The researcher’s centre was in a unique position of merging with another established radiotherapy centre to create a Satellite Site. It was noted that the Satellite Site delivered more fractions per linac within the same working day profile as the Main Site. Subtle differences in the workflows allowed for an appraisal of the processes within a fraction of radiotherapy and how this can be refined to improve efficiency.

Retrospective fraction timings were collected using the Oncology Information System for 98 breast and prostate treatments at both sites. A literature review was also conducted to further explore factors that impact fraction timings in other departments internationally.

Breast and prostate treatments took 2·1 and 2·93 minutes, respectively, longer to deliver at the Main Site. Set-up to the isocentre and verification image assessment took significantly longer in all cases at the Main Site. Literature surrounding efficiency is scarce but suggests methods used for online management of verification imaging significantly impacts appointment times.

Implementation of a paperless workflow and process improvements for image assessment such as introducing a traffic light protocol may reduce the time to deliver a fraction of radiotherapy and maximise service efficiency.