Latest / Rad Chat / Bonus Episode: John Wilkinson and Adam Turner - Managed Equipment Services in the UK
Transcript
- Naman Julka-Anderson (00:00) Hello everyone and welcome to Rad Chat, founded by me, Naman Julka- Anderson. Jo McNamara Rad Chat Host (00:04) and me, Jo McNamara. So Rad Chat is a forward thinking global knowledge hub where healthcare professionals can advance their expertise in radiotherapy and oncology. Unlike traditional academic resources, we blend real world experience, expert insights, best practice, and of course, most importantly, patient perspectives. Naman Julka-Anderson (00:23) We make advanced knowledge engaging and accessible, supporting continuous learning and professional development without compromising patient care or personal time. By providing insights into both technical skills and career development, helping you progress confidently in your field and shape your professional future. Jo McNamara Rad Chat Host (00:39) Just to let you know, our episodes may contain sensitive and difficult topics that you may find distressing or triggering. Naman Julka-Anderson (00:46) So this is a special episode in paid collaboration with Ergéa. Welcome Adam, welcome John to Rad Chat, it's really good to have you here. Adam, would you want to introduce yourself to the listeners please? Adam Turner (00:56) Yeah, hi, my name is Adam Turner. I'm the head of imaging for Somerset NHS Foundation Trust. So I'm a riddle for it by background. Naman Julka-Anderson (01:02) And John. John Wilkinson (01:03) Morning, my name is John Wilkinson, I'm a diagnostic radiographer and I'm the director of transformation at Ergéa. Naman Julka-Anderson (01:09) Great to have you both here. Sounds like a really nice partnership. Adam, do you want to start by telling us a bit about a management and managed service kind of equipment, how that helps with staff recruitment and retention? Adam Turner (01:19) Yeah, sure. I suppose the easiest way to put it is well, you know, we're all radiographers here. We're kit addicts, aren't we? We want to get the best equipment and be able to work with the best equipment and the managed equipment service that we have in partnership with Ergéa, actually sort of helps us manage to stay up to date. We have a rolling replacement program, which means that when we see our kit coming to the end of its life and we don't have that worry about Do we need to replace it? Do we need to start running marathons to raise money for a new MRI scanner or anything like that? It's just already on that replacement program. So Radiographers love kit as I said, working with good kit and knowing that it's going to work just makes your whole life so much easier, doesn't it? So that really helps with the recruitment and retention for our staff. Jo McNamara (02:07) Amazing and especially with the NHS as it is at the moment I would imagine recruitment and retention is high on the agenda and know retaining good staff is really important so I would imagine having good equipment, reliable equipment, having kind of top of the range that's going to take you through for years you know this isn't equipment that you necessarily buy every single year is it Adam? So I would imagine that that's quite attractive to retain your staff. Adam Turner (02:33) It really is. think, you know, when we show people around the department and they can see this level of kit that we've got, it is beneficial. It's only a small thing, but it does, it all builds to sort of show that it's a progressive department. It's a department that, you know, if you've got a department that invests in their equipment, they're also likely to be investing in their people. And it fills it as the whole, you know, the round service, doesn't it? So you can't work a radiology department without decent kit and you can't start thinking about advancing your examinations and staying ahead of the game clinically unless when you've got old kit. So that in itself means that the radiographers are able to start thinking about how can they develop their careers clinically. They've got the tools to do that. Naman Julka-Anderson (03:22) Do you get to go to conferences, look at things and say, actually that's what I want in the future, kind of cherry picking all the good bits. Adam Turner (03:29) Yeah, well, that's one of the benefits of the managed equipment service is that the procurement process is slightly different because ⁓ it's not the NHS who are buying that kit. So we do have a little bit more latitude and a little bit of more choice about what kit we'd like. It's based upon a replacement program. So that's laid out at the sort of day one of the contracts. We know the dates that the equipment is going to be ⁓ replaced at. And it's also set at a specific level. But if our needs change, if the service needs change, we can go back to Ergéa and say, actually, we don't need that level of kit. We want something a little bit simpler so we can save a bit of money. Or as often happens, we want something a little bit more Gucci, and we'll ask them to pump a little bit more money in, and we get a slightly better bit of kit. So that's the benefit of it. It's flexible. That was always my concern when we started the contract was that everything is laid out and there's no flexibility, but there's sort of infinite flexibility. You can add bits in, remove bits if you don't need it. So it's been really, really beneficial. Jo McNamara (04:40) John, from your perspective, what actually happens behind the scenes to get a contract with someone like Adam? John Wilkinson (04:47) There are two phases I guess. There's the procurement phase which is, I enjoy that because it's really intense, it's really competitive, we're