# An exploration of nursing and Allied Health Professional (AHP)-led post-treatment surveillance and survivorship care for people with head and neck cancer—a scoping review

## TL;DR

This review explores how nursing and allied health professionals can support head and neck cancer survivors after treatment, finding that they can provide effective care and improve quality of life.

## Contribution

The study identifies a small but growing role for non-physician professionals in post-treatment HNC care and highlights the need for further research into new models of care.

## Key findings

- Nurse or AHP-led follow-up care can meet patient needs and improve psychosocial adjustment and quality of life.
- There is no evidence that nurse or AHP-led surveillance reduces cancer recurrence detection rates.
- Advanced practitioner-led clinics may offer enhanced care and better meet quality of life needs.

## Abstract

A scoping literature review was undertaken to identify the current evidence base on the role of nursing and allied health professionals (AHPs) in delivering surveillance and survivorship services within head and neck cancer (HNC) care following treatment.

This review was undertaken according to the Joanna Briggs Institute (JBI) guidance on the conduct of scoping reviews. An initial database search was undertaken between December 2023 and February 2024 and then repeated in November 2024. Databases included CINAHL, EMBASE, and MEDLINE. A focused grey literature search targeting other material including conference abstracts was also completed. Articles were included which were written in English. The search was not restricted to year of publication/production or methodology to ensure the greatest scope of materials. Relevant articles were reviewed, and narratives summarised.

A total of 144 articles were identified through initial database screening and subsequently 29 were eligible for full text review with 3 meeting the inclusion criteria. All 3 investigated follow-up care led by nurses or AHPs for people treated for HNC. Two of these articles described alternative models of surveillance/survivorship care. One article aimed to investigate professional’s perceptions on post-treatment disease surveillance by nurses and AHPs. Outcome measures included quantitative results on quality of life measures (QoL) and disease re-sectability and qualitative data obtained via an online survey which included free text response options. Limited results demonstrated that people were satisfied that nurse or AHP led care could meet their needs and improve psychosocial adjustment and QoL. There was no evidence to suggest the rate of cancer recurrence detection is reduced when a nurse or AHP is the lead professional involved in follow up surveillance. No articles explored the experience of people receiving this model of care in detail.

A small body of evidence suggests that nursing and AHP professionals can provide an effective and safe service of follow-up care in HNC management. Clinics led by advanced practitioners (AP) may provide an opportunity to deliver enhanced care and meet QoL needs. Within a rapidly developing and changing landscape of post-treatment surveillance nurses and AHPs are well placed to provide advice, support and interventions for treatment effects. More evidence is needed to develop new models of risk stratified nursing/AHP surveillance and the competencies required to ensure the complex holistic needs of individuals are safely and effectively met.