A new aftercare model supporting head and neck cancer patients


The Macmillan Aftercare Rehabilitation Service (MARS) team provides a one-stop patient-centred specialist service at locations close to patient homes, helping head and neck cancer (HNC) patients obtain optimal functioning post-treatment, within the limits of their disease and circumstances. Comprising dietitians, a speech and language therapist, nutrition nurses and a care support worker, MARS takes a proactive, integrated rehabilitation approach to facilitate smooth patient transfer from acute to community setting, promoting patient self-care and management of his or her condition within a supportive, local environment.


In head and neck cancer (HNC) the tumour directly affects an individual’s ability to communicate, swallow, eat and drink, and is often visible, causing significant psychological and social distress. Treatment can exacerbate these problems, with weight loss and malnutrition common. 

The stagnant five-year survival rate for HNC makes quality of life (QoL) increasingly important. Qualitative interviews demonstrate a need for support and care as treatment progresses, arguably greatest at treatment end. 

The Macmillan Aftercare and Rehabilitation Service (MARS) was developed in response to a lack of localised specialist aftercare services for HNC patients, particularly dietitians and speech and language therapists (SLT), as recommended by NICE (2004). 

MARS fulfils the domains set out in the NHS Outcomes Framework 2013/14.


The overarching aim of the MARS team was to improve the HNC patient aftercare experience, with a secondary aim of offering efficiency and cost-savings to the Cancer Centre.

The team aimed to provide HNC patients, their relatives and/or carers with accessible, specialist Allied Health Professional (AHP) services and resources through choice of location and reduced travel/hospital transportation costs. This included providing a specialist resource to support local hospital clinicians, advancing dietary progression to reduce reliance on nutritional supplements and enteral feeds, and facilitating maximum verbal/non-verbal communication ability. 

Other objectives included reducing emergency voice prothesis replacements in laryngectomy patients, cutting the number of feeding tube-related complications and auditing the service on an ongoing basis. 

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QiC Oncology Winner 2014
Supporting people through a team approach
A new aftercare model supporting head and neck cancer patients
by by The MARS Team, Royal Surrey County Hospital, Guildford


Claire Hanika

Job title:
Specialist dietitian
Place of work:
Head & Neck Oncology, Macmillan Aftercare Rehabilitation Service, Royal Surrey County Hospital


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