competing against other providers of managed equipment services and what we need to do is understand what the customer wants really, really quickly. So that's a really intense, exciting phase and you win or you don't win. But then once we get into contract, it's really about focusing on that long-term partnership. So the way the NHS buys equipment outside of a managed equipment service, there's no certainty that equipment will get replaced when it reaches the end of its life, but we can take a long-term proactive approach to that. And we often be planning the next replacement three years before that equipment is going into the trust. And that's really. That speaks to some of areas of expertise we have in terms of installs, estates work, building work. Taking a 10-year-old scanner out and putting a new scanner in can have massive estates implications. Modern breeds of CT scanners, for instance, have two tubes, twice as much electricity, they require water cooling, and we can bring our expertise because we do that type of install all across the country at all of our managed equipment sites. So that proactive approach to planning equipment, minimising service disruption when the equipment is being replaced is really, really important. Jo McNamara (06:10) You get to know a lot about the equipment? I'm just thinking, you know, you're dealing with lots of vendors, you're almost shopping on behalf of people. That must be quite a privileged position to be able to go, right, I've looked at your service, I know exactly the kind of equipment you need, without that person ever really knowing that it exists. John Wilkinson (06:29) It absolutely is a privilege and it's, ⁓ you know, that was brought home. I've been to our Aracene, which is the big American trade conference or radiology the last two years. We get as a vendor neutral provider, we get unprecedented access into all of the OEMs. So they take us onto their stand, but we also get to go into the sort of, you know, the research and development areas. So my role is very much the sort of horizon scanning what's coming down the line in two three years. We've got two fantastic technology leads Michelle and Kate who are the most knowledgeable people about the imaging equipment, the range of imaging equipment on the market. They can tell you the difference between a very subtle differences between the leading four ultrasound scanners so they are the absolute experts. The privilege that I felt at when I was in Chicago last year was, you know, seeing what is coming in three years time, in five years time, looking at the, particularly in the areas like AI and how that's becoming absolutely part of the imaging process. It's not something that you take an image and you fire that via packs into your AI. AI is becoming part of the imaging process yeah, it's a great position to be in and it allows, and that view of the entire market that we have is a definitely a benefit to our customers. Naman Julka-Anderson (07:48) I suppose you being at these trade shows, feeding back to people like Adam, that helps with their operational risk in the long term. John Wilkinson (07:55) Yeah, absolutely. I think it helps us build trust quickly with our customers. And I'll give you a recent example. Adam's team are just about to open a new CDC in Bridgewater. And they're doing that in partnership with us. And I think the trust we've built up in terms of knowing what's coming down the line. Adam's looking at introducing some cardiac CT in the community. And that was very much something that we picked up on two years ago through engaging with industry. So I think it's fair to say that, particularly Michelle and Kate, our two fantastic technologists are absolutely part of the team. And Adam's team reach out to them for advice on a weekly basis. Jo McNamara (08:34) I would imagine that in your role you are juggling absolutely loads of different components and how do you find kind of offsetting all of the equipment management to another team? How does that affect your day-to-day? How does it affect your capabilities of managing and also thinking about future delivery of services? Adam Turner (08:57) It's a great relief to be honest. You know, and I think I've been sort of lucky enough to have been in a position where I've helped choose kit both before the MES and when we've had the MES and also the management of Kit. And I can think it is of all the stuff we used to have to do before we had the managed equipment service. And I don't even think about that now. For me, it's a breath of fresh air. There's a single number to call if anything breaks down or we need to chase for a service or anything like that. But more importantly, I'm paid to manage and have those issues. But for the radiographers on the ground, having a single number and a single point of ⁓ contact and someone who's going to do all the heavy lifting for contacting the you know, the service teams and the engineers, all that sort of stuff. It's just hugely beneficial. I'll be honest, I think, you know, when the contract started, I think everybody in the radiology department thinks they've got a good relationship with their engineers and you sort of, know them, you know which ones are going to be good, you know which ones you can call and they'll come and sort you out. The idea of putting in the managed equipment service felt like there'd be a third wheel and actually this is going to become less efficient and we're going to become a step further away from the relationship that we have with OEM manufacturers. It's not at all. It's not at all. It's revolutionised. You know, we have, like I said, that single point, it's a lot more efficient. There's a whole