British Association of Head and Neck Oncologists (BAHNO) standards 2020

摘要

The Association was first constituted in 1967 as the Association of Head and Neck Oncologists of Great Britain and in 1995 changed its name to the British Association of Head and Neck Oncologists (BAHNO). The stimulus for its formation remains our aim, namely the need to encourage discussion and the sharing of knowledge between the various clinical and research specialties involved in the management of the diverse group of conditions that make up head and neck cancer. Although those of us working in the field have strong links with other relevant individual medical and paramedical specialties BAHNO remains the only truly multidisciplinary professional group which can represent the interests of head and neck cancer clinicians and patients in the United Kingdom. BAHNO first published a document on the provision and quality assurance for head and neck cancer as long ago as 2002, setting standards for multidisciplinary care in so doing. In 2009, it once again contributed to the continuing improvements in the management of our patients by publishing standards for the process of head and neck cancer care that have been used both within the United Kingdom and abroad as a vehicle for change over the past decade. I am delighted that BAHNO has once again been at the forefront of clinical improvement in publishing this document which continues the theme of the association in representing the multidisciplinary nature of our work in treating head and neck cancer. I would like to thank the contributors for their tireless work and in particular Stuart C Winter and Andrew Schache for overseeing the project and bringing this publication to the light of day. Professor Cyrus Kerawala BAHNO President This standards document represents the revised and updated BAHNO Standards previously published in 2009. These Standards pertain primarily, although not exclusively, to the configuration and organisation of services tasked with the management of individuals with squamous cell carcinoma of the head and neck. Within this context, salivary and regional metastases of cutaneous squamous cell carcinoma of the head and neck are also considered. The standards have taken reference from national published guidance to inform the recommendations.1-15 The 2020 BAHNO Standards have been updated to include thyroid malignancies in keeping with the role that members of specialities aligned to BAHNO play in the overwhelming majority of these cancers. Whilst there are elements of these Standards that might similarly be applicable to units/trusts providing management of sarcomas and/or lymphoproliferative diseases, these tumour types were not specifically considered within the remit of these BAHNO Standards. ALL units/centres should have a named head and neck clinical lead responsible for the overall unit. ALL units should have a named lead responsible for co-ordinating the local provision of care. ALL individuals should be seen by a specialist head and neck nurse/clinical nurse specialist (eg Macmillan nurses in the UK) whose contact details should be made available to the patient at the earliest opportunity. ALL centres should have a list of consultants who are designated to provide head and neck cancer care. Referrals should adhere to national and local guidelines. Referrals using the UK “Two-week wait (2WW)” pathway should have sufficient detail to allow for triage into the most appropriate clinic. Referrals should contain sufficiently detailed information such that pre-referral investigations can be completed if necessary. There should be a secure image transfer system so any accessible lesions (inc. oral cavity) can be assessed. There should be an agreed pathway for a senior clinician to downgrade 2WW referrals if considered benign. Referral outside the urgent pathway, particularly by routine mail, should be discouraged. However, where unavoidable, the same information is required. The referral system should be sufficiently robust to support referral from both gen