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Advances in technology continue to revolutionise the worlds of diagnostic and therapeutic radiography. But is the NHS investing enough in resources and skills to make the most of the opportunities that new technology delivers?



Investment in new technology


Much has been made recently of NHS investment in new diagnostic and therapeutic radiography technology such as next generation Siemens CT Scanners and the state-of-the-art TrueBeam™ linear accelerator. However, while innovation in the radiography field continues at a mind-boggling rate, some health professionals have questioned whether the government is making adequate capital investment available and whether enough is being done to up-skill radiographers to prepare them for the future.

Impact on those working in radiography


Innovative technologies play a huge part in radiography jobs these days. In radiotherapy, next generation techniques such as Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) are becoming well established. In diagnostic radiography, advanced imaging is set to become the lifeblood of 'personalised medicine': the ability to determine an individual's unique molecular characteristics, using them to diagnose and treat illnesses more effectively.

Challenges of innovation


This rapid pace of innovation is exciting but also has its challenges. The bottom line is that it requires constant investment in resources and skills to ensure that valuable new assets are not only acquired in the first place, but once installed are used to their full advantage. 

"Sufficient numbers of highly trained radiotherapy staff is crucial to meeting patient demand and ensuring delivery of advanced techniques, " observed the authors of the 2014 report.Recommendations for achieving a world-class radiotherapy service in the UK, commissioned by Cancer Research UK. "Across the UK trainee retention and high attrition amongst radiography students is a cause for concern, alongside the lack of specialist staff in radiotherapy clinical oncology and palliative care."

In a lecture at the 2013 UKRC convention, Professor Audrey Patterson, The Society of Radiographers' Director of Professional Policy, suggested that personalised medicine would raise questions about "the nature of radiographer roles, the scope of practice and, most critically, provide new education and training challenges". She went on to query whether radiographers are properly prepared for the changes to come.

One shining example of NHS new technology is TrueBeam, which targets prostate, lung, head and neck cancers with much better accuracy and speed than traditional linear accelerators. NHS Supply Chain has procured 40 TrueBeam machines at a cost of around £2.5 million each. However, they have stated that, of the approximately 300 linear accelerators in NHS hospitals, as many as 100 are over 10 years old. 

Radiotherapy Innovation Fund


Much of the recent investment in new technology was enabled by the government's £23 million Radiotherapy Innovation Fund, set up in 2012. It's a real success story. However, there seems to be no clear strategy or specific funding in place to build on its success. As a result, development of some innovative treatments such as Stereotactic Ablative Body Radiotherapy (SABR) has stalled and availability has been limited.

A 2013 review by Cancer Research UK, the Royal College of Radiologists and the Society of Radiographers concluded, "NHS Trusts, with support from Government, must urgently find a solution to the current challenge in providing sufficient numbers of up-to-date linear accelerators."  The authors of the Tavistock review concurred, saying "NHS England should build on the success of the Radiotherapy Innovation Fund and continue to promote better access to advanced and innovative radiotherapy, focusing on technology and workforce skills development."

Between March 2014 and February 2015 NHS radiographers carried out 39 million imaging tests. As for radiotherapy, it's the second most effective cancer treatment next to surgery, with 40% of all patients cured of cancer having received radiotherapy as part of their treatment. As technology improves even further, so can the outcomes for patients, but only if we invest in the future of radiography and the skills of radiographers.

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