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The Royal Marsden

Refining roles

As cancer treatment evolves, The Royal Marsden has adapted its workforce to ensure it provides the best cancer care in the world. Here, we meet clinical staff whose new skills and roles help improve patient care

Louise Delacroix and Alexandra Gordon

Louise Delacroix and Alexandra Gordon, Urology Specialist Therapeutic Radiographers 

Urology is one of The Royal Marsden’s busiest clinical units, with more than 800 new patient referrals to the Sutton site alone each year. As a result, the Trust has introduced the Urology Specialist Therapeutic Radiographer role. 

Louise and Alexandra job-share the full-time post, running two clinics a week in the Radiotherapy Unit in Sutton. They see patients at different stages of their treatment to discuss any side effects and holistic needs. The pair also help to plan radiotherapy for prostate cancer patients, as well as running seminars so new patients can better understand the process. 

“We provide the link between radiotherapy, clinicians and specialist nurses,” says Louise, who was a radiographer for 19 years before training for the new role. “We have enjoyed developing our clinical skills to help achieve this patient-centred pathway.” 

The role has helped to reduce the workload for specialist registrars and consultants. It is supported by the Society and College of Radiographers and its career progression framework.

Nuala McLaren, Advanced Nurse Practitioner in Upper Gastrointestinal Surgery

Advanced Nurse Practitioners have been introduced in surgical teams at The Royal Marsden to enhance pre-operative and post-operative care for patients. 

Nuala is part of the Gastrointestinal Unit and supports patients with oesophageal, 
stomach, small bowel, pancreatic, and liver cancers who are undergoing surgery. She carries out physical assessments, admits and discharges patients, prescribes medications and answers any questions that a patient or their family may have. 

“I see patients in clinic and on the wards before and after their surgery, which provides continuity of care,” says Nuala, who is completing courses to make up a master’s degree in Critical Care Nursing. “I get to know our patients very well so can make clinical decisions and discharge them, reducing their stay in hospital. 

“My role allows junior doctors to get into theatres to continue their learning, and also means they can concentrate on more challenging cases.”

I can make clinical decisions and discharge patients, reducing their hospital stay

Nuala McLaren, Advanced Nurse Practitioner

Philippa Nightingale, Advanced Nurse Practitioner in Private Patient Medical Day Unit

Philippa is the first Advanced Nurse Practitioner in the busy Private Patient Medical Day Unit in Chelsea, which has 22 chairs for patients receiving cancer treatment. Philippa ensures that patients have the right dosage and are coping with any side effects. She also manages acutely unwell patients, which involves rapid assessment, ordering and interpreting investigations, and initiating treatments such as antibiotics or fluids. 

Before taking up the post, Philippa completed an MSc in Advanced Practice (Cancer Clinical Care/Decision Making) at The Royal Marsden School so she can now also prescribe medication. 

“The tasks I carry out would usually have been done by a specialist registrar,” Philippa says. “My role means that patients have continuity of care and are seen more quickly, while the specialist registrars are free to deal with more complex cases.”