DAHNO NEXT STEPS

1
DAHNO NEXT STEPS

• Richard Wight DAHNO Project Chair

2
Collection year 2006/7

• Key aspects for the current collection year
  October 06 October 07
• Core issues addressed in the first phase of the
  DAHNO Project are (as this year)
• Delivery of appropriate primary treatment
  (including adjuvant therapy) in the management of
  head and neck cancer affecting the larynx and
  oral cavity by a multi-professional team
• Delivery of care to agreed standards.

3
UICC 6

• The project team and Head and Neck Clinical
  Reference Group representatives now feel that the
  DAHNO audit should move to the UICC 6 TNM
  classification and as such it is proposed that
  this change occurs during the current collection
  year 1 November 2006 to 31 October 2007.
• Please look at submissions so far

4
UICC 6

• The major changes between UICC 5 and UICC 6
  relate to the classification of late tumours i.e.
  T3 (glottic) and T4 tumours (all larynx and oral
  cavity) in an attempt to more accurately predict
  outcome in these advanced tumours with T4a and
  T4b categories now available.

5
Why recording items that support risk adjustment
is important

• Future versions of this annual report will report
  outcomes by contributory provider trust and team,
  thus the importance of routine collection of
  factors that contribute to risk adjustment to
  allow true comparisons to be made
• Key items _
• Stage
• Performance status
• Comorbidity

6
BAHNO and Standards

• BAHNO council has formed a small group led by
  Professor Martin Birchall to define current
  standards for the delivery of head and neck
  cancer care.
• If accepted they will form a national set of
  standards for the delivery of head and neck
  cancer care, that will facilitate critical
  appraisal of the care pathway and provide
  information to support both local and national
  developments in this complex area of healthcare
  delivery.
• The intention of the audit for the third Annual
  Report is to compare data submissions against
  agreed standards subject to BAHNO Council
  agreeing the standards

7
Moving to Phase II

• Phase II will be introduced for the next
  collection year commencing 1st November 2007
• Training sessions will occur at the September
  workshops
• Documentation will be released ahead of the start

8
What are the core issues for Phase II

• Delivery of appropriate primary treatment
  (including adjuvant therapy) in management of
  head and neck cancer affecting the nasopharynx,
  oropharynx, hypopharynx and major salivary glands
  by a multi-professional team, and delivery of
  care to agreed standards.

9
What are the core issues for Phase II

• In larynx and oral cavity cancer to in more
  detail assess the care provided by Specialist
  nurses, dieticians and speech and language
  therapists (in particular related to surgical
  voice restoration).
• In larynx and oral cavity delivery of treatment
  to recurrent squamous carcinoma.