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5. Role Development in Therapeutic Radiography

5.1 Since the 1990s there have been many major developments in technology that have enabled high-dose radiotherapy to be planned and delivered more accurately and for treatment to be verified using diagnostic imaging systems. Together with a renewed policy focus on cancer,13,14,15 this has resulted in radical, high-dose radiotherapy being the treatment of choice for many early stage cancers as well as being an important tool for palliative care. 

5.2 This expansion of the use of radiotherapy has generated opportunities for therapeutic radiographers to develop new roles beyond registration. Initially these were opportunistic and often as a result of the increased workload of clinical oncologists, for example radiographer-led review of patients. In 2000 the Department of Health published its four-tier structure for professional practice, which identified assistant, practitioner, advanced practitioner and consultant practitioner roles for allied health professionals.16 The recently published strategy for England3 continues this direction of travel with strategic priorities that emphasise the optimal use of skills and grant patient experience . There should be at least as much effort and energy offered  and focus given to delivering an excellent patient experience alongside the goal of continually improving patient outcomes from the treatment,  recognising that patients should have access to a specialist practitioner/key worker with advanced or consultant level knowledge and skills.    

5.3 These initiatives have provided the policy framework for the SCoR to continue to pursue professional support and guidance for role development for the whole radiography workforce, including a policy document that defined three roles for advanced and consultant therapeutic radiographers; site specific, technical expert and community liaison.17

5.4 Further policy and guidance documents have sought to embed the structure into imaging and cancer centres and professional role development, underpinned by appropriate education and training now integral to the scope of radiographic practice.18 The knowledge, skills and attributes required to support role development across the whole radiotherapy pathway from referral to discharge have been agreed and published by the profession in its Education and Career Framework.19

5.5 The emergence and prevalence of specialist roles supporting the care and treatment of people with prostate cancer is an important outcome of role development at both advanced and consultant levels of practice and is the subject of this project. Their development has usually been as a result of a local need being identified and often because a radiographer has a special interest in the topic.

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