Our view

We issued a press release responding to the data release in August 2024. The data covering all sectors shows the sheer scale of the demand challenge from more people seeking care for both physical and mental health.

NHS activity in the community and in mental health services has reached new highs. Community providers recorded the highest number of care contacts on record in May 2024: 8.99 million. As this data return stabilises, we'll continue to get a fuller understanding of the sector. 1.94 million people were in contact with mental health services in June, the highest number recorded. Mental health trusts are delivering care to far more people than pre-pandemic – with 40% more people in contact with these services.

Data from July shows it's likely to be the busiest summer ever across urgent and emergency care services. More people attended A&E in July and category 1 calls increased again. Marginal improvements in A&E four-hour performance and ambulance response times demonstrates the continued hard work of frontline staff in responding to urgent care requirements. System and trust leaders are acutely aware of the demand challenge and recovery targets in place across the pathway. System partners are working together to understand the root causes and to implement system-wide approaches to improve patient flow.

In June, activity levels for diagnostic, elective and cancer care fell after May saw higher numbers of tests, operations and treatments. Trusts were faced with another round of junior doctor industrial action during this period, resulting in thousands of cancelled appointments. The elective care waiting list also increased slightly, showing once again that demand outstrips elective activity, with sustained levels of demand for planned treatments.

University Hospital Southampton (UHS) NHS Foundation Trust rolls out state-of-the-art technology to treat cancer patients

 

Rachel Barlow, deputy head of radiotherapy physics at University Hospital Southampton (UHS) NHS Foundation Trust, shares how the unit has implemented new technology to improve the safety and efficiency of delivering radiotherapy to patients.

The radiotherapy treatment centre at UHS is one of the largest in the south of England, seeing patients from across Hampshire, Dorset, Berkshire, Wiltshire, the Isle of Wight, West Sussex and the Channel Islands and treats around 4,000 patients every year.

The new technology, known as Surface Guided Radiotherapy (SGRT), uses high-definition cameras combined with software to constantly monitor the 3D surface of the patient while their radiotherapy is delivered.

The system also provides a 3D image of the patient's surface in real-time which can be matched automatically to the outline from the CT scan used for planning their treatment. This enables therapeutic radiographers to quickly place the patient in the correct position for treatment with minimal manual handling.

Prior to this technology being commissioned, patients were set up by aligning permanent tattoos on the patient's skin to room lasers, which involved significant manual handling and was more time-consuming.

Radiographers would monitor the patient for movement during treatment using CCTV cameras and if any gross movements were seen, would manually interrupt the radiation beam. SGRT eliminates this task: it can detect patient movement with sub-millimetre accuracy, interrupting the radiation beam automatically if the patient moves more than a pre-defined tolerance, within less than 200ms.

The unit is in the rare position of having this technology across all its seven Linear Accelerators (Linacs) located at the main radiotherapy department at UHS and at its satellite centre in Basingstoke. This includes four AlignRT systems made by VisionRT and three ExacTrac Dynamic (ETD) systems made by Brain Lab.

The ETD systems combine X-ray imaging to precisely position the patient using internal anatomy with surface tracking to confirm this precision is maintained during treatment delivery.

In addition to monitoring the patient for unwanted movement during treatment, the technology can also be used to 'gate' the radiation beam for patients that are treated in 'breath hold'.

This removes the need to use manual and time-consuming techniques to monitor the breath-hold position and confirms the patient has reached and maintained the correct breath-hold throughout the radiation delivery.

The key objective for purchasing and commissioning this new technology was to enable safer and more efficient treatments for patients.

Ms Barlow said: "The aspiration was that by using the technology for all our cancer patients that required radiotherapy, we would make significant time-savings, resulting in an increase in capacity to treat more patients per day.

"After implementing this new technology, we reduced the appointment times for our breast and prostate patients by 17%, which allowed us to deliver an additional 2,190 treatment appointments in a year.

"An additional, significant benefit from implementing SGRT is that there is no longer the need for patients to have permanent tattoos, which act as a constant reminder of their cancer treatment."

She added: "The clinical scientists in the physics team worked hard to commission this new technology across all treatment machines in the department and the radiographers were quick to adopt the new workflows into their clinical practice.

"It's been really satisfying to see the benefits and we're delighted to offer this new technology to all our radiotherapy patients."

Read our press statement in response to the latest data from NHS England.