Therapeutic radiographer (integrated degree)

Occupation overview

This occupation is found in the health and care sector and includes the NHS and private healthcare providers. The broad purpose of the occupation is to provide excellent care to patients diagnosed with cancer by delivering high quality and accurate radiotherapy, taking into consideration patients’ emotional, psychological, and physical needs through the stages of their cancer treatment when at times they may be extremely vulnerable.  You will be responsible for the patient from the time of referral for radiotherapy by a cancer specialist and will undertake pre-treatment preparation of radiotherapy patients, such as scanning and planning the patients’ radiotherapy. Therapeutic radiographers provide the highest standard of technical practice and patient care in order to treat and support adults, teenagers and children receiving radiotherapy (predominately for cancer) using a variety of forms such as:

  • external beam radiotherapy, a method for delivering a beam or several beams of high energy X-rays to a patient’s cancer;
  • brachytherapy, a form of radiotherapy where a sealed radiation source (eg in a needle or tube) is placed inside or next to the patient’s cancer;
  • stereotactic radiotherapy/radiosurgery which delivers multiple beams of focused radiation
  • proton therapy, a type of particle therapy that uses a beam of protons to deliver a radiation dose to a patient’s cancer;
  • superficial skin radiotherapy, which uses X-rays or electrons to deliver a radiation dose to a patient’s cancer. In their daily work, an employee in this occupation interacts with cancer patients, who may or may not be cured, their carer(s), members of the public and a range of healthcare professionals eg physicists, dosimetrists, doctors, nurses and dieticians, in a variety of settings such as hospitals and hospices. An employee in this occupation will be responsible for planning, checking and using imaging to deliver accurate radiotherapy in a compassionate and caring manner. As an autonomous practitioner, they will have responsibility for the patient from the time of referral for radiotherapy by a cancer specialist, through to aftercare and on-going support after radiotherapy. They will be accountable professionally and legally for their actions and those they are supervising.

Skills

  • Interpret, apply and reflect on professional codes of practice and legislation in order to deliver radiotherapy and care, and take responsibility for own actions.
  • Manage risk and report and escalate concerns about safety, implement lessons learned, and be open when things go wrong within own scope of practice.
  • Keep accurate records of own work.
  • Promote and protect the interests of patients, staff, and public in a radiation environment and comply with local personal dose monitoring procedures.
  • Recognise and respond appropriately to situations where it is necessary to share information to safeguard radiotherapy patients or the wider public, in line with ethical frameworks and seek advice where unsure.
  • Promote health and wellbeing, advising on reducing the risk of side effects of radiotherapy.
  • Recognise patient advocacy responsibilities, act as a patient advocate when appropriate and provide patients or their advocates with the information necessary to enable them to make informed decisions.
  • Demonstrate effective and appropriate communication skills to build rapport with patients and colleagues.
  • Work within the limits of own knowledge and skills, and delegate appropriately.
  • Demonstrate up to date CPD and lifelong learning related to contemporary radiotherapy practice.
  • Support others and facilitate learning, including assessment and providing feedback to learners.
  • Apply critical thinking.
  • Assess and interpret treatment planning data to inform decision making.
  • Take part in clinical audit, contribute to service improvement initiatives, use evidence-based research and clinical trial outcomes to inform own clinical practice.
  • Deliver with a high level of skill and accuracy, radiotherapy using external beam radiation.
  • Make reasoned decisions to continue or cease radiotherapy, and to escalate where necessary.
  • Assess patients’ clinical condition prior to the procedure,  and where necessary, use basic life support techniques and deal safely with clinical emergencies.  Use effective communication with the patient to determine their suitability for the procedure, paying attention to patients’ needs throughout.
  • Accurately calculate and check patient radiotherapy prescriptions and associated data.
  • Concentrate at a consistently high level in order to deliver safe and accurate radiotherapy.
  • Assess, and adapt patient setups, using images and scans acquired following local protocols.
  • Justify decisions in the planning of radiotherapy and be able to recognise clinically acceptable radiotherapy plans.
  • Correctly identify and prepare the patient appropriately for the specific procedure and select the correct equipment and a reproducible patient position for the course of treatment, including production of patient accessories.
  • Apply conflict resolution strategies appropriately.
  • Report risks and incidents, keep accurate, comprehensive and comprehensible records and other information in accordance with applicable legislation, protocols and guidelines.
  • Reflect on and learn from clinical incidents and complaints, and share learning with peers.
  • Signpost patients and their families to the patient complaint process, supporting them and colleagues during incidents and the reporting process.
  • Use spatial awareness and psychomotor skills to finely manipulate the radiotherapy equipment as well as finely manipulating the patient’s body to align anatomy with the radiation beam.
  • Adhere to any treatment setup tolerances as defined within local radiotherapy protocols.
  • Use dexterity and highly developed coordination and sensory skills to safely manoeuvre patients and equipment, taking into account any postural constraints due to limitations in equipment design.
  • Recognise verbal and non-verbal clues that indicate the patient may require emotional and psychological support.
  • Recognise that not all services are appropriate to all patients in all situations and demonstrate an ability to evaluate patients’ understanding.
  • Reflect on and recognise own emotions and feelings and seek clinical supervision to ensure support, whilst dealing with possibly distressing and difficult circumstances associated with patients undergoing their treatment.
  • Recognise the differing support needs of cancer patients who may not be cured.
  • Prioritise patients’ needs and recognise when own knowledge and skills are no longer sufficient, referring on to the wider radiotherapy support network as appropriate.
  • Recognise verbal and non-verbal clues that indicate the patient may not have understood the consent process, be unwilling to give their consent, or not be able to consent for themselves, referring on as appropriate.
  • Recognise when treatment needs to be suspended.
  • Use radiotherapy information technology and computer equipment.
  • Apply data protection and patient confidentiality in daily clinical practice and complete relevant, concise, factual, treatment documentation.

