Statistically, prostate cancer is the most common male cancer in the UK. Patients diagnosed with prostate cancer often have a number of treatment options that include surgery in the form of radical prostatectomy, brachytherapy, or external beam radiation therapy (EBRT). All treatment options usually involve hormone therapy before and after. Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Statistics in Northern Ireland show an increase in the incidence of prostate cancer diagnosis, this increase inevitably leads to an increase in patients opting for radiotherapy. Given the high demands on ClinicalOncologists, time to give consent to patients, complete treatment plans, review patients during radiotherapy and review patients after radiotherapy, as well as manage the care of inpatients, is difficult to find. These time constraints highlight the importance of role development and extension for radiographers. A radiologist-led review is just one way radiographers can extend their role as an allied health professional. Much of the knowledge and skills acquired as a radiographer transfer seamlessly to this role as a natural progression from normal daily interactions with patients. Cancer Research1 reports that over the past decade prostate cancer incidence rates have increased by 6% and another increase is predicted to 12% by 2035. This makes prostate cancer the second most common cancer in the UK . In 2014 the National Institute for Health, Care and Excellence (NICE)2 reported that 35% of all prostate cancer patients underwent external beam radiotherapy. With these statistics, it is inevitable that the number of patients opting for radiotherapy will also increase, in turn putting pressure on an already under pressure national health service. The Transforming Your Care (TYC)3 report highlighted eleven reasons for change in the healthcare system in Northern Ireland. These include the importance of patient-centred care, an increasing demand for all care programmes, the need to provide high-quality evidence-based service and to make the best use of available resources. Developing the role of radiology staff can help address some of the objectives of the TYC report by using and developing existing experience and skills. The review conducted by the radiologist must cover a large amount of information with patients to maximize the care they receive. The reviewer should offer advice on skin care, diet management, other details or issues related to receiving daily treatment, such as traveling to appointments, and any holistic measures that may be taken. They should clarify whether the patient is on hormone therapy, if appropriate, and discuss any side effects. Much of the review process is spent discussing side effects of treatment with patients, this includes monitoring both gastrointestinal (GI) and genitourinary (GU) reactions to their treatment using the Radiation Therapy Oncology Grading (RTOG) toxicity scale ) for bladder and bowel, toxicity must be carefully documented. During reviews, if appropriate, medications may be suggested to alleviate side effects and therefore a high level of communication between the medical oncologist and the radiologist is extremely important. The radiologist should also offer information about other servicesavailable such as counseling and must collaborate with other healthcare professionals such as social workers or radiotherapy nurses, if appropriate; any reports should also be documented. Every day, all radiographers use their knowledge and skills to assess whether or not a patient is suitable to continue the course of radiotherapy treatment. Patients are asked about their general well-being, any new side effects, or how they are managing current side effects, and any concerns are addressed appropriately. The formal radiographer-led review qualification requires the attributes that the radiographer has already established and intensifies these skills and depth of knowledge to enable the role to develop as a natural progression towards advanced practice. When searching for this literature review, it was found that the number of articles addressing the topic of radiographer-led reviews was quite limited. It is hoped that the push towards role development in other areas such as information and support or supplementary prescribing will deepen the research and broaden the available literature. Role Development The Belfast Trust Business Plan 2013-20164 includes some of the business objectives set to meet the health and social care needs of the people of Northern Ireland. Importantly, these include: “A culture of safety and excellence: We will promote an open and learning culture and put in place robust systems to provide assurance to our users and the public regarding the safety and quality of services. Continuous Improvement - We will seek to be a leading Trust through innovation at all levels of the organization Our People - We will achieve excellence in the services we provide through the efforts of a skilled, committed and engaged workforce Resources - We will work to optimize the resources at our disposal to achieve shared objectives.” The trust fully supports role development through these objectives but also through other systems that help it to function safely on a day-to-day basis such as clinical governance systems, professional regulatory bodies such as the HCPC and through the promotion of lifelong learning through continuing professional development (CPD) . As radiographers, these opportunities should be welcomed as the possibilities for role development have really changed over the last decade with the increase in cancer diagnoses and continued shortages of medical staff. The Radiographer