1. A Multidisciplinary Approach
The Patient Pathway
A Multidisciplinary Approach

2. Head & Neck MDT
A Multidisciplinary team (MDT )is composed of members from different professionals with specialised skills and expertise.
Members collaborate together to make treatment recommendations that facilitate patient care developing individualised treatment plans based on best practice.
Focus on the physical and psychosocial needs of the patient.

3. Multi-Disciplinary Working
Enhances Patient Care /Experience
Compliance with NICE guidelines (2005), Cancer Reform Strategy (2007), Peer Review Measures.
Offers a Holistic approach and Support for the patient and their carers from diagnosis to end of life.
Requires efficient communication and team work working towards the same goal.

4. Surgical Pathway Surgical Patient CNS/Head and Neck ENT.
Research Nurse
SALT
Dietitian
Pre- Op Assessment
Prosthetic Department
Wound Care
Medical Team/Surgeon
Nursing Staff – In Patient
Nutrition Support CNS
Physiotherapist

5. Oncology Pathway Oncology Patient Head and Neck CNS Radiographers
Research Team
Nutrition Support CNS
Oncologist/Medical team.
Dietitian
Chemotherapy Nurses/Team (Nurse Led/CDU)
SALT
Restorative Dentist
Palliative Care Team/Hospice
MARS

6. Additional Support Services/Team
Social Services
Occupational Therapist
Smoking Cessation
Alcohol Support services
Counselling/Listening/Clinical Psychologist
Macmillan CAB
District Nurses/Community Teams
Fountain Centre
Support groups

7. Multi Professional Clinic
Run by Allied Health Professionals
Head & Neck CNS
Nutrition CNS
Speech and Language Therapist
Dietitian

8. Who is it for?
For patients about to undergo chemoradiotherapy or radiotherapy who need a feeding tube
For patients 2 weeks post chemoradiotherapy/ radiotherapy
For follow up patients who require team input
6 - 8 patients per week

9. Benefits Allows patients time to absorb diagnosis & treatment plan
Opportunity for patients & family members to ask questions
Allows post treatment follow up determined by need
Team working

10. Radiographer Review
Weekly on treatment review of all RT and chemo/RT patients (inc. H&N lymphoma and skin)
Collaborative working with CNS team (joint reviews for chemo/rt pts)
A pt. support and experience role (to improve pt. experience as a whole)
Promote & empower pt. to understand symptoms & their causes & how to minimise these where possible e.g. good oral hygiene
Liaise with AHP & medical teams to ensure all aspects of treatment efficient, well explained & appropriate
Department point of contact for all H&N RT issues
Pt. point of contact for all H&N issues

11. Radiographer Review
Promotion of good clinical practice within radiotherapy H&N pathway
Introduce advance practice in a H&N setting in RT e.g. MSc. qualification, specific H&N competencies, general healthcare provision (obs. venepuncture, wound dressings)
Introduce grading and toxicity scoring systems to evaluate on treatment progress of and recommend interventions for specific side effects
Implement service improvements
e.g. polymem for wound dressing & medihoney for skin care
A hug

12. The Macmillan Aftercare and Rehabilitation Service (MARS)
Supporting people during their treatment for and recovery from head and neck cancer.
A team of Allied Health Professionals (AHPs) specialising in Head and Neck cancer (HNC), comprising: Dietitians; a Speech & Language Therapist; Nutrition Nurses; Care support worker.
Based at the Royal Surrey County Hospital, with outreach clinics at Frimley Park, East Surrey, Ashford, St Peter’s and Basingstoke Hospitals as well as at the Royal Surrey County Hospital.
Work alongside Head and Neck Consultants with close liaison with the Clinical Nurse Specialists.

13. Aims & Benefits of the MARS team
Provide a collaborative patient-centred specialist service to address the complex needs of this patient group, at a location close to the patients home in a ‘one-stop MDT shop’
Help patients achieve optimal functioning after treatment (within limits of the disease + personal situation)
Promote self-care/management in a supportive environment + enable access to resources or onward referral to other agencies
Meet national and local policies & guidelines on cancer survivorship
Ensure continuity of care from the cancer centre out to cancer units
Reduce demand for appointments at the cancer centre (RSCH)
Improve patient experience and satisfaction

14. Contact Details Kate Edwards kate.edwards4@nhs.net MARS: 01483 408 379
Winner QiC Oncology Awards:
‘Supporting people through a
team approach’!