customer care team who are managing. know, Dean and Rob, who manage that side of things. And I don't have an awful lot to do with it, which I think is conspicuous by its absence from my day-to-day job, to be honest. Usually if there's a breakdown that I'm really concerned about, I can drop them a little bit of a message and say, Dean, Rob, any chance you could just grease the wheels here, just keep an eye on this. This is a real critical piece of kit. They're always ahead of it. They've always got an answer because they're already, you know, all over it. So it's, it's great from our point of view, but when it comes to the kit side of things, I completely agree with John, know, Kate and Michelle do a fab job. Again, before the managed equipment service, I think when you go and choose bits of kit, you suddenly, you do a lot of research into it, don't you? And you think you become the expert. It's a bit feast and famine, your knowledge on, on bits of kit, depending on the sort of procurement cycle. These guys are doing it day in, day out, and they can really offer loads of advice and lots of top tips and that sort of industry secrets that you just don't tend to learn about. there are little secret agents out in the big wide world of procurement, be honest, the project in Bridgewater is a really good example. And as John was saying, we've used our data to try and shape what the the community diagnostic center is going to be scanning and cardiac CT at the moment is a big issue for us. The traditional way of doing that is being tethered to a radiologist and a cardiologist. If we can untether them with decent kit, means it becomes a radiographer led service. And they've helped us with that. We've got two amazing CT scanners going in there. They're going to be delivered in the next couple of weeks, I think, and it's remarkably quick which is going to mean that will be our complete solution for cardiac CT across Somerset. Not needing a radiologist, no beta blockers, no cardiologists, scan, forget, and they can report them later. So that is going to be, you know, revolutionary for our waiting list. Jo McNamara (12:25) You've partially answered my next question, because I was going to ask if there's a member of the general public listening to this going, look, they're spending more money on another process instead of potentially investing that in more equipment, more solutions. Actually, it seems like there's a lot of benefit to having that kind of team in place to help support that. Is there anything from an external general public perspective Adam that you think it's advantageous for people to consider using these kinds of systems? Adam Turner (12:57) Well, I suppose, you know, in essence, people already do, don't they? I do. I lease my car. You know, it's exactly the same thing. You know, so, and again, that's been a revolution for me. We've just started leasing a car. We've had it for, you know, a year. And I don't have to worry about anything. Everything's done for me. All I have to do is take it and replace some tires. So it's the same analogy really. So you can see that this sort of process means that as clinicians, we know I'm a radiographer, my team are radiographers, they want to do radiography activities. What they don't want to be doing is contributing to some of the procurement activities that are needed, all the servicing and spending the time. So actually it's freeing clinical teams up to be able to do what they need to be doing and doing the day job rather than being diverted to roles that they're not really experts in. Naman Julka-Anderson (13:54) What's clinician buying been like for you Adam so all the wider teams and obviously across the hospital as well. Adam Turner (14:00) I was thinking about this just before we started the podcast and I thought, what is the clinical buy? Now the clinical buy for our radiographers and radiologists is always, I need the best, I want the best. And there's always an argument about trying to go for the very top piece of kit at any possible moment. But I think there's actually, there's an unseen effect. And they talk about, don't they, know, your level of satisfaction in work. There's the sort of the negative side of things, the niggles that you need to get right so you can work. And then there's the positive side of things. What we're sorting out here is the bits of kit that don't work. You know, the things that you don't necessarily, the niggles. And those niggles don't exist with our service or with our clinicians because the kit just works. I think If you compare it to another service that perhaps doesn't have a managed equipment service or doesn't have a team who are supportive as investing in kit, then the clinicians are constantly trying to tweak their examinations, tweak their sequences, tweak their scans, trying to get the best out of kit that perhaps isn't really up to the job. We don't have that. And I think that's probably the the best way of describing how that sort of clinical engagement from certainly from the radiologist is they're always thinking about how can they make something that's already good, better, rather than how do we make something that's not great into something that's tolerable. Jo McNamara (15:27) John, from your perspective, I would imagine there's quite a bit of pressure to foresee the future of where services are actually heading. How do you actually develop that kind of spidey sense? Is it just going to conferences or is it more about looking at evidence-based research, liaising with clinicians? I'm interested to know how you can predict the future of where things are going. John Wilkinson (15:51) Yeah, I mean, I'd like to say I could predict the future, but