A164: The impact of the introduction of a Palliative Macmillan Radiographer at one U.K. cancer centre
1Deanesly Centre, New Cross Hospital, Wolverhampton, UK,2Lingen Davis Cancer Centre, Royal Shrewsbury Hospital, Shrewsbury, UK
Increased cancer patient survival, mainly attributed to improved systemic therapies, has led to greater numbers living with metastatic disease. Many patients require palliative radiotherapy (PRT) for symptom relief. There has not been a significant increase in consultant workforce to cope with these demands. To help manage the increased requirements for PRT, a Macmillan Consultant Radiographer was appointed. The impact of the appointment was reviewed by auditing time periods early on the radiographer's training and when fully competent.
Patients requiring PRT to bone between 1/1/15 - 31/3/15 were reviewed and compared to the audit from the equivalent period in 2014. Data collected included: treatment site and dose, treatment indication, timescale of the patient pathway and which healthcare professional planned their radiotherapy treatment.
The population and demographic data in each audit were comparable. Figures in brackets show the 2014 data for direct comparison with 2015. 87 patients were identified in 2015 (97). Indications for treatment were: pain 62% (55%), metastatic spinal cord compression (MSCC) 35% (41%), other neurological symptoms 1% (4%). All plans complied with the PRT prescription protocol. Sites included: spine 77% (61%), pelvis 7% (20%), hip 4% (5%), and other sites 8% (14%). The Consultant Radiographer independently planned 60% (16%) and was supervised for a further 3% (31%). Consultant Clinical Oncologists planned 31% (45%), with 6% (8%) planned by Specialist Registrars (SpR's). 94% (91%) of MSCC patients were treated within 2 days, 77% (57%) of other patients within 2 weeks.
There has been significant increase in independent planning by the Macmillan Consultant Radiographer, which proportionally reduced the Consultant Oncologists' involvement. SpR involvement had not increased despite actions being introduced such as PRT planning meetings to improve this. Further consideration must be given to this matter to ensure SpR training and education is complemented by the involvement of a palliative radiographer.