In recent years there has been a push to move away from traditional clinician led on treatment review of radiotherapy patients. Despite this impetus there has been little published work relating to how the new system can be implemented. This article describes how one department implemented a change in direction from the conventional and moved forward with radiographer-led review clinics. The Plan–Do–Check–Act cycle is used as a basis for evaluation with results of a small-scale patient audit and a comparison with other departments in the UK being presented. This method of implementation and evaluation proved successful and may serve as an early model for radiotherapy departments elsewhere.