What did you want to be when you were at school/growing up?
I regularly changed my mind but usually it was a chef or a vet. I decided that I liked animals too much to be able to deal with them being in pain to be a vet, and that being a chef wouldn’t satisfy my scientific curiosity.
Can you describe your work/what you do in 1 sentence?
Radiotherapy uses very high energy, extremely focused, X-rays to treat disease, usually cancers, and therapeutic radiographers are involved at all stages, from creating treatment plans, receiving patients arriving for treatment and verifying the treatment to be delivered is correct, to holistically supporting patients and managing treatment side effects.
In pre-treatment, where I work, we determine the optimal position and immobilisation for each patient to be treated based on what part of the body will be targeted and what the patient can do, and carry out a planning CT scan on which to create the radiotherapy treatment plan.
What qualities do you think you need to do your job well?
Attention to detail in everything you do, whether it be patient-facing clinical activities or getting the treatment ready behind the scenes.
What 3 factors make you frustrated at work?
1. The lack of recognition our profession gets. We are constantly referred to as doctors or nurses by patients, and even other healthcare professionals often do not know we exist. Many assume we are a type of diagnostic radiographer or a nurse, rather than having our own specific degree and title.
2. The lack of investment in radiotherapy. Radiotherapy is the most cost effective cancer treatment, but in conversations about cancer treatment it rarely gets a mention.
3. Healthcare professionals are their own worst enemies in facilitating each other’s professional development and making services more efficient, because different specialties tend to be protective and territorial over what they consider their domains of work.
Why would you recommend your career to a young person?
Radiotherapy is driven by technology, and in the current age of hardware and software development along with scientific discovery, there are always exciting new things to learn about and be involved in.
Therapeutic radiographers have the opportunity to build relationships with patients over a period of time, something which is rare in other professions, so not only can you help them with their treatment, you can support them through some of the hardest times in their lives.
What has been your biggest career challenge?
My biggest challenge was definitely moving to a post with increased management responsibility. I have always found it reasonably easy to learn new technical skills, whether clinical or technological, but learning how to manage people beyond just the day-to-day running of a unit was something I struggled with.
You have to constantly be aware of how anything you say or do could be interpreted by the team when you are in that position of responsibility and I definitely haven’t always got it right.
What was your best career move?
Getting off the standard linear clinical career progression to work in other roles. I spent a few years working in radiotherapy research, where I learnt how clinical trials are set up and run, and how to implement change and development within my department supported by audit.
A year working as cancer information systems lead radiographer gave me a good understanding of how we can use IT systems to assist in the smooth running of departments.
What do you enjoy most about your work?
Dealing with interesting and unusual technical challenges. In pre-treatment it is a patient's first visit to the department, so we never know exactly what we will be faced with.
I have the opportunity to use my problem-solving skills to think outside of the standard protocols and procedures to determine the best possible treatment.
What’s the best advice you’ve ever got from a patient or work colleague?
That you don’t have to be right all the time! There is a lot of pressure, especially in leadership positions, to always be able to know exactly what to do, but sometimes the best thing is to accept when you don’t know something and look wider for the answer.
If you could go back in time and give one piece of career advice to your younger self, what would it be?
Take up tangential opportunities earlier. I have met so many incredible people and had wonderful experiences in the last few years because of work I have taken on alongside my core role.
If there was one thing you could change about the environment you work in, what would it be and why?
I would love to see the role of therapeutic radiographer more integrated into the broader oncology community. We are often not involved in discussions and decision making on a patient’s treatment until the last possible moment, and that underestimation of the importance of what we do and where we fit in the care pathway can often lead to additional work or delays in patients starting their treatment.
What do you hope will be your legacy to your profession and colleagues?
That I have been able to increase peer learning and networking within my specialty in my profession. I am chair of the Society of Radiographers’ new Pre-Treatment Special Interest Group and I am hoping we will have our first annual meeting later this year.
What technological advance would have the greatest impact in your field?
The integration of MRI into radiotherapy has the potential to make a huge difference to patient care, for example, MRI scanners that can take planning images for voluming, new software solutions that can create synthetic CT scans that allow radiation dose calculations, and MR-Linacs (where MRI technology is incorporated into our treatment machines) that will allow us to see the patient's anatomy more clearly to verify our treatment is correct and to see their anatomy in real time as we treat.
What do you do to relax/de-stress?
Regular exercise definitely helps me to manage my stress levels. I used to fence, which was a very direct way of letting out any frustrations, but now general gym workouts do nearly as good a job. That and a good glass of wine!
What is your guiltiest pleasure?
I don’t really count it as a guilty pleasure, but I am a huge fan of Dungeons and Dragons. I have been running a game with friends for over four years now. Escapism is a great way to unwind!
Your most treasured possession and why?
Some of the baking equipment my grandma gave to me. I love baking and used to spend a lot of time baking with her as a child, so having the scales and cook books that I remember using when learning how to bake with her is really nice.
If you attempted to get in the Guinness Book of World Records, what would you do?
I always get told I eat too quickly, so maybe the most doughnuts eaten in a minute?
If you could change a law in some way, what would you change?
I think any law that is based on times that are no longer relevant to us should be changed. A lot of the laws around marriage and next of kin are based on times when families and relationships had to conform to norms determined by religious institutions at a time when they were integral in how the country was run – that clearly isn’t the case any more and the challenges and trauma these laws can cause for so many people shouldn’t be underestimated.
James Barber began a three-year course in therapeutic radiography at Sheffield Hallam University in 2008. After graduating in 2011, he worked as a therapeutic radiographer at Royal Derby Hospital before moving south to Cheltenham General Hospital.
In 2015 he took a post as a pre-treatment therapeutic radiographer at Guy’s and St Thomas’ NHS Foundation Trust in London, which was followed by a role in research and development at the trust in 2017 and the post of cancer information systems lead radiographer in 2019.
Since 2020, James has been pre-treatment superintendent therapeutic radiographer at the Royal Free Hospital in London. He is chair of both the LGBTQI+ Equalise Workers Group and the Radiotherapy Pre-Treatment Special Interest Group at the Society of Radiographers, and he is also a member of the UK Stereotactic Ablative Radiotherapy (SABR) Consortium Technical Advisory Group. The Consortium is working with NHS England to help facilitate expansion of SABR, which is a highly focused radiotherapy technique that aims to kill cancer cells while limiting damage to surrounding tissue.