The impact of the introduction of a palliative Macmillan consultant radiographer at one UK cancer centre.

OBJECTIVE

The UK radiotherapy (RT) workforce needs novel strategies to manage increasing demand. The appointment of a palliative RT (PRT) consultant radiographer (CR) offers a potential solution to enhance patient pathways providing timely RT. This article examined the impact of one such appointment.

METHODS

Two prospective audits were completed 1 year apart. All patients receiving PRT for bone metastases between 01/01/2014-31/03/2014 (Audit 1) and 01/01/2015-31/01/2015 (Audit 2) were included. Data collected included demographics, treatment site, dose, fractionation, treatment indication and professionals who planned the PRT. The patient pathway from decision to treat (DTT) to commencement of PRT was scrutinized.

RESULTS

97 patients were identified for Audit 1 and 87 patients for Audit 2. Demographics were similar. Figures relate to Audit 1 and in brackets Audit 2. Indications for treatment: pain 55% (61%), metastatic spinal cord compression 41% (38%) and other neurological symptoms 4% (1%). The CR independently planned 13% (60%), being supervised for 36% (3%). Consultant clinical oncologists planned 43% (31%), with 7% (6%) planned by specialist registrars (SpRs). The pathway was enhanced in Audit 2, with 85% of patients treated within 14 days compared with 73% of patients treated in Audit 1.

CONCLUSION

A CR has the potential to impact on the patient pathway, enabling quicker times from DTT to treatment. Continued audit of the role is required to ensure that it complements SpR training.

ADVANCES IN KNOWLEDGE: Increasing longevity and improved systemic therapies have led to greater numbers of patients living longer with metastatic disease. The appointment of a CR offers a potential solution to the capacity difficulties faced by UK RT services.