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3. Existing scope of practice in Information, Liaison and Support (ILS)

A wide range of current information, liaison and support (ILS) activity has been identified by radiographers working within the traditional radiotherapy centre setting(7)(8) including:

One to one care and support of patients and carers

  • Detailed information and advice on treatment reactions and side effects prior to treatment
  • Gaining consent to treatment planning and delivery
  • Information and support to individual patients/carers in the planning/treatment room setting
  • Telephone information and support for patient/carer between first appointment with oncologist and first visit to department
  • One to one psychological support sessions for patients and carers (often crisis intervention)
  • Radiographer-led holistic treatment review clinics in the department
  • Radiographer led follow-up at peripheral clinics
  • Telephone help line particularly for patients receiving chemo-radiotherapy
  • Follow-up phone calls to patients when treatment is finished
  • Routine telephone review clinic one week post treatment
  • Support in recovering from acute side effects post-treatment
  • Development/maintenance of protocols for radiographer-led review clinics
  • Responsibility for Patient Group Directives
  • Development/monitoring of patient information leaflets
  • Special needs information provision e.g. Braille or language specific
  • Psychological support for nurses and radiographers in relation to clinical case load

Liaison with health professionals and groups

  • Referral to other health professionals within the acute setting
  • Provision of education and information sessions, open mornings for pre-radiotherapy site-specific patient groups, patient support groups or other health professionals
  • Input to cancer network  meetings, such as information and patient liaison groups 
  • Liaison with local cancer information and support centres
  • Referral to community palliative care team, social worker, benefits adviser etc
  • Liaison with patient’s GP practice team
  • Expert advice on skin care and dressings to district nurses and GPs
  • Responsibility for discharge letters to GPs related to treatment reactions
  • Provision of web-based information and phone contact with GPs/District Nurses

All radiotherapy practitioners are involved in certain routine ILS activity as part of their role. In addition, identified therapeutic radiographers specialise in the provision of ILS within the setting of the radiotherapy centre. 

Historically a number of these posts were pump-primed by Macmillan Cancer Relief in the late 1990s, leading to the title of Macmillan Radiographer or Information Specialist.

Similar appointments have been funded by employing authorities such that most radiotherapy centres have a senior radiographer, supernumerary to the treatment team, specialising in the provision of this type of service. 

Traditionally ILS posts were ‘grown’ around individuals who had achieved qualifications in support services such as counselling and complementary therapies. In this way, posts evolved or were opportunity-driven by available money or an acute service gap.

It is acknowledged that service need and the capacity to deliver that service should now be the driver for a recognised career framework in the field of ILS.

The workforce profile within the centre, particularly in relation to cancer nurse site specialists, is an important factor in how therapeutic radiographers are deployed. In some departments cancer nurse specialists and ILS radiographers deliver very similar services. In others where there are no nurse specialists, radiographers take on a much broader scope of practice.

ILS is delivered not only by information and support radiographers but also by site specialists and treatment and review radiographers working at advanced practice level.

Some departments are developing protocols for routine assessment of the need for information and support for every patient during the radiotherapy phase of the patient pathway. This does not appear to be current routine practice, highlighting the potential for the inclusion of radiotherapy experience within the overall cancer pathway.  

Although the above scope of practice may appear very broad, it should be noted that not all services are provided in every centre; neither are services provided for every patient.

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