VICS Optimal Care Summits head and neck cancer consultation 2025

The VICS Optimal Care Summits program is holding a repeat consultation on head and neck cancer in 2025.

Working with the expert advisory group below, we began by reviewing progress in care and outcomes for Victorians affected by head and neck cancer since our first summit on this topic, in 2018. We then surveyed clinicians and other stakeholders across Victoria about barriers to and enablers of optimal care, and identified unwarranted variations in care and outcomes in Victoria.

At a live summit event on 24 October 2025, 93 multidisciplinary clinicians, consumers, and other stakeholders met to codesign actions to address priority variations.

Rapid literature review

In June 2025, the VICS completed a rapid review of current evidence on known patterns of head and neck cancer care and what strategies have been used so far to identify and address unwarranted variations within Australia. We found significant gaps in the Australian evidence base on unwarranted variations in head and neck cancer care and outcomes. Addressing these gaps is essential to inform equity-focused improvements in care and to develop targeted, data-driven quality improvement initiatives.

• Read the literature review (PDF)

Barriers, enablers and preferences survey

In early 2025, the VICS identified 140 multidisciplinary clinicians and other key stakeholders in head and neck cancer care in Victoria. We invited these stakeholders to complete an online survey, selecting perceived unwarranted variations in head and neck cancer care for their region and describing barriers, enablers, and preferences for optimal care. We received 58 responses, split nearly evenly between metropolitan and regional areas.

Persistent barriers identified included a fragmented patient journey, inequitable access to care, systemic under-resourcing, and burden of treatment. These challenges contribute to unwarranted variations in care, particularly in access to supportive care, delays in diagnosis and treatment, and patient-centred care.

Key enablers of more optimal care include improved system coordination and navigation, a well-resourced and collaborative workforce, and comprehensive and holistic support for patients. A critical strategy to reduce variations in care is strengthening referral pathways, through streamlined systems, to ensure timely and equitable access to screening and diagnostic services. To drive meaningful improvements, stakeholders highlighted a need for strategic investments in physical structures and resources, developing the multidisciplinary workforce, evolving current models of care, prioritising supportive care and survivorship services to improve patient outcomes, and using data for continuous improvement.

• Read the barriers, enablers and preferences survey report (PDF)

Patient experience data

To identify the experience and perspectives of people treated for head and neck cancer in Victoria, and their carers, we analysed data from the 2023 Victorian Cancer Patient
Experience Survey and conducted focus group discussions with 17 patients and carers between July and August 2025. Our findings support a need for clearer and
more tailored information, stronger GP and community awareness, timely diagnosis, earlier access to allied health and psychosocial services, and better coordinated approaches to survivorship and end-of-life care. While patients and carers praised specialist teams’ expertise and compassion, systemic gaps persist in communication, coordination, and support.

• Read the patient experience data report (PDF)

Unwarranted variations

In October 2025, the VICS reported how we identified, examined and prioritised unwarranted variations in head and neck cancer care and outcomes across Victoria. From August to September 2025, three online Delphi surveys were distributed to members of the expert advisory group below and to 129 other key stakeholders in head and neck cancer care across Victoria.

• Read the prioritisation report (PDF)

We identified 19 unwarranted variations, grouped by Optimal Care Pathway (OCP) steps:

OCP Step 3 – Diagnosis, staging and treatment planning

• Lower proportion of patients in the Loddon Mallee region being discussed at multidisciplinary meetings (MDMs)
• Low rates, statewide, of recording patients’ ECOG status in MDMs
• Low rates of supportive care screening, statewide
• Low rates, statewide, of communicating treatment plans to patients’ GPs

OCP Step 4 – Treatment

• Lower proportion of thyroid cancer patients in Western & Central Melbourne receiving surgery within 6 weeks of diagnosis
• Lower proportion of head & neck cancer patients in the Grampians region receiving radiotherapy or chemotherapy within 6 weeks of their diagnosis
• Lower proportion of head & neck cancer patients in the Grampians receiving adjuvant treatment within 6 weeks of their surgery
• Lower proportion of head & neck cancer patients in the Grampians receiving any treatment within 6 weeks of diagnosis
• Lower proportion of head & neck cancer patients in the Grampians receiving chemotherapy, radiotherapy or chemoradiation within 6 weeks of diagnosis
• Lower proportion of head & neck cancer patients in the Grampians receiving their first treatment (admitted systemic therapy) within 6 weeks
• Lower proportion of head &neck cancer patients in the Grampians receiving adjuvant treatment within 6 weeks of surgery
• Lower 5-year survival rate in the Gippsland region for patients with head & neck cancer
• Low proportion of head & neck cancer patients who have received surgery being seen by a speech pathologist during admission within 6 months of diagnosis
• Low proportion of head & neck cancer patients who did not receive surgery within 1 year being seen by a speech pathologist during admission within 6 months of diagnosis
• Low proportion of head and neck cancer patients who have received surgery being seen by a psychologist during admission within 6 months of diagnosis
• Low proportion of head and neck cancer patients seen by a social worker during admission within 3 months of diagnosis

OCP Step 7 – End-of-life care

• High proportion of head & neck cancer patients receiving systemic therapy within 30 days prior to death
• Low proportion of head & neck cancer patients with recorded evidence of an advance care directive
• Low proportion of head & neck cancer patients being admitted for palliative care within 12 months prior to death.

Expert advisory group

• Dr Alesha Thai (Co-chair) – Medical oncologist, Peter MacCallum Cancer Centre
• Dr David Rowe (Co-chair) – Ear, nose and throat (ENT) surgeon, Austin Health
• Dr Muhammad Alamgeer – Medical oncologist, Monash Health
• Andrea Bock – Nurse unit manager (NUM), Oncology and Day Service Unit, Mildura Base Public Hospital
• Dr Michael Borschmann – Director of Otolaryngology, Barwon Health / Visiting medical officer, St Vincent’s Hospital Melbourne
• Kat Brown – Head and Neck Clinical Nurse Consultant (CNC), Royal Melbourne Hospital
• A/Prof. Sidney Davis – Radiation Oncologist, Alfred Health
• Melissa Ford – Senior speech pathologist, Austin Health
• Dr Tsien Fua – Radiation oncologist, Peter MacCallum Cancer Centre
• Dr Gregory Gaughran – Medical oncologist, Barwon Health & Eastern Health / Cancer genomicist, Omico
• Carolyn Lasry – Dietitian, Latrobe Regional Health
• Dr Sweet Ping Ng – Radiation oncologist, Austin Health
• Catherine Pool – Cancer care coordinator, Goulburn Valley Health
• Kirsty Rowan – Senior clinical dietitian, Peter MacCallum Cancer Centre
• Mr Adnan Safdar – Head of Unit, ENT / Head & Neck Surgery, Monash Health
• Ms Ella Sexton – Senior clinical psychologist, Peter MacCallum Cancer Centre
• Dr Albert Tiong – Radiation oncologist, Peter MacCallum Cancer Centre
• Dr Johnathon Wake – Radiation oncologist, GenesisCare Albury.