# Feasibility and Safety of Allied Health Professional Delivered Clinics for Suspected Head and Neck Cancers: A Scoping Review

## TL;DR

This study explores the feasibility and safety of using Allied Health Professionals to perform nasoendoscopy clinics for suspected head and neck cancers, with consultant review of recorded videos.

## Contribution

The novelty lies in evaluating the use of AHPs in asynchronous clinics for head and neck cancer diagnostics, focusing on safety and efficiency.

## Key findings

- AHP-delivered clinics detected minimal cancers in low-risk patients without missing malignancies.
- Remote pathways achieved prompt diagnoses with diagnostically adequate recordings.
- ENT surgeons reported improved efficiency but emphasized the need for AHP training and governance.

## Abstract

In the UK alone, suspected head & neck cancer referrals exceed a quarter‐million, with a detected malignancy rate of around 2.6%1. This, coupled with the need for urgent assessment and treatment of cancer patients, puts an increasing strain on clinical services. Advances in technology have allowed integration of video‐endoscopy, particularly ‘store and forward’ of clinical media and patient information for deferred consultant review. Building on these, Allied Health Professional (AHP)‐delivered nasoendoscopy clinics emerged: AHPs perform endoscopy and a consultant reviews the video asynchronously. This model, in theory, preserves specialist input while helping to address current clinical pressures.

A scoping review was conducted per PRISMA‐ScR guidelines (PROSPERO 1016067). We searched MEDLINE, EMBASE, PubMed, Emcare, and CINAHL for relevant English‐language studies up to April 2025. Data on clinic setup, diagnostic outcomes, and stakeholder satisfaction were synthesized.

Five papers were included in the study. The majority (n = 3) focused on the use of Speech and Language therapists. Across four studies, patients were risk stratified into low and high‐risk groups, with low‐risk patients seen in AHP‐delivered clinics. Three studies focused on cancer diagnostic yield and review within a short time frame. Cancer detection in low‐risk cohorts was minimal, with no missed malignancies. Remote pathways achieved prompt diagnoses (mean 21 days), and the majority of recordings were diagnostically adequate. One study focused on the opinions of ENT surgeons, which was positive, reporting improved efficiency and increased focus on complex cases, but stressed the need for AHP training and robust governance.

Remote asynchronous nasoendoscopy clinics can help meet diagnostic targets and reduce consultant workload. Although robust governance is essential for safe implementation, this model remains a promising and acceptable option. Further work will fully ascertain their long‐term impact on service delivery and patient outcomes.