Review Protocol5 from the Department of Radiotherapy, Belfast Trust, provides guidance for reviewing patients. One of the principles of this protocol is to reduce time constraints for consultants and registrars. Again this supports the utilization of the resources of a skilled workforce in times where time is a major constraint. The extension/development of the role was highlighted in a Society and College of Radiographers (SoR) document6. The expansion in the use of radiotherapy and the development of new technologies has generated more opportunities for therapeutic radiographers to develop roles within their scope of practice, an example of one of these additional roles is patient-led review radiologist. This SCoR document, like TYC3, agrees that priorities should include the optimal use of expertise and resources, the provision of an excellent patient experience whilst continuously improving treatment outcomes and recognizing that patients should have access to a medical specialist with advanced level or consultant knowledge and skills. Score initiatives haveprovided a framework within which they can pursue role development support and guidance within the radiography workforce, the knowledge and skills needed to support role development in radiotherapy have been agreed and published in its Training and Career Framework for the RadiographyWorkforce7. Nowadays, the only drawback of role development for ourselves as radiographers is that while we are freeing up time for clinicians to focus on other aspects of patient treatment, whoever is filling the role in the treatment unit or our colleagues are committed to letting these expanded roles be filled. Although reskilling should primarily be for the benefit of patients and to improve service, Shi** has shown that having a radiologist-led review role leads to greater job satisfaction for radiographers, this, in turn, leads to higher morale high level of staff and better staff retention. personal. The Department of Health's white paper, Unlocking the NHS: Greater choice and control* is based on putting patients at the center of decision-making. “No decisions about me without me” should be a principle when delivering all our treatments, whether hormone therapy, EBRT or brachytherapy. It is vital that as radiographers we have adequate communication skills to support patients in making decisions about their care. During reviews with patients, it is important to offer all the information and leave the final decision to the patient, for example, if a patient has increasing nocturia, it is important to make them aware that there may be drugs that can help, but they are not at all obliged to start taking it. Often within a few days or another week, the patient will request the medication or will simply be happy to know that it is available should they decide they can no longer manage the symptoms on their own. Much of the radiologist-led review role relies on communication, and the ability to communicate well and adapt one's communication style to support patient-centered care is important. Most of the goals and objectives of the Radiographer Review Protocol** are based on communication, demonstrating the need for excellence in this skill. These include ensuring the patient understands all written information relating to the preparation, providing advice on reactions to skin care, providing advice on GI and GU side effects, clarifying hormonal compliance and ensuring patients continue to receive information and support throughout treatment. In a study by Bolerston, Lewis and Chai** therapeutic radiographers were aware that they were able to establish a relationship with patients that went beyond their radiotherapy treatment. The choice of profession was seen as a commitment to patient care due to the additional support required by the type of patient. It was also reported that effective communication can alleviate problems such as stress and anxiety, and that establishing relationships allowed patients to obtain the information they needed during their treatment experience. NICE2 guides us in offering men personalized information tailored to their needs, the review session lends itself very well to this as we can provide patients with information relevant to their needs at the time of the review. They are often offered additional information and support through the information and support radiologist position; patients may also be referred for psychosexual support if needed. NICE recommends that men and partners/guardians areadequately informed about the effects of prostate cancer on their sexual function, physical appearance, continence and other aspects of masculinity and that we support them in decision-making, taking into account the effects on quality of life as well as survival. Since one of the treatment options for men with prostate cancer will be a course of hormones, this guide is crucial. Some of the side effects of hormones may be sensitive in nature and not all patients will want to discuss these symptoms. It is important that patients and their partners are aware of all side effects and know that help is available if they decide to seek it. Patient-centered care Radiologist-led review can help ensure patient-centered care by using his or her experience and skills. One of the aims of the Radiographer Review Protocol** states: “As allied health professionals we recognize that the principles of skill mix will apply to ensure effective, efficient and safe patient care, ensuring that our individual skills complement each other each other in order to maximize the benefits to patient care and optimize the use of resources”. In the beautiful clinical guideline Patient experience in