Introduction Palliative patients account for 25% of the radiotherapy department’s workload, however, many of these patients are not end of life and may live for years with a cancer diagnosis. Historically, they had a long wait to see consultant clinical oncologists and receive radiotherapy for their symptoms (the most common of which is pain) (Jones et al., 2014).

Service improvement A service has been developed for rapid access to palliative radiotherapy for patients with bone and brain metastases, to improve the patient experience and access timely symptom control. This is a Consultant Radiographer-led service where patients can be seen, assessed for radiotherapy and consent, treatment and radiation prescriptions completed. This reduces waiting times for patients as they do not need to be seen in clinics by Consultant Oncologists. This includes an outreach service within the trust and local hospices, which ensures all patients requiring palliative radiotherapy receive timely assessment and treatment.

Aims To assess patients individually in terms of suitability for palliative radiotherapy. Promote awareness of palliative radiotherapy as a treatment option in managing metastatic cancer as a complex long term condition. Reduce length of stay and admissions. Holistic pain management – liaising with palliative care teams in the community (Farrell, Merkley, & Ingar, 2013).

Results A streamlined, direct referral process has been developed demonstrating continuity of care whilst educating staff, patients, families and carers on the use of palliative radiotherapy in the treatment of metastatic cancer. Pain is managed in a timely manner and optimised before radiotherapy treatment allowing a reduction in pain flare side effects.

Conclusion This work has highlighted the complex nature of palliative radiotherapy in the management of cancer but enables patients to access timely symptom control. Furthermore, development of a palliative MDT group including radiographers, dosimetrists and clinical oncologists is in place to assess the efficacy of the service.