Skip to main content
Planned Care Innovation Exemplars

All-Wales Patient Centred Radiotherapy Service for Advanced Cancer Symptoms – Building Capability and Capacity

Velindre Cancer Centre: Dr Mick Button Consultant Oncologist
Steve Hill, Specialist Therapeutic Radiographer

Swansea Bay University Health Board: Christine Sillman, Specialist Therapeutic Radiographer, Nikki Davies, Specialist Therapeutic Radiographer

Betsi Cadwaladr University Health Board: Rebecca Crawford, Specialist Therapeutic Radiographer, Pat Evans, Service Manager

Velindre University NHS Trust


Short courses of radiotherapy are often used to help patients with symptoms due to advanced cancer – and it can be very effective. Often it may be needed quite rapidly to help improve symptoms. It can also come with a burden to the patient and may involve multiple visits to hospital. Access can be limited due to availability of staff with the appropriate skills to make decisions with patients, plan and deliver the radiotherapy in a timely way.



  1. Involve a wide range of people in describing and understanding ways that symptom control radiotherapy can be improved.
  2. Increase our capabilities and capacity for symptom control radiotherapy in Wales through radiographer training.
  3. Improve decision making and communication skills.



Establishment of a working group involving multi-professional staff from all 3 cancer centres in Wales, with involvement (through a variety of methods/options) of a wider range of staff and patients.

Delivery of formal training to a number of radiographers to enhance their skills and improve clinical service resilience/quality.



  • Based on previous work to extend the roles of specialist therapeutic radiographers to support consultant caseloads in palliative radiotherapy planning, prescribing and consenting.
  • Three cancer centres collaborating monthly to drive advanced practitioner training, support and clinical services.
  • Collaboration with Canada and England where AP clinics are well defined and developed.
  • Development of a ‘community of practice’ focussed on palliative radiotherapy – new for Wales (strategic vision, future opportunities, practical developments)


Outcomes / Benefits:

  • 7 radiographers in AP training.
  • Weekly consultant led AP clinics in SBUHB and VCC.
  • £57/ hour cost saving if service moved to band 7 radiographer (2000 patients seen a year).
  • Patient satisfaction 9.6/10, strong focus on high quality patient care and experience.
  • Fewer hospital visits – 90% of patients seen in 2 visits.
  • Reduced carbon footprint and costs around travel.
  • 72% treated with one session as opposed to usual baseline of 42%.
  • Faster treatment – medium 2 days as opposed to 7 days.
  • High quality clinical training and career development.
  • Pan Wales Patient Centred Palliative Radiotherapy Showcase in May 2023.
  • Highlighted an important area of cancer.


What Next?

  • National MDT Community of Practice to be established more formally with other cancer partner organisations supporting.
  • Find a way to embed the operational changes.
  • Work with Advancing Radiotherapy Cymru academy to develop further opportunities.

View project posters and slides from the PCIP National Showcase Event