Performance and standards for the process of head and neck cancer care: South and West audit of head and neck cancer 1996-1997 (SWAHN I)

Evidence suggests wide Variation in cancer care between different hospitals in the UK. To establish bench-marking data, we designed a prospective, 1 y ear regional study comparing key performance measures with established stan dards for the 28 hospital Trusts in the South and West of England involved in head and neck cancer care. 566 sequential patients with a newly-diagnose d head and neck cancer were included. Numbers referred and treated per hosp ital Trust were 1-58 and 1-65 respectively. 59% of patients received a pret reatment chest X-ray (standard 95%), 45% of patients were seen in a multidi sciplinary clinic pretreatment (standard 95%), and this was proportional to the frequency of clinics held (P < 0.0001), Median number of cases treated per surgeon was 4 (1-26), and by radiotherapist was 10 (1-51), Times betwe en parts of the process of oral cancer care were closer to the standards th an those for laryngeal cancer. Two patients were entered into a clinical tr ial. One had a quality-of-life score. Thus, in 1996-1997, in the South and West of England, there were major discrepancies between actual performance and established standards in many fundamental aspects of head and neck canc er care. Re-audit is essential to determine if the implementation of the Ca lman-Hine report has resulted in improvements. (C) 2000 Cancer Research Cam paign.