A pioneering series of new patient consent forms has been launched to help standardise and strengthen the informed consent process for adult cancer patients undergoing radiotherapy.
The Royal College of Radiologists worked with a broad team of clinical oncology consultants and trainees, radiographers, nurses, patients, lawyers and risk communication experts to devise the UK’s first national standardised site-specific radiotherapy (SSR) consent forms.
Launched today (4 May) following a successful pilot, the first tranche of forms cover radiotherapy to 10 cancer sites – including breast, prostate, head and neck, oesophageal, lung (for stereotactic ablative radiotherapy and conventional fractionation regimes), rectal and skin – as well as a generic adaptable form. Consent forms for further radiotherapy sites will be released in coming months.
Radiotherapy is a common and powerful NHS cancer treatment that uses machine-generated radiation energy or particles and radioactive materials to precisely target and kill tumours. It contributes to 40% of cancer cures1 and is also used in palliative care.
The standardised forms are for recording a patient’s informed agreement to radiotherapy treatment, and relevant treatment information, after they have decided on a regime with their cancer team.
Each form clearly records a patient’s details, tumour type and location and the aim of having treatment. They list side-effects by likelihood and common frequency and include a free text section for clinicians to document specific side effects for an individual patient.
The documents have been created following demand from cancer doctors to help address variation in consent materials between cancer centres and strengthen the shared decision-making process between oncologists and patients.
An oncology community survey in 2019 found that half of UK cancer centres (54%) used their own SSR forms for prostate cancer, with others adapting generic forms3. However, the listing of specific early and late-stage side effects was highly variable across different forms from different cancers centres.
Meanwhile, the most recent National Cancer Patient Experience Survey for England found that 14% of radiotherapy patients did not feel they had all the information they needed or would like ahead of treatment.
Cancer teams are able to download the radiotherapy consent forms as amendable and printable PDFs directly from the RCR website.
The RCR has also partnered with digital consent company Concentric Health, collaborating to ensure that the project outputs are suitable for both paper and digital consent processes. Patients at hospitals using Concentric will be supported with anytime access to their personal consent information, based on the approved RCR national templates, via the supplier’s online platform.
Dr Tom Roques, the RCR’s Medical Director of Professional Practice for Clinical Oncology, said:
"As cancer clinicians we must ensure our patients are fully informed partners in the decision-making process ahead of treatment.
"The new national consent forms have been comprehensively worked up by cancer experts from across the UK, with input from lawyers.
"Each site-specific form has been designed to provide consistent and relevant information on treatment and side-effects, while being flexible enough to be tailored for individual patients. They will help make sure that all people having radiotherapy in the UK – a really vital and effective cancer treatment – are supported in their shared decision-making to a very high standard."
- Public Health England. Radiotherapy activity across England. London: Public Health England, 2017.