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Background

More than half the workforce in radiotherapy are therapeutic radiographers.  Since 1997 when the Society and College of Radiographers (SCoR) published  Therapeutic Radiography: A Vision for the Future2,  guidance and advice documents have been published3,4,5,6,7,8,9 which have defined the direction of travel for therapeutic radiographers and supported them to embrace change in order to respond and to deliver patient-centred care.

This document supersedes and replaces existing SCoR therapeutic radiography guidance.10,11,12  It outlines the practice of therapeutic radiography in providing high quality care to patients while continuing to develop the scope of practice of therapeutic radiography, safely and effectively13 when working as a critical part of the radiotherapy team and responding to the challenges of a changing health care provider environment. 14,15

It builds on the recently published SCoR’s ‘Principles of safe staffing for radiography leaders’16 guidance, informs the therapeutic radiography profession and supports the head of radiotherapy (radiotherapy service manager) by outlining the principles to be considered with regards to the therapeutic radiography workforce. It encompasses the future vision of a flexible workforce utilising all their skills at the highest possible level. Therapeutic radiographers may fulfil the role of ‘key worker’ for individual patients throughout their care pathway, while also utilising their unique knowledge and expertise to ensure evidence-based practice and the safe implementation of innovation for specific patient groups and technical specialities within radiotherapy. Of core consideration are the requirements for the delivery of safe and effective patient-centred services, set in the current political context.15

Therapeutic radiography staffing guidance has previously modelled the workforce required to staff a generic radiotherapy service, thus identifying the therapeutic radiography  workforce needed to staff a “linear accelerator hour”, the so called  Benchmark Figure.10  In 2010, the National Cancer Action Team (NCAT) developed a sophisticated Workforce Integrated Planning Tool (WIPT)17 which enabled service managers to map and identify non-medical workforce requirements for radiotherapy services, allowing for variables such as equipment, workload, demand, model of service. The uptake and ongoing use of this tool was not widespread across radiotherapy services, indicating the limited usefulness of this mathematical approach to identifying radiotherapy workforce requirements. The International Atomic Energy Agency (IAEA) has investigated and documented an activity-based approach 18  by measuring a range of procedures but acknowledges that this is an onerous task and lags behind emerging technologies and, as a consequence, is limited in its usefulness.

These issues along with continually evolving service developments across the UK indicate that it is unrealistic to establish a replacement benchmark figure that would be meaningful, useful and safe; compounded by the increasing diversity of models of radiotherapy service provision. This guidance does however provide example therapeutic radiography workforce arrangements to illustrate the outline requirements for a series of differing service provider models. These have been based upon data collated from recent UK Surveys.19,20,21,22

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