Radiotherapy waiting times

A waiting time was calculated for every record with a valid ready-for-care date and radiotherapy course start date (99.6% of all courses of radiotherapy that began in Australia in 2016–17; almost 63,300 records. See Technical notes for details of data exclusions for waiting times calculations).

Waiting times are presented by state and territory for public providers, nationally for private providers, and in total. While the data are presented separately for public and private providers in this report, comparisons should be made with caution because some data recording practices may differ across individual sites, states and territories, and sectors, particularly in the way ready-for-care dates are set, which affects the calculation of waiting times. These differences may also reflect varying service provision arrangements between the public and private sectors (and in both sectors across jurisdictions).

Comparison of waiting times between 2013–14, 2014–15, 2015–16 and 2016–17 should be treated with caution due to differences in participation rates by private radiotherapy providers which generally report shorter waiting times. Submission of data on radiotherapy courses with valid waiting times by private providers in 2015–16 and 2016–17 collections was greater than in previous years.

Waiting times for all patients are presented as the number of days a patient waited at the 50th and 90th percentiles (rounded to the nearest number of whole days). The 50th percentile (the median waiting time, or the middle value in a group of data arranged from lowest to highest for the number of days waited) represents the number of days within which 50% of patients began radiotherapy treatment. The 90th percentile data represent the number of days within which 90% of patients began treatment.

50% of patients received treatment within 9 days of being assessed as ready for care. 

90% of patients received treatment within 26 days of being assessed ready for care.

Emergency radiotherapy

An emergency course is defined as treatment required within 24 hours of the patient being determined to be ready for care, in the opinion of the treating clinician. However, as only the date the patient was ready for care and the date they started the course of radiotherapy are collected (and information about the time of day is not available), this indicator is reported as the proportion of patients who were treated either on the same day or the day after they were ready for care.

There were 920 emergency courses in 2016–17 (1.5% of courses).

For the reporting of waiting times for emergency courses against the emergency timeframe, data are presented as the proportion of courses where treatment began either on the same day or the day after the patient was ready for care.

Almost 95% of emergency treatment began on the same day or the next day.

Calculation of waiting time from ready-for-care date

The waiting time is the number of days from when the patient is ready to be treated with radiotherapy in the opinion of the treating clinician (‘ready for care’) until the day the patient first receives radiotherapy treatment—that is, the number of days between the Ready-for-care date and the Radiotherapy start date. Reported waiting times include non-working days (such as weekends or public holidays) and other days on which a service was not able to provide services (such as when key staff are unavailable or where there has been equipment failure).

Other waiting periods—such as the time between when a person contacts their general practitioner and their first appointment with a medical oncologist, and the time between receipt of the patient’s first referral to a radiation oncologist to the date of that patient’s first consultation with a radiation oncologist—are not collected in this data set.

The ready-for-care date is set by the treating clinician and takes into account things such as the need for prior treatment or post-operative healing. If the patient is not ready for care on this date for personal reasons, the ready-for-care date will be set at a later time, when the patient states they are ready.

Service bottlenecks or peak periods of demand that may affect ease of access to radiotherapy services should not influence clinical decisions around the setting of ready-for-care dates. Treatment may be delayed due to waiting times in pre-treatment imaging or testing, treatment service availability, staff shortages, equipment breakdown, or even a lack of available accommodation for a patient travelling for treatment. Factors that are, and are not, expected to influence the ready-for-care date are described in the metadata for ‘Ready-for-care date’ available in METeOR (METeOR identifier: 448141).

Source: AIHW NRWTD 2016–17.

Notes:

In 2013–14 (see also [1]):

  1. Courses for Victoria and South Australia were under-counted—see [2].
  2. Waiting times at the 50th and 90th percentile for Australia included Western Australia and private sector providers, but not South Australia—see [1].
  3. Victoria did not report emergency status and the Northern Territory had no emergency cases.
  4. Emergency patient data for South Australian and Western Australian were not reported separately but were included in data for Australia—see [1].
  5. Emergency patient data for Australia includes Western Australia and private sector providers, but does not include South Australia or Victoria.

In 2014–15 (see also [2]):

  1. The drop in the number of courses in New South Wales between 2013–14 and 2014–15 reflects one service moving from the public to the private sector.
  2. In 2014–15 courses in South Australia were under-counted—see [2].
  3. Waiting times data for South Australia should be treated with caution due to concerns regarding the setting of ready-for-care dates—see [2].
  4. Waiting times at the 50th and 90th percentile for Western Australian are not reported separately, but are included in data for Australia.
  5. Emergency patient data for Western Australian and Northern Territory are not reported separately, but are included in data for Australia—see [2].

In 2015–16 (see also [3]):

  1. The increase in the number of courses in Western Australia reflects an increase in the number of services participating from one in 2013–14 to four in 2014–15 and 2015–16.

In 2016-17:

  1. Emergency patient data for the Northern Territory has been suppressed due to small numbers.

References

  1. AIHW 2015. Radiotherapy in Australia: report on a pilot data collection 2013–14. Cat. no. HSE 167. Canberra: AIHW.
  2. AIHW 2016. Radiotherapy in Australia: report on the second year of a pilot collection 2014–15. Cat. no. HSE 181. Canberra: AIHW.
  3. AIHW 2017. Radiotherapy in Australia 2015–16. Cat. no. HSE 191. Canberra: AIHW.