Introduction Vaginal vault brachytherapy (VBT) using post-operative vaginal applicator (POVA) has been a standard adjuvant treatment for endometrial cancer and reduces the risk of local recurrence. The Clatterbridge Cancer Centre (CCC) has offered VBT since the start of the service. Radiographer-led delivery of POVA was implemented to free up clinician time and improve service delivery. Historically all POVA insertions were carried out by the clinicians. More recently clinicians have performed the initial assessment and applicator placement for the first insertion and the subsequent insertions were then carried out by competent radiographers. The aim of this study was to evaluate the safety and effectiveness of radiographer-led delivery for subsequent treatments.

Methods This is a retrospective audit of endometrial cancer patients treated with VBT between 31st March 2020 and 28^th February 2023. The aim is to identify the frequency of clinician input for the subsequent treatments and identify any complications.

Results During the specified time period, 278 patients were treated with VBT amounting to a total of 724 treatments. All of the 278 planned first fractions were carried out by the clinicians and only 15 of the subsequent 446 treatments required clinician input. 431 (96.6%) treatments were carried out solely by the radiographers. There were no procedure related complications noted. Some of the reasons requiring clinician input were radiographer unavailability, anxious and tense patients requiring change in the size of applicator and vaginal bleeding requiring examination.

Conclusion/Implications Radiographer led VBT is safe, effective, frees up clinician time, improves service delivery and streamlines work force utilisation.