title: The impact of the introduction of a palliative Macmillan consultant radiographer at one UK cancer centre.
abstract: 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.
  
  
  CONCLUSIONS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Deanesly Centre, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Goldfinch
authors.affiliation: 1 Deanesly Centre, New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
authors.forename: Rozenn
authors.initials: R
authors.lastname: Allerton
authors.affiliation: 2 Lingen Davies Cancer Centre, Royal Shrewsbury Hospital, Shrewsbury, UK.
authors.forename: Sheena
authors.initials: S
authors.lastname: Khanduri
authors.affiliation: 2 Lingen Davies Cancer Centre, Royal Shrewsbury Hospital, Shrewsbury, UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Pettit
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D002173:Cancer Care Facilities / Q000458:organization & administration*; D003253:Consultants; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010166:Palliative Care / Q000458:organization & administration*; D011446:Prospective Studies; D000072177:Radiologists; D006113:United Kingdom