Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, for what reasons NHS England is proposing to have only two cancer centres using stereotactic radiosurgery to treat the most complex brain tumours.

NHS England has recently completed a public consultation on a revised service specification for stereotactic radiosurgery/stereotactic radiotherapy for intracranial conditions. This can be accessed at:

https://www.engage.england.nhs.uk/survey/srs-srt_service_revision/consult_view

The consultation contained reference to the 4 Tier clinical model and proposed a service model as follows:

- 17 services delivering both Tier 1 and 2 activity;

- 2 services delivering both Tier 3 and 4 activity; and

- 2 services delivering paediatric oncology activity.

Tier 1 and Tier 2 activity predominantly includes oncology indications, whilst Tier 3 and Tier 4 activity contains benign indications. Therefore, NHS England has not proposed to commission only two services to deliver complex brain tumour treatments.

Tiers 3 and 4 are focused on patients with benign non-cancer lesions that are extremely small in number per year, not life threatening, and will generally be treated at a single visit. These patients are not managed as part of a “cancer centre” but, following consultation, the consensus was to concentrate these patients into a small number of very experienced centres.