Policies, processes, and principles of informed consent in radiotherapy for gynaecological cancers: A UK national survey

INTRODUCTION: Informed consent is a legal requirement under The Health and Social Care Act 2008 and a vital part of patient-centred care. Despite national frameworks and guidance, there is significant variability in informed consent implementation across settings. This national service evaluation aimed to assess policies, processes, and principles guiding informed consent for gynaecological radiotherapy across United Kingdom (UK) NHS departments. METHODS: A survey exploring processes and training, principles, and values was sent to 58 NHS radiotherapy departments. Data were obtained from 38 departments (66 % response rate), representing all UK nations. Ethical approval was obtained. RESULTS: Variation was observed in staff training, use of best-practice guidelines, and content of consent documentation. While 71 % of departments used Royal College of Radiologists (RCR) consent forms, fewer identified professional guidance indicating a potential gap in guideline familiarity. Documentation varied in the number and detail of side-effects described but alignment was observed in core ethical principles. Respondents highlighted structural challenges, notably time and staffing constraints, which limited processes and patient support. CONCLUSION: This is the first study to provide a national overview of informed consent policies and practices in NHS radiotherapy departments for gynaecological cancers. It identifies inconsistencies in training, documentation, and guideline awareness, but highlights shared professional values. Findings support the need for national guidance, standardised consent materials, and targeted staff education to ensure equitable and fully informed patient decision-making. IMPLICATIONS FOR PRACTICE: Informed consent should be treated as an ongoing, patient-centred process that extends beyond the clinician-patient interaction. All staff should be familiar with policies and procedures to support patients' understanding of treatment and long-term impacts. Standardised materials must be tailored to individual needs to facilitate meaningful, patient-centred discussions.