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Improving the Breast Cancer patient pathway with the appointment of a Consultant Breast Radiographer (CBR)

by Ruth Bees

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Purpose/Problem

Adjuvant breast radiotherapy comprises a significant workload for radiotherapy centres. Improvement in cancer patients’ experience and reductions in waiting times are at the forefront of NHS England’s drive to achieving world-class cancer treatment (1). Allied Health Professionals are increasingly being developed into specialty consultant roles to improve cancer services (2) and address the national Consultant oncology workforce challenge (3, 4).

Method

The CBR was appointed to attend breast MDTs, run new/follow-up patient clinics and supervise radiographer-led breast planning. This post replaced Consultant Oncology sessions.

Quality Measure Indicators (QMI) were collected for 20 patients before/after the CBR appointment. QMI 1 = Time (days) from surgery to start of radiotherapy. QMI 2 = Time (days) from MDT to oncology consultation. QMI 3 = Patient experience at CBR consultation. QMI 4 = number of new patients seen by CBR over 6 months.

30 radical breast radiotherapy patients were given patient experience surveys.

Results

QMI 1: time from surgery to radiotherapy start decreased by 12.7%. QMI 2: time from MDT to oncology consultation decreased by 45.2%. QMI 3: 70% surveys returned: 100% understood the recommendation, side-effects and could give informed consent for radiotherapy; 95.2% understood the radiotherapy pathway. QMI 4: new referrals: increased by 15.6%, the CBR undertook 19.6% workload.

Conclusion

The introduction of a CBR at our Trust significantly reduced time to new patient consultation and radiotherapy start; and demonstrated excellent patient experience for patients, despite the increase in new referrals. Consultant radiographer posts need to be expanded to develop and improve clinical oncology services.

References

  1. NHS England (2019) The NHS long term plan. Available at: https://www.longtermplan.nhs.uk/ (Accessed: 28 March 2019]).
  2. NHS England (2016) Quick Guide: the role of allied health professionals in supporting people to live well with and beyond cancer. Available at: https://www.england.nhs.uk/wp-content/uploads/2018/10/quick-guide-ahp-cancer.pdf (Accessed 28 March 2019).
  3. Clinical oncology UK workforce census 2018 report, www.rcr.ac.uk
  4. Full team ahead: understanding the UK non-surgical cancer treatments workforce. Cancer Research UK Dec 2017
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