In 2005, against a background of expanding radiotherapy services and increasing demands on therapy radiographers, the UK radiotherapy managers group were concerned about vacancies and low establishments impacting on service delivery, and lack of guidance on staffing establishments. They undertook a survey and work to develop a staffing framework, also to highlight the criticality of adequate radiographer staffing to radiotherapy, both in service delivery and treatment safety. The survey, of 2004 services and staffing, aimed to see if commonality existed in establishment size related to services delivered, and whether staffing levels correlated with activity levels.

Reasonable parity in the total number of funded WTE establishment for “core” services, per centre, per planned daily Linear Accelerator (linac) hour of service was shown. The resultant staffing formula for core services is 1.33 WTE per linac hour. This includes radiographers, assistants, helpers and others contributing to the core activities. The average linac day length was 8h. The average fraction time was 11min with a range of 1.7–5.7 fractions per hour, the variations in activity rate correlating with actual staffing levels. The formula was tested in three departments and example staffing models constructed to help in operationalising the four-tier career structure.