Clinical prioritisation for curative radiotherapy: a local waiting list initiative.

Abstract

Waiting time for radiotherapy is a major problem in radiation oncology practice. The aim of this paper is to present the experience of the Peter MacCallum Cancer Centre in trialling a number of strategies to reduce patient waiting times. All patients starting megavoltage radiotherapy with curative intent in three separate 1-week blocks had their waiting times recorded. The cohorts were each 8 weeks apart and were before (September), during (November) and after (January) the introduction of a priority points system. Median waiting time was 35 days in September, 42 days in November and 31 days in January. The number of extremely long waits (>90 days) decreased to 1 by January. Significantly more patients were pre-booked for treatment in January (27/51) compared with September (17/65; P = 0.003) and November (12/65; P < 0.001). Pre-booked patients had shorter waiting times compared with patients who was not pre-booked (P < 0.0001). Difficulties at one particular treating location contributed to the longer median waiting times in November. Although there had no significant difference in waiting time in non-breast unit patients between the three cohorts, there was a decrease in waiting times in breast unit patients, especially between November and January (P = 0.0008). There was no significant increase in delay to starting treatment in other treating units, resulting in more equitable access across all units. A combination of encouraging pre-booking and the introduction of a priority points system has led to a decrease in waiting times, especially among breast unit patients.