title: An audit of clinical resources available for the care of head and neck cancer patients in England.
abstract: OBJECTIVE
  Thirty-four cancer networks are now responsible for the delivery of head and neck cancer services in England. A survey of all cancer networks was carried out to define the services available for the diagnosis, treatment and support of patients with head and neck cancer.
  
  
  METHODS
  Fifty-two cancer units were identified in England from the Cancer Services Collaborative 'Improvement Partnership', and approached through a variety of methods. One questionnaire was circulated to all 34 network leads to establish the services and resources in each network. A second questionnaire was circulated to all known head and neck teams in the UK.
  
  
  RESULTS
  Multidisciplinary team (MDT) working was evident in all centres, although frequently the MDT was not fully staffed, especially in areas of national staff shortages, such as in pathology, radiology, dietetics and speech therapy. Rapid referral pathways were present for initial assessment of patients, but clinically significant delays were identified in complex investigations, access to intensive care beds and oncological care, especially radiotherapy.
  
  
  CONCLUSIONS
  Major changes in service configuration are likely to be required if the current national targets of time to diagnosis and treatment are to be met.
authors.affiliation: National Clinical Leads for Head and Neck Cancer, UK. patrick.bradley@qmcuh-tr.trent.nhs.uk
authors.forename: P J
authors.initials: PJ
authors.lastname: Bradley
authors.forename: B
authors.initials: B
authors.lastname: Zutshi
authors.forename: C M
authors.initials: CM
authors.lastname: Nutting
mesh_terms: D004739:England; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008485:Medical Audit; D010348:Patient Care Team; D011859:Radiography