Head and Neck Cancer Support Network Trust. (2024). Submission for the Optimal Cancer Care Pathway for People with Head and Neck Cancer [Review of the Draft Optimal Cancer Care Pathway for People with Head and Neck Cancer, by Te Aho O Te Kahu]. Full submission available at headandnecknetwork@gmail.com.

Comment 4:

  • Reference: Pages 16 and 17.

  • Feedback: People with head and neck cancer are deeply concerned about their experiences in attending Multidisciplinary Clinics. Patients report being presented to a group of 15-25 people in a room. The patient is seated in an examination chair and they are subjected to a range of examinations including endoscopic. Patients report this experience as degrading and traumatising. This experience is not patient-centered and does not respect the mana of the patient and their whānau.
    We suggest there is greater clarity in the Multidisciplinary Meeting and the patient clinic where the lead clinician manages the diagnoses of the patient. At present these two functions are merged and confusing.
    We see no valid reason for patients to be presented to an audience, and we strongly suggest that patient examinations be video recorded and provided for discussion at the Multidisciplinary Meeting.

  • Supporting Evidence

  • Prgomet, D., Bišof, V., Prstačić, R., Curić Radivojević, R., Brajković, L., & Šimić, I. (2022). The multidisciplinary team (MDT) in the treatment of head and neck cancer–a single-institution experience. Acta clinica Croatica, 61(Supplement 4), 77-87.

” Recommendation 4: Improved Coordination of Care through an After-Effects Clinic

  • Proposed Change: The inclusion of an After-Effects Clinic

  • Justification: Improved coordination of care and an after-effects clinic are critical steps toward enhancing the survivorship and quality of life for individuals affected by head and neck cancer. These measures address the unique challenges these patients and whānau face, fostering a holistic and comprehensive approach to care that extends beyond initial treatment.

    • Justification for Improved Coordination of Care
      Head and neck cancer treatments often involve multiple specialities, including oncologists, surgeons, radiologists, speech therapists, and dieticians. The complexity of these treatments necessitates seamless communication and collaboration among healthcare providers.
      Improved coordination of care ensures that each specialist is aware of the patient’s comprehensive treatment plan and progress, reducing the risk of conflicting interventions and enhancing the overall effectiveness of the care provided.
      Streamlined coordination also minimises the burden on patients and whānau, who might otherwise need to navigate complex healthcare systems and treatment regimens on their own. By implementing better-coordinated care pathways, healthcare providers can deliver more efficient, patient-centered care that optimises outcomes.

    • A generic contact point for all patients and whānau in Aotearoa New Zealand
      We recommend the head and neck national service has a generic email address that patients and whānau can use to access the support after treatment and as they manage after-effects. One of the biggest issues patients face is how to contact the head and neck service, and how to access it post-treatment.

    • Proposal for Regional Navigator Support

    • We strongly suggest the appointment of Navigators to provide invaluable support to head and neck cancer patients by guiding them through the complex healthcare system. Serving as a central point of contact, they coordinate appointments, treatments, and follow-ups, ensuring timely and efficient care. They offer personalised education, helping patients understand their diagnosis and treatment options, which reduces anxiety and empowers informed decision-making. Navigators provide emotional support, addressing the psychological challenges of cancer, and fostering a sense of continuity and trust in care. Their role is essential in improving patient outcomes and enhancing the overall healthcare experience.

    • Proposal for an After-Effects Clinic
      The establishment of an after-effects clinic specifically for head and neck cancer survivors is an essential component of comprehensive care. Survivors often face long-term challenges, such as difficulties with speech, swallowing, and nutrition, as well as psychosocial issues like anxiety and depression. An after-effects clinic would provide a dedicated space where survivors can access ongoing support and specialised services tailored to their unique needs. This clinic would facilitate regular follow-ups, rehabilitation services, and counselling, ensuring that patients receive holistic care that addresses both physical and emotional health. By focusing on survivorship, and developing survivorship plans the clinic would empower patients and whānau to manage patients health proactively, leading to improved outcomes and a higher quality of life.”