The changing radiation oncology landscape in New Zealand

Introduction This paper outlines the New Zealand (NZ) responses to the biennial facilities surveys of the Royal Australian and New Zealand College of Radiation Oncologists (RANZCR), Faculty of Radiation Oncology (FRO) from 2011 to 2019. Methods The facilities survey is conducted by the FRO Economics and Workforce Committee (FROEWC) and focuses on equipment, treatment activities and staffing. Results The number of facilities increased by two to 10, both in the private sector. The total number of linear accelerators (linacs) increased by four; one in public and three in private. The majority of linacs were over 8 years old (62.5%). Treatment courses have increased by 19% and fraction numbers by 13.7%. Courses per linac have remained relatively constant. There was growth in IMRT, orthovoltage, high dose rate brachytherapy and paediatric treatments. There was a slow increase in number of radiation oncologists and trainees. The number of radiation therapists was unchanged with a 20% increase in treatment courses per radiation therapist. Physicist numbers have increased but 61.4% of physicists are overseas-trained and vacancies persist. Conclusion The survey results indicate a rapidly changing radiation oncology landscape in NZ between 2011 and 2019. The challenges of increases in cancer numbers, treatment courses and complexity of treatments and a need to focus on quality standards against a set of minimal increase in machine numbers, ageing machines, static or slowly increasing staffing numbers and heavy reliance on overseas staffing require a national review of radiation oncology services to ensure a sustainable future.