about every 10 years—one machine at Ninewells had been in operation for 14 years and had become unreliable.

There had also been a recognition that more staff were needed and a fast-track training programme for graduates had been put in place, leading to a substantial increase in the number of radiographers.

Dr Dewar said it had been difficult to provide training for students at a time when there were staffing problems. Ninewells had been forced to bring in locums and had faced an “unstable situation” where waiting lists would have shot up if even one person had left or gone off sick.

“Now we are nearly fully staffed we are a bit more comfortable. We are slightly behind our targets at the moment, but that is more to do with the Christmas holidays,” he said.

For radical radiotherapy—where a cure may be possible—the target is to start within four weeks. Currently the waiting period for the average patient is five weeks.

In the case of palliative radiotherapy, which helps ease the symptoms of people whose cancer is incurable, the target is two weeks. At present people are being seen within two to three weeks.

Dr Dewar said he had heard of far worse cases in England, with waits of as much as 15 to 20 weeks. He said, “That is extremely distressing for the patients and for the staff.”

He described the current Ninewells situation as “stable” and said that plans were being made to add a third linear accelerator and fund more staff to cope with future rises in demand.