Leading the way in cancer care

Published: 14 November 2016 Ezine

Author: Rachel Kirby, Macmillan advanced practice radiographer

Rachel Kirby talks about her role as a Macmillan advanced practice radiographer in thoracic oncology.

After working in clinical radiotherapy in both the UK and Canada, I began a newly created Macmillan advanced practitioner post at Addenbrooke’s Hospital, Cambridge in July 2015. 

The post is a joint funding venture between Macmillan and Cambridge University Hospitals NHS Foundation Trust (CUH) and is aimed at improving the experience of lung and oesophageal cancer patients.  

Q. What does your role involve?

A. The provision of holistic information and support to patients and their carers throughout their treatment and beyond is central to the role. Chemo-radiation regimens are complex. Therefore continuity and a single point of contact are not only valued by patients but also the wider multidisciplinary team, ensuring that the patient journey is seamless and efficient.

Radiographer-led radiotherapy review and follow-up clinics allow me to assess and optimally manage treatment related toxicities. They also provide the ideal opportunity to help patients and carers cope with the psychological, social and financial consequences of diagnosis and treatment. This has been facilitated by embedding elements of the recovery package; a series of interventions developed by the National Cancer Survivorship Initiative for patient assessment and the documentation of all aspects of management (www.ncsi.org). 

Ultimately, we aim to educate and empower patients to actively manage their symptoms, develop coping skills and get the most out of life as they move forward, regardless of their prognosis. Additionally, good patient management, education, and effective signposting to charitable and community-based services should help to reduce the demand for acute hospital facilities, such as the oncology assessment unit and emergency department.  

Q. Are there any other aspects of the role?

A. Equally important are the non-patient facing responsibilities to ensure that the service is safe, adheres to government guidelines, and remains at the forefront of oncology and radiotherapy practice. We actively recruit into local, national and international clinical trials in both medical and radiation oncology. All aspects of our work and clinical practice are supported by a robust quality assurance, education and competency framework.

As the role evolves potential areas of progression include target and organs at risk volume delineation and a radiographer-led palliative radiotherapy pathway to further improve service access and efficiency. Recent changes to legislation in April 2016 now mean that registered therapeutic radiographers are permitted to train as independent prescribers, which provides excellent potential for professional development and better patient experience.

Q. How do you see the future of cancer services developing? 

A. The pressures on cancer services to cope with current demand and secure a sustainable future are now very real. The Macmillan Integrated Cancer Care Project (MICCP) at CUH is a three year venture aimed at improving and developing stratified patient pathways and implement the recovery package. Nurse-led and allied health professional led clinics represent a sustainable way of coping with increased workloads, while continuing to offer a high-quality service based on existing expertise within the cancer division.

Q. What are the rewards?

A. The Macmillan ethos is synonymous with the values that underpin CUH and I hope that these are reflected in my practice. I feel incredibly privileged to work at Addenbrooke’s and alongside Macmillan. 

The resilience and determination of our patients never cease to amaze and perpetually drive me to make a positive difference to their journey, however small that difference might be. 

I would like to express my thanks to everyone who helped to secure this post initially, and who have provided me with invaluable support and encouragement since