The Department of Health and Social Care has paid for new linear accelerator (Linac) machines at 28 hospitals in England, funded by a £70m investment, claiming the cutting-edge machines, which deliver doses of high-energy radiation, can reduce the rounds of radiotherapy patients need and reach cancers in harder-to-treat areas like the abdomen.
But radiographers warned the new machines alone will not be enough to free up appointments as the NHS is facing a shortage of the skilled medics to operate them.
The shortfall has been put down to a combination of factors, including fewer students choosing to study therapeutic radiography, fewer available academic training programmes and wider challenges related to recruitment and retention of NHS staff.
At the same time, the NHS faces rising demand for therapeutic radiographers due to a growing cancer patient population: an estimated 3.5 million people will live with cancer in 2025, a rise from 3 million in 2020, according to official figures.
Cancer could add £14.4bn to the UK’s health spending every year until 2050, according to modelling by the Organisation for Economic Cooperation and Development.
Only 71.4 per cent of people in England received their diagnosis and started their first treatment within two months (or 62 days) of an urgent referral in March 2025. The target is 85 per cent and has not been met since December 2015.
A further 91.4 per cent of people started treatment within 31 days of doctors deciding a treatment plan in March 2025 – the target is 96 per cent. Up to 4,730 people were waiting longer than 31 days for treatment to start from the date of doctors deciding a treatment plan.
‘Only part of the solution’
Angela Baker, of the Society of Radiographers, said the investment in radiotherapy equipment “is both welcome and urgently needed” but said the machines “are only part of the solution”.
Dr Tom Roques, vice-president for clinical oncology at the Royal College of Radiologists, said new machines are “of no use unless you’ve got the staff to operate” them.
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It estimated around 64 machines to be out of date as of October 2024. “Year-on-year, around 20 machines will go past their recommended life span so this investment is welcome but not enough,” a spokesperson for the charity said.
A 2024 Radiotherapy UK report said replacing replacing radiotherapy machines that have exceeded their recommended lifespan could free an additional 87,500 appointments a year.
New Linacs can deliver modern techniques such as Stereotactic Ablative Radiotherapy (Sabr), which can target tumours more precisely, causing less damage to surrounding healthy tissue. This can mean fewer side-effects and a better experience for patients.
‘Staff shortfall compromises patient care’
Spencer Goodman, professional officer for radiotherapy at the SoR, said the machines alone “will not resolve the mounting challenges facing radiotherapy services”.
Even though the new machines can reduce the number of treatment sessions, the demand for staff remains as the complexity of delivering such care can increase, he said. “Combined with the overall rise in demand for radiotherapy, this means we still need more staff to ensure safe, high-quality care.”
They said it was “a stark failure against the NHS target of zero scans results taking longer than a month”.
Without enough radiologists, some patients’ cancer may progress to the state where radiotherapy is no longer useful (Photo: Rui Vieira/PA)Dr Roques, a clinical oncologist, said: “If you’re taking so long to diagnose somebody because you haven’t got the right doctors and nurses to make those diagnoses or report those scans, then some patients’ cancers would have progressed to the point where radiotherapy is no longer a useful treatment.
In 2022, MPs on the APPG for radiotherapy said £230m needs to be invested by the Government in replacing Linac machines that are in use beyond the 10-year-old recommended lifespan.
Farron called on the Government to use the upcoming Spending Review to “invest in a comprehensive strategy for radiotherapy”.
“We have just awarded NHS staff an above inflation pay rise for the second year in a row, to help keep more doctors in the health service and solve the retention problem.”
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