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Q&A session with Jo Watts, Swindon Radiotherapy Operational Manager

28/06/2022

Jo Watts, Swindon Radiotherapy Operational Manager talks about radiotherapy, reasons for choosing it as a career path and the new OUH Radiotherapy Centre @ Swindon.

Can you introduce yourself? I am Joanne Watts and I have been a Therapeutic Radiographer for 19 years. I am the operational manager for the OUH Radiotherapy department @ Swindon and I have lived in Swindon all my life.

 How long have you been at OUH? I have worked at OUH since 2015 and also 4 years previously.

What fuelled your passion for radiotherapy? When choosing a career, I knew I wanted to pursue a job where I could help people and make a difference. I found out about radiotherapy and gained some work experience and loved it and therefore went on to do the Radiotherapy degree course. I really enjoy all aspects of my job, getting to know the patients and ensuring that their time in the department is as positive as it can be and providing high quality care and treatment. I always treat people in the way I would want my family or friends to be treated. Being from Swindon, I feel extremely passionate about providing a radiotherapy service to the people of Swindon and the surrounding area. 

You are the radiotherapy manager for the new OUH Radiotherapy Centre @ Swindon, what does managing the centre entail? I will be working alongside my Physics and Medical colleagues to ensure the provision of a high quality and safe service. I am responsible for the overall day to day operations of the Radiotherapy Satellite and to provide leadership, clinical and technical expertise. I will work closely with OUH and GWH to provide excellent standards of care and treatment. I will also still be clinical and will work in all areas of the department so that I can maintain these skills.

What are you hoping to achieve being the manager of this new centre? I would like the department to provide high quality care and treatment to many cancer patients of Swindon and the surrounding area. I would like the patients to have a positive experience during their course of treatment. It is really important that patients receive the same high standards of care and treatment as we are providing in Oxford. Being a relatively small team of Radiographers, the patients should get consistency of care and get to know the team as well. This is one of the most rewarding parts of my job, getting to know the patients. It is also important to me that the department is a supportive place to work where the Radiographers enjoy what they are doing and can also progress in their careers

Describe a day in the life of a radiographer? All patients have their treatment individually designed and we use a specially designed CT scanner to take the images we need to do this. The pre-treatment team will advise patients about the CT procedure and treatment, check they have information about any side effects and how we can help minimise these and make sure patients are happy to proceed. They will administer contrast where we need to highlight body structures during the scan so we can visualise them really well when we design the plan. They perform CT scans for all patients that need radiotherapy. They will work out what position is best and most comfortable so patients can be in the same position every time they come for treatment. For some patients we will make individual support equipment to help with that. Once we have scanned the patient, they will usually be able to go home whilst we design and check the plan, ready for their treatment to start.

The scans are sent by the pre-treatment team into the radiotherapy planning system, and they will start to work on designing the plan. Once they have done initial preparation work the doctor will decide exactly where they want the treatment to be given and how much dose they want to give each day and for how many days. Our Physics colleagues then take over and produce a plan to meet the doctors’ specifications.

When a patients plan is ready and approved by the doctor, Radiographers ensure that all new patient plans have been input onto the treatment unit and independently checked before they start their treatment course. Once all these checks are signed off the patient will be able to start treatment.

On the first appointment the Radiographer team will advise all new patients about their radiotherapy treatment procedure, what is going to happen that day and on subsequent days. They routinely treat 35-40 patients per day with many different cancers in different parts of the body, ensuring all treatments are delivered within millimetre accuracy.

Radiographers check with patients each day when they come in for treatment that they are coping with treatment and any side effects, and they also review patients in clinic during treatment to provide information and support and sort out any supportive medication or care they might need.

We build up a rapport with our patients and enjoy our daily encounters!

For every patient who comes in for radiotherapy, how many people are involved in that process and what role does each person play?

The Consultant who decides on the correct course of treatment and refers the patient for radiotherapy.

The Scheduling Team who books the appointments and contacts the patient.

The Radiotherapy Assistant who greets the patients on arrival and who may book their reviews and their hospital transport. They may also record height and weight of the patients and do basic health checks and ensure that the Radiographers have the information needed before they scan the patients. Assistants may also put in the cannula in a patients arm before contrast is given in the scanner and they also have many administrative duties.

