51 Does it matter where you are treated? Insights from a national review of NHS brain tumour services (2020-2026)

Abstract Introduction Despite advances in brain tumour care, evidence suggests that patients face variations in treatment, care and research opportunities. To further explore equity of care in the context of the United Kingdom (UK) and identify key challenges, we reviewed NHS brain tumour services. Method We collected data from 25 neuro-oncology centres (covering 90% of the UK population) in 2020–2022 and again in 2024–2026 through the Tessa Jowell Centre of Excellence, a UK-wide benchmarking and service improvement programme. Analyses drew on 168 data points spanning the entire patient pathway, based on detailed application forms and feedback from 3,000+ patients. Results Between 2020-2022 and 2024-2026, centres reported major improvements including new precision medicine trials, expanded molecular testing (with centres submitting samples for whole genome sequencing rising from 25% to 90%), and introduction of specialist rehabilitation services. Persistent and emerging challenges fell into three themes: (1) NHS-wide barriers delaying diagnosis/treatment: Turnaround times for urgent scans increased 28%, while centres with at least one patient waiting >42 days to begin radiotherapy increased from 32% in 2020–2022 to 80% in 2024–2026. (2) Barriers to innovation: centres varied in access to tissue freezing, genomic testing and research opportunities; 96% of centres reported challenges in opening clinical trials, limiting patient access to new treatments. (3) Geographical inequity in wrap-around care: centres reported marked variation in access to rehabilitation, psychological, and palliative care; 40% centres lacked dedicated neuropsychology support and over 50% reported rehabilitation staffing gaps. Patient feedback highlighted inequities in nursing support. Conclusions Benchmarking data show progress but persistent inequities in UK brain tumour services. Findings will support best practice sharing and targeted national efforts to improve equitable access to care.