Preliminary Policy Proposal (PPP) takes next step towards improving access to SIRT
The SIRT Preliminary Policy Proposal (PPP) takes an important next step toward improving access to Selective Internal Radiation Therapy (SIRT) for patients with neuroendocrine cancer liver metastases, a critical area of treatment where equitable access is currently limited.
A Preliminary Policy Proposal (PPP) is a submission to the NHS to request the development of new or revised commissioning policy: often for a specialised service / treatment that may not be available or has not gained fully funded approval. It can be used to provide further evidence of clinical effectiveness, cost benefit and highlight where a clinical need is not being met, for example equitable access to SIRT for those with neuroendocrine cancer liver metastases.
Developed through a collaborative effort between patients, clinicians, researchers, and key organisations such as UKINETs, the MRT Consortium, and Neuroendocrine Cancer UK, the proposal aims to secure more consistent and fair access to SIRT across the NHS.
SIRT is a highly specialised radiotherapy treatment for primary and secondary liver cancers, which can be especially beneficial for patients with neuroendocrine cancer metastases that cannot be removed surgically. The treatment has not only the potential to slow cancer growth but also to alleviate hormone-related symptoms, like those seen in Carcinoid Syndrome. However, as SIRT is classified under the interventional procedures category by NICE, the funding for its widespread use is not automatically guaranteed, creating potential inequalities depending on local NHS decisions.
NICE’s interventional procedure guidance from May 2024 recommended SIRT for treating liver metastases in neuroendocrine cancer patients as best practice.
However, NICE’s clinical guidelines and interventional procedures work programmes are not subject to a mandatory requirement regarding funding, unlike medicines and treatments recommended by NICE through its technology appraisals work programme.
The significance of this PPP lies in the hope that it will lead to a more consistent funding framework for SIRT across NHS regions, reducing geographical disparities.
The proposal is now moving through the next stage of review, and the collaborative efforts involved are essential to creating a pathway toward better, fairer access for patients who may benefit from this treatment. It is hoped that the ongoing advocacy and evidence provided by the working group behind this proposal, will lead to a positive outcome.
Further information about SIRT can found in our Virtual Handbook and on our YouTube channel
NB SIRT does have NICE appraisal recommendation for those with primary liver cancer (hepatocellular carcinoma): Technology appraisal guidance Reference number: TA985 Published: July 2024.
NICE is due to review its 2020 IPG for SIRT use in colorectal liver metastases in 2026
More information on “Ways to access treatment” can be found at Cancer Research UK here