Radiotherapy Option Appraisal

The Minister for Health of the Government of Jersey appointed In-Form Solutions to undertake an option appraisal for providing radiotherapy services on the island of Jersey. This service is currently provided by specialist NHS providers in England which involves patients transporting by air and staying away from home for often long periods of time. This creates anxieties and inconvenience to patients and their families, but it also raised a number of clinical concerns for island clinicians. This review considered and identified alternative options for the reprovision of Radiotherapy Services including an on-island provision.

Our team consisted of experienced project managers, cancer care commissioners, costing and finance specialists and analysts. A Project Group with service manager and clinical representation from Jersey was formulated and this group met weekly chaired by our Project Director. Our project plan was discussed and updated, containing a written progress report outlining our findings, risks, and progress. Each meeting was physically recorded and documented with key actions.

We undertook a series structured meetings with clinicians, patient representatives, charities, and service managers within Jersey, all being recorded for transparency as well as specialist providers in the UK and overseas such as other island jurisdictions. We predicted and modelled demand for Radiotherapy within the next 20 years and we were able to quantify capital and revenue costs for the current service, acknowledging the effects of the pandemic. We undertook a series of workshops with service clinicians and mangers and each shortlisted option was further assessed, costed, and modelled against likely demand and presented to the Steering Group. These were discussed and considered to ensure these options were accurate and realistic.

The team then presented a draft written report of our findings and costed options which were again discussed and accepted by the Steering Group prior to release to the Minister. This was then personally presented to the Minister, service managers and political representatives including the leader of the opposition. Upon public release, we then presented the report to the island’s media in Jersey through a press conference which attracted significant media coverage. The report was positively received, delivered on time, and was reported as a “well balanced review” under considerable public scrutiny, sensitivity, within tight time constraints. The key activities and deliverables included:

• A market assessment and analysis of Radiotherapy Services for now and in the future.
• A development of a set of defined options and process of shortlisting.
• A final written option appraisal which was publicly distributed.
• Presenting our findings and taking questions from the Minister, the opposition, senior ministers and the media.