title: An evaluation of current services available for people diagnosed with head and neck cancer in the UK (2009-2010).
abstract: OBJECTIVE
  To evaluate current care and service provision for people with head and neck cancer in the UK.
  
  
  METHODS
  Self-report questionnaires for cancer networks, clinical leads of oncology units and leads for multidisciplinary teams (MDTs) were designed. These questionnaires were based on a previous survey. Questionnaires were sent out between 2009 and 2010.
  
  
  RESULTS
  Questionnaires were received from all networks (n = 37), most oncology units (48 of 53) and most MDTs (51 of 63). Care for people with head and neck cancer is increasingly being provided by a centralised MDT. The membership of these teams varies; facilities available for team meetings are fit for purpose in most cases. MDTs are meeting frequently (weekly meetings in 96%) and discussing on average 18 cases at each meeting (95% confidence interval 15-21 cases). Most oncologists have access to all common anti-cancer drugs and most have access to all forms of radiotherapy. Intensity-modulated radiotherapy is not yet available in some oncology units (28%). A small number of units have only one oncologist (13%). Despite audit and research being part of the rationale for MDT working, regular discussion of morbidity and mortality is unusual (40%) and use of a database to record decisions is not universal. Only seven centres record decisions into the Data for Head and Neck Oncology database. Reported recruitment to studies is generally low (<2% of cases enrolled in studies in 62%).
  
  
  CONCLUSIONS
  Head and neck cancer care is increasingly provided through a centralised MDT. Increased resources and further changes in practice are required to implement current National Health Service cancer policy. Teams need to improve recording of their decision-making, discuss morbidity and mortality and support recruitment to clinical studies.
authors.affiliation: School of Oral and Dental Sciences, University of Bristol, Bristol, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hughes
authors.forename: J
authors.initials: J
authors.lastname: Homer
authors.forename: P
authors.initials: P
authors.lastname: Bradley
authors.forename: C
authors.initials: C
authors.lastname: Nutting
authors.forename: A
authors.initials: A
authors.lastname: Ness
authors.forename: M
authors.initials: M
authors.lastname: Persson
authors.forename: M
authors.initials: M
authors.lastname: Jeffreys
authors.forename: A
authors.initials: A
authors.lastname: Waylen
authors.forename: S
authors.initials: S
authors.lastname: Leary
authors.forename: S
authors.initials: S
authors.lastname: Thomas
mesh_terms: D003657:Decision Making; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000628:therapy*; D019538:Health Care Surveys; D006801:Humans; D010818:Practice Patterns, Physicians'; D050397:Radiotherapy, Intensity-Modulated; D013222:State Medicine; D011795:Surveys and Questionnaires; D006113:United Kingdom