ESTRO 2024 - Abstract Book

S49

Invited Speaker

ESTRO 2024

Sophie Why

Royal Surrey Foundation Trust, Radiotherapy, Guildford, United Kingdom

Abstract:

Introduction: The 2021 census indicated 0.5% of the U.K population felt their gender did not align with the sex they were registered at birth. Although this is a small percentage of the population, within radiotherapy confirming pregnancy status with these patients is crucial. Assumptions should not be made about gender and childbearing capacity. There is a possibility transgender, non-binary and those patients with intersex characteristics could become pregnant and as such should be included in conversations regarding pregnancy when required. Following an incident, wording in IRMER guidance changed to ‘pregnancy status should be checked for individuals with childbearing capacity’. It is not always clear if a patient has the capacity to bear children, and it was deemed no longer adequate to only ask patients presenting as female to confirm the potential or possibility of pregnancy. To support this change, the Society of Radiographers (SCoR) introduced an inclusive pregnancy status form to be implemented in all radiotherapy and radiography departments. With the introduction of this form ALL patients aged between the ages of 12-55 would be asked which sex they were registered at birth and whether they had intersex characteristics in order to determine whether the pregnancy question needed to be asked. Consideration was given to the sensitive nature of the topic, and also negative press regarding this topic in other hospitals, with potential negative reactions from patients. Method: Before implementation, advice was sought from the SCoR who had led 3 pilot studies nationally. At the beginning of the implementation within the department, the change was raised at relevant multi-disciplinary meetings through the division. There was some reluctance to this change, in order to address these concerns the decision was made to launch a pilot study and review in 3 months. The aim was for the process to become standard practice within the department after the pilot period. A working party was established to ensure adequate representation throughout the department. As well as the potential impact on patients and their family / caregivers, staff would need to be confident in working with LGBTQIA+ service users, due to the terminology and questions that may be asked. Feedback was sought from staff within radiotherapy regarding the changes, and they were encouraged to share any concerns. This allowed training to be tailored to suit their needs and alleviate initial concerns and hesitancy. Staff feedback was also collected at the mid-point and conclusion of the pilot via an anonymous online survey. Posters were placed around staff areas of the department detailing the change and addressing key concerns from the feedback. Posters for patients were placed in waiting areas highlighting the rationale for the form. Patients were informed about the form at a telephone appointment prior to their CT planning scan, and it was completed when they attended in person. Anonymous patient feedback was obtained during the whole pilot period via a paper questionnaire and analysed by the governance team.

Process change and results:

Overall, the patient and staff feedback was very supportive. No patients during the pilot, or since, have refused to complete the form, and very few have required a more in-depth explanation. In the pilot, 96% of patients understood why they were asked to complete the form, and 98% felt the form was clear about the need to avoid pregnancy during radiotherapy.