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Objective: This article describes the external audit measurements conducted in two UK centres implementing total skin electron beam therapy (TSEBT) and the results obtained. Methods: Measurements of output, energy, beam flatness and symmetry at a standard distance (95 or 100 cm SSD) were performed using a parallel plate chamber in solid water. Similarly, output and energy measurements were also performed at the treatment plane for single and dual fields. Clinical simulations were carried out using thermoluminescent dosemeters (TLDs) and Gafchromic® film (International Specialty Products, Wayne, NJ) on an anthropomorphic phantom. Results: Extended distance measurements confirmed that local values for the beam dosimetry at Centres A and B were within 2% for outputs and 1-mm agreement of the expected depth at which the dose is 50% of the maximum for the depth-dose curve in water (50%) value. Clinical simulation using TLDs) showed an agreement of -1.6% and -6.7% compared with the expected mean trunk dose for each centre, respectively, and a variation within 10% (±1 standard deviation) across the trunk. The film results confirmed that the delivery of the treatment technique at each audited centre complies with the European Organisation for Research and Treatment of Cancer recommendations. Conclusion: This audit methodology has proven to be a successful way to confirm the agreement of dosimetric parameters for TSEBT treatments at both audited centres and could serve as the basis for an audit template to be used by other audit groups. Advances in knowledge: TSEBT audits are not established in the UK owing to a limited number of centres carrying out the treatment technique. This article describes the audits performed at two UK centres prior to their clinical implementation. [ABSTRACT FROM AUTHOR]

Aims To determine whether the recording of diabetes-related health indicators has increased and differences diminished between age, gender and deprivation groups, following the introduction of the new General Medical Services contract (nGMS), an incentive- and target-based contract for UK family physicians. Methods A serial cross-sectional study set in 310 primary care practices in Scotland serving a population of 1.5 million registered patients, focussing on diabetic patients. Data were taken immediately before the introduction of the nGMS and after it had been in place for 1 year. Results One year after the introduction of the nGMS contract, there was a 54.2% relative increase in the number of patients electronically recorded as having diabetes. In addition, measurement of the quality indicators glycated haemoglobin (HbA1c), blood pressure, serum creatinine and cholesterol significantly increased ( P < 0.05). Women were less likely than men to have HbA1c[odds ratio (OR) 0.85, 95% confidence intervals (CI) 0.80–0.91], serum creatinine (OR 0.90, 95% CI 0.84–0.96) and cholesterol recorded (OR 0.83, 95% CI 0.77–0.90) or achieve HbA1c (≤ 10.0%; OR 0.87, 95% CI 0.82–0.91) and cholesterol targets (≤ 5.0 mmol/l; OR 0.83, 95%CI 0.77–0.90). Conclusion The introduction of the nGMS contract was associated with a rise in the recording of patients with diabetes and the recording of diabetes-related quality indicators. However, women have not benefited equally from the nGMS contract. Strategies are needed to further improve the ascertainment of quality measures and care for women with diabetes, to lessen the potential burden of morbidity amongst female patients in the community. [ABSTRACT FROM AUTHOR]