Statistically, prostate cancer is the most common male cancer in the UK. Patients with a diagnosis of prostate cancer often have a number of treatment options, including surgery in the form of radical prostatectomy, brachytherapy, or external beam radiation therapy (EBRT). All treatment options usually involve hormone therapy before and after. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay Northern Ireland statistics show an increase in the incidence of prostate cancer diagnosis, this increase inevitably leads to an increase in the number of patients opting for radiotherapy. Given the high demands on the time of clinical oncologists, it is difficult to find time to provide patient consent, complete treatment plans, examine patients during radiotherapy and examine patients after radiotherapy, as well as manage care of hospitalized patients. These time constraints highlight the importance of developing and expanding the role of radiologists. A radiologist-led exam is just one way radiologists can expand their role as an allied health professional. Much of the knowledge and skills acquired as radiologists transfer seamlessly to this role, as a natural progression from normal day-to-day interactions with patients. Cancer Research1 reports that over the past decade, prostate cancer incidence rates have increased by 6% and another increase is predicted to 12% by 2035. This makes cancer Prostate cancer the second most common cancer in the UK. In 2014, the National Institute for Health, Care and Excellence (NICE)2 reported that 35% of all prostate cancer patients had external beam radiotherapy. With these statistics, it is inevitable that the number of patients opting for radiotherapy will also increase, putting pressure on an already strained national health service. The Transforming Your Care (TYC)3 report highlighted eleven reasons for change in healthcare in Northern Ireland. These include the importance of patient-centered care, increasing demand for all care programs, the need to provide a high-quality, evidence-based service and to make best use of available resources. Developing roles within the radiography staff can help achieve some of the objectives of the TYC report by utilizing and developing existing experience and skills. The radiologist-led exam must cover a large amount of information from patients in order to maximize the care they receive. The examiner should offer advice on skin care, dietary management, other details or issues related to daily treatment, such as travel to appointments, and any holistic measures that may be taken . They should clarify whether the patient is taking hormone therapy, if applicable, and discuss any side effects from it. Much of the review process is spent discussing treatment side effects with patients, this includes monitoring gastrointestinal (GI) and genitourinary (GU) reactions to their treatment using the Radio TherapyOncology Grading (RTOG) toxicity scale for bladder and bowel, toxicity should be carefully documented. During examinations, medications may be suggested to alleviate side effects, if any.A high level of communication between the medical oncologist and the radiologist is therefore extremely important. The radiologist should also offer information about other services available, such as counselling, and should liaise with other healthcare professionals, such as social workers or radiotherapy nurses, where appropriate. Any references must also be documented. On a daily basis, all therapeutic radiologists use their knowledge and skills to assess whether or not a patient is suitable to continue their radiotherapy treatment. Patients are asked about their general well-being, any new side effects, or how they are managing their current side effects, and any concerns are addressed appropriately. The formal radiographer-led examination qualification takes the attributes that the radiologist has already verified and intensifies these skills and in-depth knowledge to enable role development as a natural progression into advanced practice. While researching this literature review, it was found that the number of articles addressing the topic of radiologist-led reviews was quite limited. Hopefully, the drive to expand the role into other areas such as information and support or additional prescribing will deepen the research and expand the available literature. Role Development The Belfast Trust Corporate Plan 2013-20164 includes some of the corporate objectives set to meet the health and social care needs of the people of Northern Ireland. These include: “A culture of safety and excellence – We will foster a culture of openness and learning and put in place robust systems to provide assurance to our users and the public regarding safety and quality of services. Continuous Improvement - We will seek to be a leading, trusted company through innovation at all levels of the organization. Our People – We will achieve excellence in the services we provide through the efforts of a competent, engaged and committed workforce. Resources - We will strive to maximize the resources available to us to achieve common goals. The trust fully supports the development of roles through these objectives but also through other systems which help it to operate safely on a daily basis, such as clinical governance systems, professional regulatory bodies such as the HCPC and through the promotion of lifelong learning through continuing professional development (CPD). . As radiologists, these opportunities should be welcomed, as the chances for role advancement have really changed over the past decade with the increase in cancer diagnoses and the continuing shortage of medical staff. The Radiographer Review Protocol5 from the Belfast Trust Department of Radiotherapy provides guidance for reviewing patients. One of the principles of this protocol is to reduce the time constraints of consultants and registrars. Again, this supports the use of skilled workforce resources at a time when time is a significant constraint. The expansion/development of roles has been outlined in a Society and College of Radiographers (SoR) document6. The expansion of the use of radiotherapy and the development of new technologies has generated more opportunities for therapeutic radiologists to develop roles within their scope of practice, an example of one of these additional roles is the examination of patients led by a radiologist. This SCoR document, like TYC3, agrees that prioritiesshould include the optimal use of skills and