Introduction: As a consequence of the development of improved treatment techniques and utilisation of digital records in radiation oncology, the RANZCR Peer Review Audit Tool has become outdated. The aim of this internal audit was to objectively evaluate the practice of our radiation oncology department to ensure that patients are being treated according to evidence‐based national guidelines through the use of a new self‐audit algorithm, the Radiation Oncology Quality Assessment Tool (ROQAT).

Methods: Using ROQAT, a retrospective audit was conducted of patients who received definitive treatment within the first six months (June 2017–November 2017) of opening a new radiation oncology department at the Sunshine Coast University Hospital. Data were collected from MOSAIQ® and electronic medical records.

Results: Two hundred and six patients were included. The median age was 65 years. Most commonly treated tumour streams included: breast (n = 62), skin (n = 31), colorectal (n = 25), genitourinary (n = 21) and head and neck (n = 21). Documentation was complete for all patients. Seventy‐four per cent of patients were discussed in a multidisciplinary team meeting. Fifty‐five per cent of patients were treated with inverse planning techniques. Treatment with radiation therapy was indicated in 97% of patients. Dose and fractionation were concordant with protocols in 83% of cases. Thirty‐nine per cent received concurrent chemotherapy, and of these, 93% were in accordance with protocols. More than 50% were treated according to published delineation protocols.

Conclusion: The ROQAT is a proposal for a new audit tool that reflects modern radiation therapy practice, with emphasis on compliance with evidence‐based guidelines.