Extended hours working in radiotherapy in the UK

To analyse extended hours working patterns within UK cancer centres and to assess alternatives to the normal 9.00 am to 5.00 pm working day.

Questionnaires were sent to 62 radiotherapy managers in June and July 2005 to survey where extended hours working had been implemented, the objectives for using a longer working day and how departments organised their service issues, including staffing levels, costs and patients. This was followed by visits to six departments that were working extended hours. A second questionnaire sent to 60 radiotherapy physics managers in September 2005 requested information for the hours of daily, monthly and annual megavoltage machine servicing and quality assurance (QA). A third questionnaire was distributed to all radiotherapy outpatients from four departments who attended on a single day of survey in 2005. It looked at patient preference for treatment hours.

In total, 57 (92%) radiotherapy managers responded. Thirty-one departments (55%) were working extended hours, 22 (39%) had short-term experience and three (5%) departments had no experience. Increasing capacity to reduce waiting lists was the main reason for working extended hours. The additional hours were predominantly worked by radiographers, with little or no support from the other department disciplines. The servicing and QA spreadsheet was returned by 53% (n=32) of physicists. The average amount of servicing and Quality Assurance (QA) work being scheduled out of hours in each department was 35% (0-100%). The patient questionnaire was completed by 470 patients. When asked if patients would want to come to a reasonable appointment time outside of the normal working day, 29% (n=136) said 'yes' and 12% (n=55) were unsure.

It was concluded that two shifts covering an 11.5 h working day is a robust alternative to the normal working day, taking into consideration efficient use of radiographers and patient preference for out of hours appointments.