A Multidisciplinary Approach The Patient Pathway A Multidisciplinary Approach

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.

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.

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

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

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

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

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

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

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

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

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.

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

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