Beyond the Signature: Balancing Standardisation with Individual Needs in Radiotherapy Consent  

Hi, I’m Danny, a Therapeutic Radiographer and Network Manager for the North West Radiotherapy Specialised Services Clinical Network.  

The Gynae Cancer Narratives Project gave a voice to people who had experienced treatment for gynaecological cancer. People spoke openly about their realities – the uncertainty, the treatment-associated effects, and, on reflection, not fully understanding what radiotherapy would mean for their lives.  

 “I felt I was making an informed choice, sadly that wasn’t the case. So much information was lacking”. Georgina  

 Their honesty shone a light on where support, information and process could be improved – one area participants identified for focus was consent. The idea for the GRACE project was born – with an aim of supporting and improving how people make decisions about their radiotherapy for gynaecological cancer.   

The GRACE project comprises four work packages, each playing a role in informing how decisions about radiotherapy are made and supported. Work Package 1 starts with listening and making sure that the voices of those with lived experience shape the design and delivery of services. Work Package 2 dives a little deeper using interviews and focus groups, capturing the real-world, lived experiences of both patients and professionals as they navigate the consent process. Then, Work Package 3 turns those insights into action by considering what really matters to people when making treatment choices.  

I’m delighted to be part of the GRACE project team and to co-lead Work Package 4 with Dr Laura Wareing. Work Package 4 is about developing the infrastructure by bringing together insights from the other work packages and ensuring this knowledge informs policy and, ultimately, practice. It’s about making sure these important conversations around informed consent don’t just happen – but happen well, in a way that is responsive to individual needs. This work is a great fit for me, as I’m passionate about ensuring services are both evidence-based and person-centred and fits with my role as network manager which is looks to ensure compliance with the Radiotherapy Service Specification. Two aspects of the radiotherapy service specification are concerned with reducing unwarranted variation and enhancing patient experience.   

Standardisation and person-centred care can sometimes appear to be in conflict – where one emphasises consistency and protocols, the other prioritises individual preferences and flexibility – but with thoughtful design, I believe they can work hand-in-hand to support tailored, meaningful care. Standardising elements of the consent process is important. It helps ensure that patients receive clear, consistent information and that safety and quality are consistent across services. I welcome the introduction and implementation of the Royal College of Radiologists’ standardised consent forms as a valuable step toward improving clarity and consistency across the system. At the same time, it’s essential that frameworks facilitate shared decision-making. No two people come to treatment with the same values and preferences, the GRACE project aims to ensure the consent process reflects this.  

By balancing standardisation with flexibility, we will work to ensure that consent becomes both robust and  person-centred. Our goal will be to embed approaches that not only meet clinical and legal standards, but also recognise individuals’ values, concerns, and decision-making preferences – so that consent evolves into a thoughtful, tailored conversation.  

As we move forward with co-developing and testing resources, I’m excited about the potential for this work to inform policy, practice and ultimately people’s experience. If you’d like to follow our progress or explore opportunities to get involved, we’d love to hear from you.