The Pre-Treatment Team of Radiographers will perform the CT scan and start designing the individualised plan.

The Physics Team are also on site and will carry out daily, weekly and monthly quality assurance checks on all the equipment to make sure it is functioning correctly before it is used. They plan the treatment ensuring that the dose is targeting the correct area whilst minimising the dose to healthy tissue. The physics team work very closely to provide help and support to the medical and radiographer staff to design the best plan possible for each patient throughout the whole course.

The Treatment Radiographers will input and check the plan and then confirm the patient is in the right position using image functions on the treatment machine itself before they deliver the treatment.

Review Radiographer will review patients on a regular planned basis and also as and when needed, to help manage side effects and wellbeing.  

Macmillan Information Support Worker will provide information and support about cancer services to radiotherapy patients and their friends and relatives supporting them. They will also get information for them about other local services that may be helpful to them.

Oncology Specialty Doctor will be available in the Department for any medical needs

Onsite Engineer will deal with any machine faults, breakdowns and routine services that are required.

There are also many support services from other areas including the chemotherapy team at the GWH, pharmacy, pathology, transport drivers etc.

What benefits do you think this new radiotherapy centre will provide local residents? There has been a long-standing demand from the Swindon population for a radiotherapy service. This has been very apparent in the way the local community have supported the Brighter Futures fundraising campaign, the results of which have helped significantly in us being able to open this new, well equipped department.

Currently the population of Swindon and the surrounding area must travel in excess of 45 mins to have their radiotherapy treatment in Oxford. Many patients decline radiotherapy due to the excessive travel, being too poorly to travel or due to the impact it has on their home and work life as they often need to attend daily for a period of weeks. Therefore, a local radiotherapy service will substantially improve patient access to radiotherapy treatment and therefore patient experience should improve. By having a local radiotherapy department, it ensures excessive travel is not a reason for patients declining radiotherapy. Because of the rarity of some cancers and the type of specialist treatment equipment and other support services patients need during treatment, a small number of patients will still have to travel to Oxford but the reasons for this will be explained by their consultant when they meet with them.

What feedback have you received from some of the patients you have helped through radiotherapy? We offer a feedback form to all our patients so that we can review the service that we provide and make changes in response to those comments to keep improving the service. We welcome this feedback as it gives us a different perspective on things we see and do every day and may have just ‘got used to’ We regularly receive wonderful, thankful comments as well as thank you cards and letters.

“I found the staff on the radiotherapy team at the Churchill Hospital unbelievably helpful. I was not looking forward to having radiotherapy at all but everyone in the team was so lovely and made the appointments much easier. Thank you all.”

“I cannot praise the people in this department high enough. They were totally professional and compassionate throughout. Especially during the week I had Covid”

“All of staff were considerate and friendly putting myself at ease with the treatment being administered.  The patience and consideration shown to the patients was admirable and so much appreciated”.

What job roles will be present in this new centre? We will have Therapeutic Radiographers, Physicists, an engineer, radiotherapy assistant and a Macmillan information support worker.

The new centre is an expansion of our care services to ensure people are well cared for. What does this mean for the Trust? The satellite radiotherapy service compliments other cancer services provided by the OUH Trust and GWH Trust to Swindon and Wiltshire patients. By providing a radiotherapy service within a 45 min travel time the trust are not only making it a better experience, they are making it much more accessible.

The service in OUH has been working 7 days a week for over 5 years now, one of the few UK centres operating every day of the week and we still struggle to meet the demand for treatment from our wide catchment area. Expanding our service will not only improve the experience for patients in this area it will mean we have more time for all our patients. This also achieves one of the OUH Trust core objectives ‘Closer to Home’. 

What is the most rewarding part of your job? The most rewarding part of the job is getting to know the patients and knowing that you are helping and making a difference. I always try to ensure that their time in the department is as positive as it can be. Currently being involved with the set up of the Radiotherapy service in Swindon is hugely rewarding knowing that this will mean patient travel time will decrease and access to radiotherapy will increase.

What is the most challenging part of your job? 
When setting up the radiotherapy satellite service we are faced with many challenges including the management of unexpected delays with the building, setting up additional service needs and ensuring everything is in place for the opening.