Frontline Feature - Radiotherapy team | News

Laura Turner, Acting Radiotherapy Services Manager, talks about how her Radiotherapy team are dealing with Covid-19:

The challenge with all Oncology services during this unprecedented time is being able to continue to provide uninterrupted care to our patients, maintain business as usual, and adapt to the challenges thrown our way.

In Radiotherapy we see over 200 patients a day, predominantly outpatients.

Our patients are, by nature of their cancer diagnosis, vulnerable to Covid-19.

While many of the Trust’s outpatient functions have been able to move to telephone or video appointments, here in Radiotherapy we need our patients, radiographers and equipment in the same room.

As a radiographer and department manager, the weight of responsibility of keeping both our staff and patients as safe as possible has been huge. 

The first thing we did was to try to reduce face-to-face contact wherever possible, to minimise contact for all.

Explanatory chats and patient reviews are now done over the telephone.

The rapid installation of the Attend Anywhere software has helped with this transition, and we hope that with increased laptop access in coming days this will be able to be rolled out further.

All our patients now know to check in at reception and then wait in their cars for the phone call telling them we are ready to treat them.

Almost overnight we went from a waiting room full of patients, jigsaws, magazines and laughter, to a stark, empty room with chairs the required two metres apart.

The Oncology Division has done a great job in ensuring staff have access to good communication: giving us all the best chance of navigating through this ever-changing landscape.

Daily huddles and local email updates have been key.

There were so many questions in those first couple of weeks:

• How will we treat our patients if they are symptomatic or positive?
• If we can’t treat all patients who gets chosen and who misses out?
• How can we be telling patients to come in when the government is insisting they fully isolate at home because they are in the ‘vulnerable ‘category?
• How do we run our brachytherapy service if we have no access to anaesthetists?
• Why haven’t we got PPE?
• What about the patients with no other treatment options or if we have so many staff off sick to treat: who decides to take away their only chance of curative treatment?

With a massive amount of work the team ironed out the biggest issues:

• We have a robust pathway for treating positive patients. 
• We have support of housekeeping to provide terminal cleans after every query or positive patient.
• We now have the PHE updated recommendation of PPE provision for all staff.
• We have expedited the introduction of shortened schedules of treatments for some patients in line with national guidelines.
• We have an escalation plan in place for how to manage the patients for if (and I hope it remains if) we don’t have the capacity to keep treating them all.
• We have made sure that the governance of all decisions is documented and robust.

However, in some respects these things have been easier to deal with.

These are the practical, tangible problems that therapy radiographers have an innate flair for solving.

Much more challenging, from my perspective at least, is the paradox of life ‘outside’ and life ‘inside’ the department.

Not being on the ‘Covid frontline’ brings feelings of guilt, could we/should we be doing more?

Logically we know we can’t.

Our patients need us to keep them as safe as possible from Covid and to continue to treat their cancer.

This is our fight and that is our focus.

I cannot put into words how proud I am of the whole team here in Radiotherapy.

 Keeping the service going and bringing about the changes required to cope with the pandemic is commendable.

Thank you all.