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10.11 Case Study 9 Karen Bew

Advanced Practice Brachytherapy Superintendent in Poole Hospital NHS Foundation Trust

Career Pathway

I qualified in 1989 with a Diploma in Radiotherapy from Southampton College of Radiography.  In 1995 I completed an end on degree gaining a 2:1 BSc (hons) in Therapeutic Radiography. During this time I progressed to a Senior 1 Radiographer on the treatment units. In 2007 I undertook a Masters module in Technical Advances in Radiotherapy, and lead the introduction of CBCT into the department. In 2008, I became the Brachytherapy Superintendent in order to introduce the new HDR machine and bring together all the brachytherapy services.


I was engaged to set up and develop the new HDR brachytherapy service that was replacing the LDR treatments for gynaecological cancer. As part of this remit I was tasked with bringing all brachytherapy together in the department, providing an overall service utilising the same area. I instigated setting up a theatre/treatment room for both gynae HDR and prostate LDR treatments, negotiating staff and services from both day and main theatres to support this. We now have a dedicated theatre and anaesthetic support for prostate LDR seed insertion and cervical HDR insertions using both general and spinal anaesthetics. I have achieved a Masters module in Advanced Practice from Sheffield with regards to vaginal vault insertions for HDR brachytherapy.

For the past five years I have been running this area, doing everything from bookings, patient information, protocols, training, education, research, audits, horizon scanning, budgeting and business plans to emotional and psychological support. In the last year a second advanced practice radiographer was appointed to brachytherapy full time to help the day to day running of the service so I could concentrate more on the managerial side, developing the service, being the RPS, and managing staff appraisals, development and recruitment alongside the other departmental superintendents. I have been involved in Peer Review, Cancer Wait time Targets, quality meetings, risk management, skill mix review and clinical group meetings. I have played an active role in the acquisition of PDU (Practice Development Unit) status for the Dorset Cancer Centre from Bournemouth University showing that as a centre we link our practice to both local consumer needs and national goals. I have participated in a variety of conferences and forums,mainly as a delegate but also a speaker, having given talks at the national Brachytherapy Radiographers Forum. I also give talks at a local level in the hospital and to patient support groups on a variety of topics linked to brachytherapy. 

Future plans

We are just changing from a 2-step prostate brachytherapy procedure to a 1-step procedure, and setting up training and writing protocols and procedures for this. Future projects will be training both advanced practice brachytherapy radiographers in ultrasound acquisition for positioning cervical applicators in theatre and  1st fraction vaginal vault insertions,  prostate volume acquisition and fiducial marker implantation. This role should develop into a Consultant role with more research and development and participation in national initiatives.

Karen Bew

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