I think that's probably a bit much. in terms of, I mean, my background, I've worked in imaging transformation now for about 15 years in industry, in consultancy and in the NHS. So, you know, I'm an imaging improvement geek. It's what I do. And I think that there's a real... I see in imaging at the moment, the things that driving transformation aren't sustainable. People are finding an AI product and they're using that as the vehicle to drive transformation. Or there's a policy change in the center and that's driving transformation. Where I think that the two things that I see that drive real imaging transformation, and I've been lucky to see this in a couple of places in my career, is strong leadership. And I think Adam's a picture of that. Strong leadership, the trust knows the direction it's going. But then alongside that strong leadership, you have to have a long-term plan. And you need to know where you're going and what direction you're moving in. And because things can change really quickly. So I've seen lots of projects which have started with a fanfare of we're going to use this AI and we're going to get this result. And that's not delivered. Whereas if you work in partnership over a long period of time, you can focus on what's important and how that changes. So for imaging managers, I'm not going to try and guess what Adam would say, but he wants high quality service, he wants good access, he wants his patients getting through the system really quickly and out to their treatment. And what we try and do is focus on that. So the equipment is very much a huge part of that. Adam can't scan if he doesn't have the kit, but we like to think in a managed service, go above and beyond that. So Adam and our team were just starting some work around developing some machine learning algorithms which will help Adam understand how patients move through his department. And I think that's sort of organic way of developing AI is the right way to do it rather than just finding a shiny thing on the shelf and saying, we'll use that. So yeah, I like to set that sort of end destination with our customers. And then, you know, I'm lucky back in. I've got a good view of the marketplace and I can see what's out there and what can help us drive that forwards. Jo McNamara (18:14) John, how do you and potentially Ergéa feel about consistency across the NHS? Because I'm thinking about AI. We've had this conversation for literally years now. And AI has always been in radiology, radiotherapy. It's part of what we do, isn't it? It's just now classified as AI. But with the developments, do you think there is a role to play for managed systems where potentially you have oversight and you're able to get consistency between NHS trusts where you may have patients moving between regions, is that something that you can kind of identify with or see that that could be a benefit in the future? John Wilkinson (18:55) Yeah, I think consistency in imaging departments is one of my hobby horses. I've done some work in a London hospital. That's a fantastic process for this part of the imaging process. And then cross the road and see really the opposite. know, sharing best practice is a hobby horse of mine in terms of imaging process think in terms of AI, we have a partnership with Newton's tree and Harris at Newton's tree has used a phrase, it's an example of a market failure. There were hundreds of algorithms, two, three years ago, but we've not really had any realisable, tangible benefits to imaging. And that's really interesting. So ⁓ we have consciously decided, my colleague, Dr. Ismail Gouchi, who's our head of digital you know, has driven a process to get us to a decision where we know that the way we're going to develop AI is with customers over the long term. And that's a really important approach, I think, because the AI market weirdly in imaging, you know, it was probably one of the hottest properties in AI, wasn't it? It was all pixel based, all, you know, you won't need to see a radiologist. We've seen consolidation of the market. But we're very clear. We're going to work with our customers to develop operational AI. Naman Julka-Anderson (20:09) How do you help departments and people like Adam navigate the privacy concerns and stuff around AI and worries around that? John Wilkinson (20:17) Well, we work with experts. So we have a partnership with Newton's Tree and we have a brilliant internal team around digital and innovation. The is set up for the right reason with a clear aim that all of the information governance protocols are in place, but not just at the start of the project. We've seen that where at the start of the project there's a lot of focus on IG and information governance, but that has drifted as the projects and AI by its nature changes over time. That's the difference between AI and a program. So we just make sure there's regular check-ins, regular governance. looking at the performance of that algorithm over time. Jo McNamara (21:02) Adam, do you think clinical practice has evolved quicker by having a management service than it would have done had you have just gone out and procured your own equipment? Adam Turner (21:11) That's a good question. I think it probably has. think, you know, clinical practice probably has, you what we have been able to do is through the freedom and flexibility of being able to choose the kit that we want. And I think, you know, most radiology departments, tend to become a certain vendor for your MR scanner or a certain vendor for your CT scanner and certainly we've sort of moved along those lines and it's not because we have a favorite and you know we've got a particular love of that kit. It's from the training point