Head and Neck

1
Head and Neck Thyroid

• Kate Goodchild
• Clinical Oncologist, MVCC
• NSSG Chair

2
Key Features of Service

• MVCN HN Network includes Bedford Hospital - So
  total pop. covered is 1.7m
• Northwick Park SMDT provides service to some West
  Herts patients.

3
Key Achievements

• Surgical services were centralised at LD in
  August 2009.
• Pathways reviewed, established and consolidated
  2011
• Histopath service at LD improved additional
  room equipment, partial site specialisation.
  Centralisation of thyroid FNA reporting
• Transfer of PET-CT to SMDT from PSSC via IEP 2012
• Improved communications with primary care with
  Mac GP in NSSG 2011.

4
Key Achievements (2)

• Survivorship
• New follow up protocol developed being piloted
• Introduction of after care service pack at Luton
  Lister
• Nutrition
• More dietetic support at MVCC
• New weekly clinic to support pts with PEG tubes
  _at_MVCC
• Patient experience
• Patient focus groups held to explore pt
  experience across the HN pathway
• Caphosol introduced into treatment clinic to help
  manage mucositis.

5
Key achievements (3)

• Thyroid
• New iodine rooms at MVCC in 2011 and introduction
  of pre-assessment clinic
• Lower dose iodine for pts with low risk thyroid
  Ca introduced following outcome of research
  trials
• Centralisation of thyroid FNA reporting

6
Head Neck Peer Review Results
2009 Result 2010 Result 2011 Result 2012 Result
Network Board N/A 76.5 (IV) 87.5 (Visit) 100 (SA)
NSSG N/A 100 (IV) 100 (Visit) 87.5 (SA)
LD (Locality) (SMDT) N/A N/A 100 (IV) 94.6 (IV) 53.2 (Visit) 22.2 (Visit) 88.9 (SA) 91.7 (SA)
7
Some Challenges

• Data collection for COSD,DAHNO
• Extending IMRT capacity to meet NRAG guidance
  (30)
• Need for more out patient clinic space at LD
• Ensuring funding for NCRN Research Nurse

8
Other Challenges

• Move to site-specialised Head and Neck Pathology
  reporting
• Increase Consultant ENT sessions at Lister and
  Luton
• Managing Radiotherapy induced skin reactions
• New relationships with SCN

9
Priorities for the Future

• HN to be next GP Education Film (if programme
  continues)
• Will target dentists as well as GPs
• Primary Care audit to be undertaken
• New protocol for management of skin reactions.
• Patient information videos (accessed via LJMC
  website) to show patients journey through
  radiotherapy ( including short term long term
  side effects) have been produced. Service user
  driven, funded by Macmillan