IMAGING & ONCOLOGY - Society of Radiographers

58to a previous audit undertaken by the oncology doctors between July 2006 andJune 2007.Audit standards1. Record of three treatment options discussed: 100 per cent2. Risk of bladder and bowel toxicity assessed: 100 per cent3. Record of discussion of treatment related late side effects: 100 per centResultsBetween July 2006 and June 2007, 22 new patients were seen by the oncologists andbetween 2008 and 2009, 26 new patients were seen by the consultant radiographer.Results for the standards relating to documented evidence that treatment optionswere discussed, risk of late toxicity and risk factors identifi ed are shown below.Treatment choice (Figure 3) was evenly distributed between the three treatmentoptions in those patients seen by the oncology doctors (AS-32%, BT-36%, EBRT-32%).However, in the patients seen by the consultant radiographer (AS-46%, BT-38%, EBRT-16%), fewer women opted for EBRT (16% v 32%). This may refl ect the interpretationof the preliminary results of the PORTEC II study 12 . This study was the fi rst randomisedtrial comparing the effi cacy of vaginal vault brachytherapy and EBRT to determinewhich treatment provides optimal local control with best quality of life. The conclusionsfrom the study were that vaginal BT is effective in preventing vaginal recurrence,and whilst there was a slight but signifi cantly increased pelvic failure in this groupcompared to the EBRT arm, distant metastases, overall survival and relapse-freesurvival were similar in both groups.Consultant oncologistTreatmentoptions discussed93 per cent(13/14)Oncology registrar 38 per cent (3/8)ConsultantradiographerFigure 396 per cent(25/26)Late side effectsrecorded100 per cent(14/14)63 per cent(5/8)100 per cent(26/26)■ AS ■ BT ■ EBRTRisk factorsrecorded93 per cent(13/14)63 per cent(5/8)96 per cent(25/26)DiscussionThe quality of documented consent in the consultant radiographer letters wascomparable to that by the consultant oncologists. Oncology registrars performedless well and this is most likely due to the learning curve of junior registrars whowere audited during the evaluation. Education and training of registrars mustremain a priority in areas of clinical practice in order to prevent deskilling, especiallyas these practices are now managed by different professional groups. A trainingand assessment programme has therefore been implemented by the consultantradiographer for all registrars during their six month clinical placement rotation withthe team, both in the new patient clinic and the brachytherapy clinic.This audit has demonstrated that the quality of consent information and advicewomen are now receiving is comparable to that given by consultant oncologists. Thisshows that redesign of the patient pathway has facilitated the most appropriate andcost-effective use of medical skills for undertaking complex treatments. It has also ledto the successful development of a radiographer led service for endometrial cancerpatients that includes leading the development of education and training programmesfor oncology registrars and leading service development and research activity, whilstoffering a high-quality clinical service. A follow-on prospective study of patientsatisfaction will be undertaken in the near future.2010IMAGING &ONCOLOGYOncologistsConsultant RadiographerThe quality of documentedconsent in the consultantradiographer letters wascomparable to that by theconsultant oncologists