adult NHS services: improving the experience of care for people using services. NHS for adults** it is explained and advised that treatment and care should take into account individual needs and preferences. It is suggested that patients should have the opportunity to make informed decisions about their care and treatment, in collaboration with their healthcare providers.With time constraintsIn clinics, it is important to try to get to know patients as individuals; patients appreciate this recognition as their individual needs can vary greatly and how each person may experience a condition differently may also have a different impact on life. As well as providing clinical information and support for side effects, other support is also offered where appropriate, such as counselling, help with transport costs. NICE explains how we should ask patients about their home, social and work situations and consider how each of these might be affected by a diagnosis or treatment and how this might influence their ability to make decisions about their care or how they could manage themselves. This also brings to light the issue of patients making decisions for themselves and deciding at what point they should accept support, if at all. The Department of Health has produced a framework which outlines the elements important to patient experience in the NHS. The NHS Patient Experience Framework**. Respect for patient-centered values, preferences and needs. These include cultural issues, the dignity, privacy and independence of patients, awareness of quality of life issues and the importance of shared decision making. It is important to ensure patients have information, communication links, educational progress, prognosis and treatment processes in order to facilitate autonomy, self-care and health promotion. We should welcome the involvement of family and friends on whom patients rely for decision making. All patients should have access to accurate care, for example we should be aware of a patient's positioning in the waiting room and waiting time for radiologist-led reviews. As radiology providers, there is documentation in place to protect ourselves as professionals but also to protect patients as usersof the service we provide. Score's Code of Professional Conduct** requires us to act in a manner based on respect, accountability, empathy, trustworthiness, integrity and justice. It is also important for us to maintain public trust in our profession. From a legal perspective there are also many aspects to consider and autonomy and scope of practice are discussed throughout the document and are useful in supporting radiographers who wish to gain radiologist-led review competence. The first section of the code refers to providing the best care to patients based on up-to-date evidence, this highlights the importance of evidence-based practice and is why the radiotherapy service develops at the rate at which it carries out roles such as that of reviewing radiologist. Section 2 of the code of conduct highlights the importance of working within your scope of practice with the current legal, ethical, professional and governance frameworks relating to the role and workplace, an example of this would be Health and Care Professions Council (HCPC). For HCPC registration it is essential to provide evidence of continuing professional development (CPD), if required, as this provides a means of assessing practical competence. Working within the scope of practice should also lead to awareness of the limitations in a particular role. Knowing limitations when reviewing patients is important to provide patient-centered care, but also to work safely and seek help when necessary. Section 3 discusses the need to keep records up to date and accurate and to ensure they are completed honestly. One of the goals/objectives of the radiologist review protocol5 is to clearly document all details of the consultation. Documentation of information from reviews can be seen simply as a communication tool between staff or the wider MDT, but in reality it is much more important than that, notes can protect the patient and prevent them from coming to harm but, at the otherwise, they can protect the auditor. All things discussed should be noted, this is extremely important when the radiologist may examine more than twenty patients in one session, it would be almost impossible to remember all the details of every single reviewer. As previously mentioned, the increasing incidence of cancer diagnoses has led to an increase in the number of patients requiring or opting for radiotherapy. Old in-treatment review protocols no longer met expected standards, patient needs or the radiotherapy service and current in-treatment review systems are now being stretched to meet growing needs. This demonstrates the need for more radiology providers to undergo a formal training program and be qualified to examine patients according to departmental protocols. Having more staff trained in radiologist-led review is in line with the development/extension of the role as well as continuing professional development as required by the CPC, this role can then be further developed, for example with the additional prescribing role. All current government health policies regarding cancer care aim to ensure that staff provide excellent service and that patients receive optimal management of their disease. The radiologist-led review helps the radiotherapy department to achieve the business objectives set out by the Belfast Trust and the TYC document by using the knowledge and skills of radiographers and developing these through postgraduate qualifications. This also means we can simplify the patient care journey.