An integrated care systems model approach for speech and language therapy head and neck cancer services in England: service development and re-design in Cheshire and Merseyside

Abstract

Purpose of reviewThe incidence of head and neck cancer (HNC) is increasing globally and changes in treatment mean that patients are living longer with the condition. It is recognised that while there have been improvements at the diagnostic phase of the pathway, follow-up and on-going care can be fragmented and inequitable. Integrated care models (ICMs) are acknowledged as beneficial. The National Health Service in England is moving to a model whereby services are being re-organised to integrated care systems. This paper reviews the literature and discusses potential models of care to enhance speech and language therapy (SLT) provision for patients with HNC in line with the emerging ICS.Recent findingsThe COVID-19 pandemic has provided an opportunity to review service provision and SLT teams quickly adapted to offering remote support. Discussions are currently on-going to explore the potential for patient initiated follow-up via the PETNECK 2 trial and the Buurtzorg ‘neighbourhood model’ holds promise.SummaryICMs put the patient at the centre of care and have reported benefits for experience of care and clinical outcomes. Navigating organisational structures is complex. The Buurtzorg model provides a practical and theoretical framework to support organisational change.

Strategies for expanding patient and public involvement into under-served head and neck cancer communities

“…'Under-served' was a term identified by the National Institute for Health and Care Research (NIHR)-INCLUDE project as being appropriate to describe communities which are unintentionally less well represented than others; NIHR identify multiple reasons why communities are under-served [4]. It could be argued that in the head and neck cancer (HNC) population, many of these reasons are compounded by the complexity of living with/post-HNC: in addition to the physical burdens, people with diseases of the head and neck risk social isolation and are frequently challenged with difficult socio-economic circumstances [5].…”