resources, providing an excellent patient experience whilst continually improving treatment outcomes for patients and recognizing that patients should have access to a specialist practitioner with an advanced or consultant. knowledge and skills. The scoring initiatives have provided a framework within which they can seek support and guidance for role development within the radiography workforce. The knowledge and skills required to support the development of the radiotherapy role have been agreed and published in its Training and Careers Framework for Radiography Staff7. Currently, the only downside to expanding the role of ourselves as radiologists is that while we free up time for physicians to focus on other aspects of treating patients, that fills the role in the treatment unit or are our colleagues asked to ensure these extended roles are covered. While the redevelopment is primarily expected to benefit patients and improve the service, Shi** demonstrated that having a radiologist-led review role led to greater job satisfaction for radiologists, which in turn, leads to better staff morale and better employee retention. staff. The Department of Health's white paper, Unleashing the NHS: Greater Choice and Control*, is based on the fact that patients are at the heart of decision-making. “No decision about me without me” should be a principle throughout the delivery of all our treatments, whether it is hormonal therapy, EBRT or brachytherapy. It is essential that as radiologists we have adequate communication skills to support patients as they make decisions about their care. When conducting examinations with patients, it is important to offer them all the information and leave the final decision to the patient. For example, if a patient is experiencing increasing nocturia, it is important to make them aware that there may be medications that can help them, but they are. under no circumstances obliged to start taking it. Often, after a few days or a week, the patient will ask for the medication or simply be happy to know it is available if they decide they can no longer manage their symptoms on their own. Much of the role of the radiologist-led examination relies on communication. The ability to communicate well and adapt your communication style to support patient-centered care is important. The majority of the goals and objectives of the Radiographer Review Protocol** are communication based, demonstrating the need for excellence in this skill. This includes ensuring the patient understands all written information regarding the preparation, providing advice on skin reactions, providing advice on GI and GU side effects, clarifying hormonal compliance, and ensure that patients continue to receive information and support during their treatment. In a study by Bolerston, therapy radiologists Lewis and Chai** were aware that they were able to establish a relationship with patients that went beyond their radiation treatment. Choice of profession was perceived as a commitment to patient care due to the additional support required by the patient type. He also reported that effective communication can alleviate problems such as stress and anxiety and that building relationships allows patients to get the information they need during their treatment experience.treatment. NICE2 guides us to offer men individualized information tailored to their needs, the review session lends itself very well to this as we can give patients information relevant to their needs at the time of the review. Additional information and support is often offered to them through the Information and Support Radiologist position. Patients can also be referred for psychosexual support if necessary. NICE recommends that men and partners/carers are adequately informed about the effects of prostate cancer on their sexual function, physical appearance, continence and other aspects of masculinity and that we support them in decision-making, taking into account the effects on quality of life as well as survival. Since one of the treatment options for men with prostate cancer will be hormonal treatment, this advice is essential. Some side effects of hormones can be sensitive in nature and not all patients will want to discuss these symptoms. It is important that patients and their partners are aware of any side effects and know that help is available if they decide to benefit. Patient-centered care The radiologist-led examination can help ensure patient-centered care using their experience and skills. One of the objectives of the Radiographer Examination Protocol** states: "As allied health professionals, we recognize that the principles of skill mix will apply to ensure effective, efficient and safe patient care, ensuring "that our individual skills complement each other to maximize benefits for patient care and optimize the use of resources." In the beautiful clinical guidance entitled The Patient Experience in Adult NHS Services: Improving the Care Experience for People Using Adult NHS Services**, it is explained and advised that treatment and care should take into account individual needs and preferences. It is suggested that patients have the opportunity to make informed decisions regarding their care and treatment, in partnership with their healthcare professionals. With time constraints In clinics it is important to try to get to know patients as individuals, patients appreciate this recognition as their individual needs can vary greatly and the way each person may experience an illness differently can have a different impact on his life. While providing clinical information and support for side effects, other support is also offered where appropriate, such as advice, help with transport costs. NICE explains how we should ask patients about their domestic, social and work circumstances and consider how each of these might be impacted by a diagnosis or treatment and how this may affect their ability to make decisions about their care or how they could manage themselves. This also brings back the question of patients making decisions for themselves and deciding when to accept support, if at all. The Department of Health has produced a framework which outlines the important elements for the NHS patient experience. The NHS Patient Experience Framework**. Respect for patient-centered values, preferences and needs. These include cultural issues, dignity, privacy and independence of patients, awareness of quality of life issues and the importance of shared decision-making. It is