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Report shows how many head and neck cancer patients receive important elements of care

July 11, 2014: Information is released today about the number of head and neck cancer patients receiving important elements of care.

The National Head and Neck Cancer Audit has examined how far England's 28 regional cancer networks are delivering the 'Ideal Patient Pathway' of care to head and neck cancer patients5.

The Ideal Patient Pathway consists of six elements of care (with a seventh included for patients undergoing surgery), which when combined indicate that the patient received holistic and integrated care across the complex care needs of their head and neck cancer. These elements of care include having a nutritional, speech and language and dental assessments, having imaging of the chest, and having the case discussed by a multi-disciplinary team6.

The findings are published today in the National Head and Neck Cancer Audit ninth Annual Report 2013, which was commissioned by the Healthcare Quality Improvement Partnership (HQIP) 2. The audit is developed in partnership with British Association of Head and Neck Oncologists (BAHNO) and managed by the Health and Social Care Information Centre (HSCIC). Data was submitted by all head and neck cancer teams in England and Wales relating to the care of 8358 patients between 1 November 2012 and 31 October 2013.

The full report is available here:


Notes to editors

  1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 220 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.
  2. The Healthcare Quality Improvement Partnership (HQIP) is led by a consortium of the Academy of Medical Royal Colleges, the Royal College of Nursing and National Voices. Its aim is to promote quality improvement, and in particular to increase the impact that clinical audit has on healthcare quality in England and Wales. HQIP holds the contract to manage and develop the National Clinical Audit Programme, comprising more than 30 clinical audits that cover care provided to people with a wide range of medical, surgical and mental health conditions. The programme is funded by NHS England, the Welsh Government and, with some individual audits, also funded by the Health Department of the Scottish Government, DHSSPS Northern Ireland and the Channel Islands.
  3. The audit analysis was performed by the HSCIC and Public Health England, South East Knowledge and Intelligence Team (SEKIT) and the Welsh Cancer Intelligence and Surveillance Unit on data extracted from the Data for Head and Neck Oncologists (DAHNO) data collection database. The data extract period includes patient records with a date of diagnosis between 1 November 2012 and 31 October 2013. Data on 8209 patients was included in the audit, with 7817 cases from England and 541 cases from Wales.
  4. The Ideal Patient Pathway consists of a variety of aspects of care, which when combined indicate that the patient received holistic and integrated care across the complex care needs of their head and neck cancer. All but the final aspect (Resective pathology discussed at MDT) are agreed national standards*:
  • Pre-treatment seen by clinical nurse specialist (CNS)
  • Pre-treatment nutritional assessment
  • Pre-treatment speech and language therapy (SALT) assessment
  • Pre-treatment dental assessment
  • Pre-treatment chest CT / CXR
  • Discussed at multidisciplinary team (MDT)
  • Resective pathology discussed at MDT - where patients have had surgery.

*The British Association of Head and Neck Oncologists, BAHNO Standards 2009

For the second time the audit has looked at its data from the perspective of individual patients. How many of the key aspects of care patients have received is published alongside the performance of cancer networks in delivering these aspects of care. The radar chart presents the percentage of patients recorded as having six aspects of care as a percentage of all the cancer patients submitted to audit, whilst a seventh aspect whether resective pathology was discussed at MDT is added for patients treated by surgery.  In an Ideal Patient Pathway each patient would receive all of the six aspects of care; this is reported as a distribution of patients recorded as receiving six or fewer aspects of the pathway.

5. It was not possible to include Wales in Ideal Patient Pathway analysis, as their national cancer information system does not record a number of the key aspects.

6. The multi-disciplinary team brings together:

  • at least three surgeons; drawn from the ENT, Oral & Maxillofacial Surgery or plastic surgery specialities,
  • two clinical oncologists;
  • histopathologist/cytopathologist;
  • radiologist;
  • clinical nurse specialist;
  • head and neck cancer ward member of nursing staff
  • speech and language therapist;
  • dietician;
  • MDT co-ordinator/secretary;

7. As part of the NHS Transition, the cancer networks have been superseded by the Strategic Clinical Networks. The cancer networks ceased to exist from the end of March 2013 but were in existence during part of the period covered by the ninth Annual Report.

8. Figures over one million have been rounded to the nearest 100,000. Figures over 100,000 have been rounded to the nearest 100. Figures over 1,000 have been rounded to the nearest 10.

9. For media enquires please call 0300 303 3888 or email

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