Cancer services warning

Chemotherapy is one of the key cancer treatments

Patients may be missing out on cancer treatments because their area has the wrong kind of unit, cancer experts have warned.

The Royal College of Physicians and the Royal College of Radiographers have, for the first time, drawn up guidelines based on population and geography for what type of unit a district general hospital should have.

The report, published on Monday, outlines three types, ranging from specialist centres with large teams to smaller hospitals which should offer a basic level of cancer care.

Professor Malcolm McIllmurray, who headed the joint working party which compiled the report, told BBC News Online cancer services had developed in a "haphazard" way.

He said: "I suspect there are services that are developed that are not developed in a way that will ultimately be satisfactory.

Type 1

Care for 'common cancers' - breast, lung, colorectal

Chemotherapy nurses

Designated chemotherapy ward with 24-hour oncology cover

Large catchment area, patients with long travel times

"I suspect there are a lot of places where things aren't happening at all where they should be happening."

He said there could be patients who were unable to access the services they needed because they were so far away from the hospital which provided it."

He added:" This is the first time anyone's tried to set down what you might describe as a minimum standard for delivering services."

Type 2

As type 1, but no chemotherapy ward or 24-hour cover

Large catchment area, short travelling times

The report, 'Cancer Units: The provision of non-surgical specialist cancer services in district general hospitals', is being sent to NHS regional cancer co-ordinators, hospital chief executives and the Department of Health.

The cancer co-ordinators will have to examine their region and try to redefine the way the service is organised.

Unit types outlined

Professor McIllmurray said cancer units must conform to one of the three types outlined in the report, which he said could become part of the accreditation process units must go through.

Units need accreditation to continue to operate.

Type 3

Specific and general oncology clinics

Multidisciplinary teams

Palliative care

Small catchment area with short travel times

"There probably are patients who are not getting the treatment they really require."

The medical colleges' report links into the government's plan for cancer networks where all units providing cancer care, at whatever level, can link together.

Its recommendations could mean additional cancer doctors and nurses, said Professor McIllmurray, particularly in the specialist centres.

The type of staffing and treatments each type of unit should provide is spelt out in the report.