Mind the gap: a national audit of radiotherapy prescription conformance and traceability

Abstract

The Board of Faculty of Clinical Oncologists and The Royal College of Radiologists published the first edition of explicit guidelines in 1996 for “the management of the unscheduled interruption or prolongation of a radical course of radiotherapy”.

The recommendations highlighted the significant detrimental effects on local tumour relapse rates in some cancer types, when the time taken to deliver a radical radiotherapy prescription is increased.

A national audit was carried out in February 2001, to establish compliance and trace ability of radiotherapy prescription delivery. The audit aimed to establish if local protocols are in place and if regular audit process took place to promote continuous improvement to treatment delivery compliance.

Sixty-four radiotherapy managers were invited to participate in the study, by completing a short questionnaire. A response rate of 74% was achieved.

The findings from the study indicated that the majority of radiotherapy centres within the United Kingdom have a protocol for the management of radiotherapy prescription compliance, where causes in non-compliance are documented. In contrast, a statistically significant number of radiotherapy department fail to monitor or evaluate causes of radiotherapy prolongation.

The author recommends, that, in order to reduce local tumour relapse rates, the use of a strategic, robust local and national audit system must be in place.

The second edition of recommendations for managing radiotherapy prolongation was published in 2002. The theme of strategic auditing remains high on the agenda.