Knowledge

  • The HCPC Standards of Proficiency for a therapeutic radiographer, the Society and College of Radiographers (SCoR) Code of Professional Conduct and legislation that informs ethical frameworks and guidance.
  • Legislative and clinical governance frameworks in which radiotherapy is delivered and the political, social, and economic factors impacting on health and social care and radiotherapy service delivery.
  • Limits of own scope of practice, knowledge and skills.
  • The appropriate radiation protection for self, patients, staff, students and learners, and public, including personal protective equipment.
  • How to respect and uphold the rights, dignity, values and autonomy of radiotherapy patients their families and carer(s).
  • Communication strategies in a clinical setting in order to care for radiotherapy patients.
  • How to identify risks to patients, staff, students and learners, and public safety, and uphold data security. Report any issues that may impact on your own capacity and capability to practise as a therapeutic radiographer.
  • Employer’s processes and procedures relating to consent, confidentiality, safeguarding and use of information and the impact of culture, equality and diversity in practice.
  • How to keep own knowledge and skills up to date through Continuing Professional Development (CPD).
  • How to support students and other professionals who are actively learning radiotherapy practices.
  • How to read, interpret and accurately follow the treatment plan and associated imaging protocol.
  • The structure and function of the human body in health and disease including, anatomy and physiology, cancer pathologies and mechanism of disease.
  • The radiobiological principles on which the practice of radiotherapy is based.
  • The epidemiology, aetiology, risk factors and mechanisms of spread of cancer, and the signs, symptoms and investigations that instigate a referral to a cancer specialist.
  • Local and national clinical protocols and patient care protocols, including basic life support techniques, how to deal safely with clinical emergencies, medications and self-management strategies.
  • The impact of other cancer treatments such as surgery and chemotherapy on the planning and delivery of radiotherapy.  The impact of other factors including the radiation dose, the timing and type of radiotherapy, and post-treatment complications of radiotherapy to the patient.
  • Radiotherapy physics, radiation beam interaction and image production, including the methods for drug administration. The principles of quality control and quality assurance related to the accurate delivery and verification of high dose radiation for the treatment of cancer.
  • Radiotherapy side effects relating to the area being treated and offers patients appropriate advice and guidance to manage these side effects, referring to other professionals where necessary, following evidence-based advice where appropriate.
  • The importance of high quality checking processes in ensuring the highest standards of patient care and safety are maintained, and the radiation risks associated with ineffective or repetitive checking processes.
  • How to systematically evaluate patients’ treatment and ensure findings are used to improve patients’ experience and clinical outcomes.
  • The need for radiotherapy clinical trials and research to support the on-going development of the evidence-base for radiotherapy and the role of the therapeutic radiographer.
  • How to build and sustain professional relationships both independently and collaboratively and understand the roles of wider team members such as physicists, doctors, specialist nurses, dietitians, etc. who work with radiotherapy patients.
  • Conflict resolution strategies and when to apply them.
  • The need for prompt reporting of radiation incidents, national incident reporting systems and requirements, and what constitutes a reportable incident.
  • The requirement to maintain patient confidentiality, keep accurate patient records and manage all other information in accordance with applicable legislation, protocols and guidelines.
  • The importance of maintaining own safety and that of colleagues and patients when moving and handling patients repeatedly throughout the working day.
  • The limitations of own communication skills when communicating with patients, their families or advocates who may be dealing with life-limiting or life-altering diagnoses.  Recognise when to seek further support and advice.
  • The holistic needs of the patient whilst undergoing their radiotherapy, including how to identify patients who may require additional psychosocial support e.g. needle phobic or claustrophobic patients and how to refer them and process access to appropriate professional and support services.
  • A therapeutic radiographer’s responsibility within the interprofessional cancer support service.
  • The procedure for obtaining valid consent, the implications of not obtaining consent, suspension of treatment on the basis of changed circumstances, the patient withholding consent, and the SCoR consent guidance documentation.
  • Cybersecurity guidelines and local policies and procedures.

Behaviours

  • Act with honesty, integrity, openness, and respect at all times.
  • Act with empathy and compassion by being considerate of others’ feelings, especially when making decisions.
  • Remain calm and resilient when dealing with distressing and emotionally challenging situations, and be able to manage own emotional responses.
  • Behave respectfully and be non-judgemental by engaging with people in non-discriminatory ways.
  • Be willing to share knowledge, be self-motivated, proactive, adaptable and reliable in order to deliver the best possible patient care.
  • Be decisive and act with confidence when interacting with patients, staff and the public.
  • Practise self-awareness by understanding own emotions, limitations, strengths, weaknesses, and recognising the impact of personal interactions on others.

Entry Requirements

English and Maths qualifications

Apprentices without level 2 English and maths will need to achieve this level prior to taking the End-Point Assessment.  For those with an education, health and care plan or a legacy statement, the apprenticeship’s English and maths minimum requirement is Entry Level 3. A British Sign Language (BSL) qualification is an alternative to the English qualification for those whose primary language is BSL.

Mandatory qualification 1: BSc (Hons) Therapeutic Radiography or (where the apprentice already holds a level 6 honours degree) a pre-registration MSc in Therapeutic Radiography.

Duration

Duration (months): 36

Professional Qualifications/Recognition

Society and College of Radiographers / Level 6 and Level 7

Health and Care Professionals Council (HCPC)

Originally published on Gov.uk, this information has been re-used under the terms of the Open Government Licence.

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