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Radiotherapy populations for England, Wales and the UK

Radiotherapy activity: 01 April 2023 - 31 March 2024

MSOA boundary census year: 2021

ONS England and Wales population estimate year: 2022

Publication date: 04 September 2025

Author: NDRS Analysis Treatments Functional Team

Version history:

  • v1 published 04 September 2025, CAS snapshot 2508

Previous publications: https://digital.nhs.uk/ndrs/data/data-outputs/cancer-data-hub?area=historic-projects

Introduction

Radiotherapy is a major treatment modality in the care of patients diagnosed with cancer. Treatment can be delivered with curative intent or with a view to disease control or palliation of symptoms associated with advanced disease.

The national radiotherapy dataset (RTDS) is collected from radiotherapy providers in England and includes information about treatment delivery for all patients treated within the NHS. Radiotherapy is delivered by 48 NHS providers across England and 3 across Wales, each receiving referrals from surrounding primary, secondary and third sector care providers. Planning of radiotherapy services relies upon an understanding of the expected number of patients requiring treatment in a provider’s catchment area. As such, defining the number of people within these catchment areas and their geographical location is crucial to inform service planning. Here we aim to provide this information, based upon existing data captured by the National Disease Registration Service in combination with geographical population data provided by the Office for National Statistics (ONS).

Methods

To derive England and Wales radiotherapy centre populations, all radiotherapy episodes (excluding Proton Beam Therapy) were linked to a patient’s postcode. Each radiotherapy episode captures the radiotherapy centre it was delivered at. Using the national postcode directory (ONS) file, these postcodes were then linked to identify the Middle Super Output Area (MSOA, a geographical region including 5,000-15,000 people) in which each patient resides. As all radiotherapy episodes in each MSOA have their delivery NHS radiotherapy provider captured, the percentage of radiotherapy activity in each MSOA delivered by each NHS Trust was calculated. Using the 2022 MSOA mid-year populations we then assigned the appropriate proportion of each MSOA population to each provider organisation.

Example: 35% of radiotherapy activity for patients living in E1234500 was delivered at Trust A, therefore 35% of the population for E1234500 will be assigned to Trust A.

MSOA population figures are not available for the Channel Islands, Isle of Man, Northern Ireland and Scotland. To account for radiotherapy activity delivered in English and Welsh radiotherapy centres to non-England and Wales patients a formula was created that divided the total 2022 population for England and Wales by the total number of radiotherapy episodes delivered to residents of England and Wales in Apr2023-Mar2024.

Example: 60,238,038 England and Wales residents / 153,078 episodes = 393 people per episode.

For each episode delivered to a patient from the Channel Islands, Isle of Man, Northern Ireland and Scotland, the number of episodes delivered to these individuals was multiplied by the above adjustment figure.

Example: 23 episodes are received by Scottish residents in Trust A in England = 23 episodes * 393 = 9,039 additional people added to Trust A. This approach assumes the treatment rate in Scotland is the same as that seen in England and Wales - see Appendix.

During this exercise a number of patient postcodes did not map to the postcode directory, at closer inspection these were identified as the following:

  • No fixed abode, invalid, not known, null (N=2 / 0.001%)
  • Overseas patients (N=284 / 0.196%)

No adjustment to the population size was possible for these cases and as such they were excluded from the radiotherapy episode activity and population calculation.

For any MSOA that had no radiotherapy activity assigned i.e. no patients known to reside in that MSOA were treated with radiotherapy during the time period of interest, that MSOA population was not accounted for in the calculation of the radiotherapy catchment populations. In Apr2023-Mar2024 1 MSOA(s) was/were not accounted for - see Appendix.

The total catchment populations are reported in three ways:

  • England catchment populations – for providers located in England, includes the allocation of both English and Welsh MSOA populations based on the percentage of radiotherapy activity delivered by each provider, it is a subset of the UK population.
  • Wales catchment populations – for providers located in Wales, includes the allocation of both English and Welsh MSOA populations based on the percentage of radiotherapy activity delivered by each provider, it is a subset of the UK population.
  • UK catchment populations – for providers located in England and Wales, includes the allocation of both English and Welsh MSOA populations based on the percentage of radiotherapy activity delivered by each provider as well as an adjusted population to account for radiotherapy activity delivered to patients who live in Scotland, Northern Ireland, Isle of Man and the Channel Islands.
    • The UK population estimates are the total of the Welsh or English estimates and the adjustment. As an example, the population for Barts Health NHS Trust is 1,476,473 in the England population table and 1,478,438 in the UK population table. This is because the UK estimate includes the adjustment of 1,965 people, as reported in Appendix 1.
    • The overall UK radiotherapy catchment population is estimated to be 60,490,676 people. This is derived from an estimated radiotherapy catchment population in England of 57,306,138, Wales of 2,925,158 and adjustment of 259,380 for the other countries.

