Recommendations

Cancer incidence is the basis for planning

26. The nationally coordinated radiation oncology planning must consider:
    1. Projected cancer incidence;
    2. Target optimal utilisation rate;
    3. Regional and rural service access;
    4. Projected changes in demographics.

Workforce and infrastructure are planned together in a coordinated way

27. Establish a system for facilities to regularly report on their activities to inform coordinated planning.
28. Implementation of new technology must consider workforce implications.
29. Overcapitalized radiotherapy services, such as brachytherapy and radiosurgery, should be rationalised.
30. New facilities should be planned with the capacity to allow expansion and service continuity.
31. All facilities must have adequate information and communication technology infrastructure and expertise.
32. Workforce planning should consider the need for multidisciplinary care and adequate supply of allied health and support services.
33. Australia needs 267 linacs by 2022 to achieve the optimal utilisation rate of 52.3% (approximately an extra 100, in addition to the replacement of current fleet).
34. Governments must have a plan for the number of new linacs that will come into use over the next ten years.
    1. Coordinated across the public and private sectors;
    2. Aligned with workforce training and development;
    3. Developed in close consultation with the professions and consumers;
    4. Taking into account the lead time of 2-5 years for starting an operational service.
35. Services should be planned to operate with 10% additional capacity such that surges in demand can be met without increasing the waiting times for treatment.
36. Development of sustainable fellowship programs for Radiation Oncologists must be a key priority to ensure the development of important clinical and research skills.
37. Develop workforce strategies offering enhanced career pathways for Radiation Therapists (RT):
    1. Support advanced practice and role evolution for RTs;
    2. Explore assistant roles in radiotherapy.
38. The Radiation Oncology Medical Physicists (ROMP) workforce crisis requires an urgent and multi-faceted response:
    1. Australia must have a nationally self-sufficient ROMP workforce by 2022;
    2. Support promotion of a physics career to school students and undergraduates;
    3. Increase and streamline funding for TEAP positions, and embed into the radiation oncology workforce profile;
    4. Strengthen recruitment strategies to attract and retain the ROMP workforce;
    5. Urgently develop innovative models of service provision that do not compromise quality;
    6. A national workforce summit must be held by June 2013 to get consensus on the implementation of workforce solutions.
39. Develop plans to support professionals returning to full-time and part-time work.

Workforce training is aligned with service demand projections and supported appropriately

40. Governments to match the funding contracts for training positions in both public and private accredited facilities to the length of the training programs.
41. Accreditation and training processes that allow for:
    1. Increased trainee numbers in the three key professional areas i.e. Radiation Oncology, Radiation Therapy and Radiation Oncology Medical Physicists;
    2. Embedded funding for clinical supervisors, preceptors and training network coordinators to adequately support the training programs; and
    3. Continued professional education and development for those in the workforce;
    4. Support of training in rural and regional areas.
42. To establish innovative models of training such as:
    1. Virtual and simulated learning programs;
    2. Nationally coordinated training networks to enable optimal utilisation of resources.

A National Cancer Action Plan which includes radiation oncology is adopted:

43. There needs to be a National Cancer Action Plan developed, implemented and maintained for Australia:
    1. In consultation with the professions and consumers;
    2. Encompassing radiation oncology as a core element of quality cancer care.

Jurisdictional radiation oncology action plans are developed, maintained and integrated with the National Cancer Action Plan

44. Jurisdictions must develop, regularly review, evaluate and update 5-year action plans for radiation oncology and these must be coordinated nationally.
45. Financing options for establishing and resourcing services should be explored and must ensure access to radiation oncology services is safeguarded;
46. To ensure that infrastructure is used efficiently:
    1. Business process review must be undertaken regularly;
    2. Business process improvement must be part of standard practice;

Closer consultative collaboration between governments, policy-makers, service providers, patients and the professions to ensure most effective use of resources

47. Establish and strengthen radiation oncology networks where smaller centres are linked to major centres.
48. The existing national ROHPG capital replacement program must be maintained and regularly updated to reflect changes in radiation oncology practice.

Innovative models of quality service provision are developed to improve efficiencies

49. There should be ongoing horizon scanning for new radiotherapy techniques and technologies, to inform facilities planning;
50. Essential role of imaging in radiation oncology must be acknowledged:
    1. Regulatory constraints such as licensing must be remedied;
    2. Training and expertise of professionals must be enhanced;
    3. Funding for planning and treatment of patients must support evidence-based practice;
    4. The role of the Diagnostic Imaging Medical Physicists needs to be recognised and supported.
51. The use of essential radiotherapy techniques must align with best practice:
    1. At least 30% of radiotherapy patients should receive IMRT treatments;
    2. Benchmarks for other essential radiotherapy techniques should be developed and services should publicly report against these.