important toensure that patients have information, communication links, educational advancements, prognoses and care processes to facilitate autonomy, self-care and health promotion. We should welcome the involvement of family and friends who patients rely on to make decisions. All patients must have access to attentive care. For example, we need to be aware of a patient's placement in the waiting room and the wait time for radiologist-led exams. As radiologists, documentation is in place to protect ourselves as practitioners, but also to protect patients as users of the service we provide. Score's Code of Business Conduct** requires us to practice in a manner based on respect, empowerment, empathy, trustworthiness, integrity and fairness. It also makes it important for us to maintain public trust in our profession. On a legal level, many aspects must also be taken into account. Autonomy and scope of practice are discussed throughout the document and are useful in supporting radiologists who wish to achieve competency in radiologist-led assessment. The first section of the code refers to providing the best patient care based on up-to-date evidence, which highlights the importance of evidence-based practice and is why the radiotherapy service is growing at pace where he does so with roles such as review radiologist. Section 2 of the Code of Conduct highlights the importance of working within your scope of practice with current legal, ethical, professional and governance frameworks relating to the role and workplace, an example of this would be the Council of health and care professions (HCPC). For HCPC registration it is essential to provide evidence of continuing professional development (CPD), if required this provides a means of assessing competence to practice. Working in practice should also lead to awareness of the limitations of a particular role. Knowing boundaries when examining patients is important in order to provide patient-centered care, but also to work safely and seek help if necessary. Section 3 addresses the need to keep records up to date and accurate and ensure that they are completed honestly. One of the goals/objectives of the radiologist review protocol5 is to clearly document all details of the consultation. Documenting information from reviews may be seen as a simple communication tool between staff or the wider multidisciplinary team, but it is actually much more important than that: annotations can protect the patient and prevent them from suffer any harm, but conversely, they can protect the examiner. All topics discussed must be annotated, which is extremely important when the radiologist may examine more than twenty patients in one session. It would be almost impossible to remember all the details from each individual assessor. As mentioned previously, the increasing incidence of cancer diagnoses has led to an increase in the number of patients requiring or opting for radiotherapy. Old in-treatment review protocols no longer met expected standards, the needs of patients or the radiotherapy department and current in-treatment review systems are now strained to meet growing needs. This shows the need for more radiologists to complete a formal training program and be qualified to examine patientsin accordance with departmental protocols. Having more staff trained in radiologist-led review is in line with the development/extension of the role as well as CPD as intended by the CPC, this role can then be developed further, for example with the role of additional prescription. Current government policies in cancer healthcare all aim for staff to provide excellent service and for patients to benefit from optimal management of their disease. The radiologist-led review helps the radiotherapy service achieve the corporate objectives set by the Belfast Trust and the TYC document by using the knowledge and skills of radiologists and developing them through postgraduate qualifications. It also means we can streamline the patient care journey and provide a high quality service with a high level of patient-centred care. Continuity of care is also easy to implement in the radiotherapy department thanks to forward planning of staff rotations and continuity of clinical rotations. Currently, at the Northern Ireland Cancer Centre, patients who opt for prostate brachytherapy are followed up with a telephone call three months after treatment. Since the PSA level is ultimately what is used to monitor patients, these post-exam phone calls could be implemented for radiation patients in the future. In turn, this could help reduce long waits for post-treatment oncology review appointments and would once again alleviate time constraints and pressure on our oncologists. As mentioned in the discussion, communication plays an important role in the overall radiologist-led examination process. Information is continually passed from staff to the patient regarding preparation for treatment, expected reactions to treatment, and information about hormone therapy and its side effects. In this situation, communication is two-way and it is important that the patient feels comfortable and confident in discussing problems they are experiencing regarding any aspect of their treatment. Empathy and approachability are great skills to develop further and patients appreciate that we have more time to spend with them than with an oncologist. When problems arise with patients that are outside the scope of practice of a radiologist competent to examine patients, it is necessary to be able to communicate clearly with other healthcare professionals and oncologists. Knowing when to refer a patient to another member of the multidisciplinary team such as the information and support radiologist is vital. Currently at the Belfast Trust it is necessary to complete a postgraduate module in Radiologist Led Assessment in order to become competent to carry out our assessments. This is not the case in all departments in the UK, but it is a good standard to meet. As cutting-edge cancer treatments are continually being researched and developed to enable dose escalation, such as the move from conformal radiotherapy to IMRT and now VMAT, we are continually updating our scientific knowledge and practices in accordance with these modernizations and follow various courses. and a briefing session to facilitate further development.Keep in mind: This is just a sample.Get a personalized article now from our expert writers.Get a personalized essay.Patients with prostate and breast cancer.