to manage perfectly well by utilising the nationally produced resources, or do they? Whether centres develop their own information resources or whether they use information produced by one of the many national cancer charities, inconsistencies and unnecessary duplication are inevitable, and this is a problem we face frequently. This issue was also reported by Macmillan Cancer Support (MCS) in their recent report, Let’s talk about it: improving information and support for people affected by cancer12


. It highlighted gaps in information provision for topics such as chemo-radiation.


Some members of the medical and healthcare professions comment frequently on the matter of multiple producers and the resultant duplication and waste that seemingly arises13,14


. McCartney


discusses this issue and suggests the current system is "a waste of money" and says it is “stupid” to have so many differing organisations producing information on the same topics. Frustratingly, this in itself most probably contributes to inconsistencies in the quality of the resources that we provide to our patients, and is therefore potentially confusing.


An uncertain future? Furthermore, as a consequence of NHS reforms introduced by the coalition Government of 2010, which included the demise of the National Radiotherapy Implementation Group (NRIG), there has been much uncertainty regarding the future of both the IPS and IS15


. These changes have reinforced a lack


of assurance with regard to the sustainability of IPS and this, along with the IS not being universally implemented, has created concern about aspects of the future of cancer information services from the national perspective. Perhaps this uncertainty helps to fuel cancer centres’ motivation for producing their own information resources, but the consequence is to maintain the unwelcome scenario McCartney describes. The impact of the newly elected Government has yet to be felt. A recent unpublished audit has also demonstrated a wide range of radiotherapy information


resources on the same or similar topics. These results show that, out of 37 cancer information centres surveyed across England and Wales, 12 respondents confirmed they produced locally, a significant number of radiotherapy booklets for patients with cancer. Interestingly, this may highlight an apparent disparity in the confidence that healthcare professionals, based at cancer centres, have about national resources produced by MCS, as the survey showed that centres produce fewer resources about chemotherapy compared to radiotherapy. They are confident to use the MCS chemotherapy regime information sheets, but seem reluctant to use radiotherapy information contained within the tumour site-specific booklets. The reasons given for this were that these booklets were too general and not of the required detail to meet their patients’ radiotherapy information needs. Consequently, many individual cancer centres continue to produce their own tumour site-specific radiotherapy information booklets for patients. The audit results also highlighted issues around the large size of many MCS booklets and their potential to overwhelm patients. As leaders of their respective professions, several of the professional bodies have produced guidelines and some patient information resources. Examples can be found from Society and College of Radiographers16


, British Association of Dermatologists17 and Chartered Society of Physiotherapy18 . -16-


However, it is noticeable that although the Royal College of Radiologists offers a number of patient information leaflets about diagnostic investigations, there are no corresponding ones about radiotherapy. It also has to be noted that even where these resources do exist, they often do not comply with NHS guidelines and IS. Considering radiotherapy is a rapidly changing, highly technical and sophisticated treatment modality,


it is probably unsurprising that national producers have struggled to provide radiotherapy patient information resources that meet the needs of many radiotherapy centres in England and Wales. In the case of the key national cancer charities, their editorial teams comprise nurses and oncologists, so another influencing factor may be that therapeutic radiographers are rarely, if ever, represented on them. It is therefore, reasonable to assume that these teams will inherently have greater insight and understanding of chemotherapy compared to radiotherapy, and thus be more able to produce acceptable chemotherapy information sheets. Surely this needs to change in the future? One way to achieve this could be by encouraging a greater number of the local centre radiotherapy experts, ie both therapeutic radiographers and oncologists, to be involved more actively in the production of nationally produced radiotherapy resources. This could help to ensure they meet the needs of the patients and staff at these cancer centres, reducing the need for so many to be produced locally. In the last three years, the Society and College of Radiographers has been actively engaged with the key national cancer charities with this objective in mind, but it would seem this is still insufficient to ensure the radiotherapy component of nationally produced patient information resources meets the needs of patients, when attending cancer centres for radiotherapy. The recent Patient Information Forum (PiF) report1


acknowledges the specialist skills required


by information producers and the need for adherence to quality standards such as the IS. More recently, MCS12


raised concerns regarding inconsistencies in the quality of patient information


resources. The plethora of providers, and the fact that the IS is not mandatory, nor has it been widely implemented, means it is probably not achieving its full potential to assist with addressing this issue. MCS12


recommends that NHS England communicates more widely, the benefits of adopting the IS,


to encourage its use and educate patients as to the benefits of looking for IS endorsement on any information they seek for themselves. Currently, for those using the internet for their own research there may be difficulties in establishing which information is from a trustworthy source.


Where do we go from here? The current wasteful and confusing situation cannot continue. The recent political drive to empower patients and improve health outcomes is likely to continue and may well place a greater reliance on patients being able to self-manage, particularly beyond their acute phase of treatment19


. For this strategy


to be safe for patients and acceptable to clinicians, it has to be underpinned by the provision of consistent, high quality support and information for patients. Having therapeutic radiographers appropriately represented on all relevant national groups and actively contributing to the editorial process, will help to ensure that nationally produced patient information resources reflect current radiotherapy practice.


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