of view. If you've got you know one platform to put in another scanner next door with a completely different platform it just creates you know a lot of inequity and makes the clinical teams lives a more difficult. And I think each time you put in a new scanner, if it's the same manufacturer, but it's, you know, five years newer, it's always going to be iteratively better. So I suppose it's a bit like when you go skiing, isn't it? You know, if you go skiing for a week, you come back the next year. And you're probably at the same level as you were on Wednesday last week, because you still got to catch up a little bit and then you get better and iteratively better. And I think that's what you do with a CT scanning. You learn how to use it. And then when you get the next generation, you're already familiar with the platform. So you can just deal with the innovation. So it's all about the innovation, not the learning about the basics. So from that point of view. Yeah, I think it probably has helped with the sort of clinical innovation within the department. Jo McNamara (22:47) So that's why it took me 30 years to carve. Naman Julka-Anderson (22:50) With the CDC coming in, Adam, how are you matching the service to the main site at Musgrove? Adam Turner (22:56) Yeah, it's exactly the same as what I was talking about just then. Same kit, but better. Same manufacturers. So we just had our 3T scanner delivered this weekend. Once that's up and running, it will be plug and play because it will be a newer version, which means we'll be able to take literally a USB flash drive of our existing set of protocols, plonk it onto that scanner. And it will be like walking into the same scanner in a different hospital. that kit is going to, know, and all we need to do, so when the apps process just come along, all we need to do is focus on that innovation. We're already starting from as far as we can go with our existing kit. Well, how can we make those changes? How can we get better? And the same with the CT scanners we're putting in there. It's going to be the same kit. just... port the protocols across and then we can start thinking about how can we make it better, faster, less radiation. So it's getting better and better. Jo McNamara (24:01) So Adam, you've literally sold Ergéa and the whole process of which you've gone through. Were there any challenges at all? Were there any barriers that you faced going through implementation? Adam Turner (24:13) Yeah. Yeah. I just want to I'm not a salesman. I've never have been. I would say, I'm trying to think, are there any barriers? I think the biggest barrier that we have faced, which is actually turned into a positive, is you've got to invest heavily, really heavily in the setup of this contract. You've got to know where you're going. You need that strategy. You need the direction. need to understand because we're not trying to make a managed equipment service for today. We're trying to develop a managed equipment service for the service in 10 years. you've got to have that horizon scanning. There is some flexibility, but with that flexibility, you obviously need additional investment if you want to add bits of kit. So the best way of getting this to work is to know your service, know your demand, know where you want to put kit. You know, obviously we didn't know we were going to put a CDC in Bridgewater eight, nine years ago, but it's allowed us the flexibility to do that. But for the routine kit that's in the radiology department, it's been plain sailing. And that is a result of doing really hard graft on the planning for the service. Naman Julka-Anderson (25:28) And John, suppose from your perspective, is there anything you'd like to see be more efficient or improve in the future? John Wilkinson (25:34) I think in terms of the contract with Adam and his team that our big focus is on digital innovation going forwards and we're really looking forward to working with Adam and his team around helping them understand how patients move through the department. In terms of sort of imaging equipment generally which is my I guess that's not you know I'd like to see the NHS departments taking a longer term view about their equipment procurement. Now I work for a big MES provider. I want to be really clear that's not the only way you can take a long term view. we, I again, a privileged position that my job is to talk to people like Adam, talk to imaging managers, the length and breadth of the country, you know, and we see really good practice, people getting their equipment replaced on time. And I, you know, with an imaging manager last week, who I'm sure won't mind me using his example of his 17 year old MRI scanner, which breaks down. There's a leak in the roof above it. The chillers don't work. yeah, but that's not an advertisement for a Ergéa or for managed services per se, but I'd really like to see the NHS take a longer term view. It has been feast or famine. there's been there's been events like COVID or times when there's been available capital and the NHS have been given scanners, but quite often the NHS hasn't had time to plan for those scanners, hasn't had time to understand where to use them. Post COVID, there was something like 40 CT scanners sat in warehouses because people didn't know where to put them. So if you can take that long-term view, people like Adam completely understand their service. So why not let people like Adam take a long-term view about what that service should look like. Jo McNamara (27:17) There are real frustrations, isn't there? And I obviously speak from a radiotherapy perspective, but I absolutely know that there are loads of challenges in accessing funding when the government