DT News - UK - Head and neck cancer: Audit suggests lack of optimal patient care

Dental Tribune International

Tue. 30 July 2013

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LONDON – Only 3 in 100 head and neck cancer patients in England receive the ideal standard of care, according to the National Head and Neck Cancer Audit. The study revealed wide variations in the number of patients receiving important elements of care, but also an improvement in survival rates.

According to the audit, only 3.1 per cent of head and neck cancer patients in England receive every element of care deemed important by experts. Sara Osborne, head of policy at Cancer Research UK, said it was disappointing to see such variation.

The Ideal Patient Pathway contains seven elements of holistic and integrated care, such as nutritional, speech and language, and dental assessments, and chest scans or X-rays before surgery. It also involves the patient’s disease being discussed by a multidisciplinary team, including specialist surgeons, oncologists, speech therapists and nursing staff.

Researchers examined data submitted by all head and neck cancer teams in England and Wales relating to the care of 8,100 patients between November 2011 and October 2012. They found that the largest group of patients (24.7 per cent) received three elements of the Ideal Patient Pathway, with some aspects delivered more consistently than others were. For example, 96.4 per cent of surgical head and neck cancer patients had their case discussed by a multidisciplinary team, but only 18.8 per cent had an assessment by a speech and language therapist before surgery.

According to the audit data, there has been an improvement in survival rates among head and neck cancer patients over the last two years. The figures show that the number of patients who survived a year from their diagnosis rose from 84.4 per cent in 2010 to 87.5 per cent in 2012.

The authors cautioned against attributing this solely to improvements in the delivery of patient care, but said that it is an encouraging trend that should be explored in more detail.

“We are delighted to report again the involvement of the head and community in actively contributing to the audit, which forms a key part in promoting better care,” said the audit’s lead clinician Richard Wight. “The new focus on the Ideal Patient Pathway has been encouraged by patient representatives. This analysis supports continuing improvement and provides assurance to commissioners of head and neck cancer care.”

Dr Emma King, Cancer Research UK head and neck cancer surgeon, said: “We all must strive towards every patient receiving the ideal pathway. This data will help us identify problem areas that need to be addressed in order to achieve this.”

Cancer Research UK’s Sara Osborne added: “It’s now up to the new strategic clinical networks to provide clinical support to address any variation in care for all head and neck cancer patients wherever they are in the country.”

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