Derived radiotherapy centre populations

England catchment populations

Table 1: Populations derived for radiotherapy centres in England where the patient resides in England or Wales

Wales catchment populations

Table 2: Populations derived for radiotherapy centres in Wales where the patient resides in Wales or England

UK catchment populations

Table 3: Populations derived for the UK

England & Wales provider catchment areas

The below map displays radiotherapy provider catchment areas grouped by radiotherapy network. This information is designed to provide a visual representation of radiotherapy populations and does not contain the level of accuracy possible with the above tabular data for the following reasons:

  • For MSOAs where radiotherapy activity was delivered by multiple NHS Trusts, the MSOA is allocated to the NHS Trust which delivered the highest percentage of activity.
  • In cases where the highest radiotherapy activity for an MSOA is delivered equally by more than one NHS Trust, for example radiotherapy activity for MSOA E02004540 is split 33% each between Barts, Middlesex and Barking, so a single Trust is arbitrarily selected.

Areas which are shaded darker are where 75% or more of radiotherapy activity for that population is delivered by the indicated provider.

Use the list in the bottom left to filter which networks are shown on the map and to hide/show ICS boundaries. Click the circle markers which represent radiotherapy providers to see their names.

Map 1: Provider catchment areas for England and Wales

Table 4: Provider overlapping catchment areas

This table includes a count of the MSOAs which pairs of providers have in common in terms of radiotherapy delivery. The purpose of this table is to provide an idea of which providers have overlapping catchment areas. Where the same provider is listed as both Provider 1 and Provider 2, the count is of the total number of MSOAs with some of their population having radiotherapy treatment at that provider.

In total there are 7,264 MSOAs in England and Wales, 6,856 in England and 408 in Wales.

Data quality and caveats

The Royal Marsden NHS Foundation Trust (RPY) have approximately 10% of their RTDS data missing between April 2023 and December 2023. The Royal Marsden typically account for 3-4% of all radiotherapy episodes in England and they are committing to resolving this issue and submitting the missing data.

For radiotherapy providers with catchment population areas that overlap to a large extent with other providers, there is potential for higher variability in their overall catchment population from year to year.

Since the last radiotherapy populations publication there have been the following NHS organisational changes or changes to the way we report.

  • North Cumbria Integrated Care NHS Foundation Trust (RNN) has merged into (The Newcastle Upon Tyne Hospitals NHS Foundation Trust (RTD)

  • North Middlesex University Hospital NHS Trust (RAP) has merged into Royal Free London NHS Foundation Trust (RAL)

  • Salford Royal NHS Foundation Trust (RM3) is now grouped with The Christie NHS Foundation Trust (RBV)

  • Proton Beam Therapy has been excluded

Appendix

Population adjustment

This section provides information on the population adjustments for Scotland, Northern Ireland, Isle of Man and the Channel Islands for each NHS radiotherapy provider in England and Wales.

Table 5: Derivation of adjusted populations for Scotland, Northern Ireland, Isle of Man and the Channel Islands

Unallocated MSOA populations

Table 6: MSOAs that were not allocated

This section provides a list of MSOA(s) which have not been allocated to radiotherapy providers. This is because no patients resident in the MSOA received radiotherapy treatment during Apr2023-Mar2024.

About the NDRS

The National Disease Registration Service (NDRS) is part of NHS England (NHSE). Its purpose is to collect, curate, quality-assure and analyse on patients with cancer, congenital anomalies, and rare diseases. It provides robust surveillance to monitor and detect changes in health and disease in the population. NDRS is a vital resource that helps researchers, healthcare professionals and policy makers make decisions about NHS services and the treatments people receive.

The NDRS includes:

  • the National Cancer Registration and Analysis Service (NCRAS) and
  • the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS)

Healthcare professionals, researchers and policy makers use data to better understand population health and disease. The data is provided by patients and collected by the NHS as part of their care and support. The NDRS uses the data to help:

  • understand cancer, rare diseases, and congenital anomalies
  • improve diagnosis
  • plan NHS services
  • improve treatment
  • evaluate policy
  • improve genetic counselling

For queries relating to this document, please contact

Patient acknowledgement

This work uses data that has been provided by patients and collected by the NHS as part of their care and support. The data is collated, maintained and quality assured by the National Cancer Registration and Analysis Service, which is part of NHS England.