allocate 200 million pounds, which sounds like an extraordinary amount of money for updating service-guided radiotherapy, when actually the realities are that really isn't enough per department. Adam, do you get around some of the financial challenges of long-term planning within your department and the Trust Adam Turner (27:51) can be challenging. You're right. It can be feast and famine. I think you need to know where the opportunities lie. And having a good relationship with the regional NHS team is really helpful. But also, you need to have some plans in your back pocket ready to go. And you need to know where, if you were given some funding, where can I spend this to get the best bang for my buck? And, and there's quite often there's a bit of capital under spend. So usually where projects have started or have failed to start and they need to sort of get rid of the money. I think it's always helpful to have an idea of what you need to do. Using the team at Ergéa helps facilitate that because they will be able to come in, use the funding you've got. And they turn key the whole lot and they will move stuff and projects rapidly. mean, I'm astounded how quickly they're moving on the CDC and Bridgewater, to be honest. And I was hoping there'd be a bit of delay because we've got to sort of have some staffing, but it doesn't seem to be showing any signs of slowing up. literally just being thrown up in months. I can't wait to get in there. But yeah, so that's a great example. know, the CDC has been funded from the centre and the trust has been bold, the trust has had the ambition to do it and we've seen the need, we always knew there was a need. So it's that sort of trio of stakeholder engagement that means we can get these projects moving. Naman Julka-Anderson (29:23) John, do you and your colleagues help with business cases for people like Adam? John Wilkinson (29:27) Yeah, we worked with the trust on the business case for the Bridgewater CBC. And yeah, we have that capability within our team. think what's in that, going back to one of Adam's previous answers where he talks about the upfront cost of getting one of these sort of contracts in place, that's really important in previous role in London, my job was to write a business case for one of these big MES contracts, managed equipment service contracts. And that's, you know, it's an undertaking. It was a £175 million business case. Now, if you're building a building that's £175 million, the size of the team doing that is huge, you know, planning the building. yeah, that is the NHS investment process is completely correct. There should be oversight, should be scrutiny, we should look to ensure value for money. yeah, people shouldn't underestimate the amount of time and effort it does take to get these contracts in place. Naman Julka-Anderson (30:31) So coming to the end of the episode, we always like to end with top tips. John, do you want to go first? Anything for any potential customers or people considering MES? John Wilkinson (30:40) I think all successful projects need to be strongly led so it's letting people like Adam, know, Adam understands his service, I'm imaging service manager by trade, they understand their services so let them drive their equipment plans, take a long-term view and you know the departments I see that doing well have those two things in place, strong imaging leadership and a long-term view about their equipment plan. Naman Julka-Anderson (31:01) And Adam, any top tips for our listeners? Adam Turner (31:03) Relationship over transaction, I think is the top tip. Clearly this is a partnership, but it's based upon a contract. We rarely have to refer to the contract because the contract is a foundation for a partnership. If you're going to pick a partner to work with your service, make sure you pick a team who understand your service, understand the needs, and are going to work with you to reach the goals of your service. And it's all about the relationships. And I think if you've got two good teams in two great organizations, you're set up for success. Naman Julka-Anderson (31:40) Amazing. Thank you so much both for coming on. It's been very insightful. Thank you everyone for listening to Rad Chat with me, Naman Julka-Anderson and Jo McNamara. Thanks Adam, thanks John. John Wilkinson (31:48) Thank you. Adam Turner (31:49) Thank you. Naman Julka-Anderson (31:49) You can use this episode as part of our free, continual professional development, accredited content, which offers flexible learning that fits your busy schedule. Just check out the show notes for the reflective questions, links to literature and resources, and a link to complete the form to receive your accredited certificate. Jo McNamara Rad Chat Host (32:05) Stay up to date with the latest radiotherapy and oncology advancements by liking and following us on social media channels and hitting subscribe wherever you get your podcasts. Naman Julka-Anderson (32:15) Join a supportive community designed by professionals who understand the unique challenges of radiotherapy and oncology. Check out our website www.radchat.co.uk. Together we're actively working to improve our profession and make a lasting positive impact on cancer care. Jo McNamara Rad Chat Host (32:31) It goes without saying that we can't achieve this alone. It takes all of us working together to create real change. That's why we value every voice and every contribution. We ask that you listen and learn, spread the word, share your story and if you need to, contact us. Naman Julka-Anderson (32:47) If you like what we're doing, buy us a coffee, keep us caffeinated, go to our website to find out more. Thank you all for listening and take care.