rehabilitation care pathway - cancerni.netcancerni.net/files/file/ahp/ncat_rehab_headandneck.pdf ·...

National Cancer Action Team

RehabilitationCare PathwayHead & Neck

Pre DiagnosisDrop Down Pathways

Anorexia & cachexiaDysphagiaFatigue & energy management

PD1 Assessment

a Assess respiratory, functional & mobility status andtreat as necessary

b Ensure optimum and timely access to specialistassessment & rehabilitation service for all patients.

PD2 Cognitive & Psychological Factors

a Assess & plan anxiety management programme inorder to provide confidence for patient &/ or carers inmanagement of condition & lifestyle

PD3 Communication

a As specific cancer symptoms emerge, undertakeswallowing & communication assessment

PD4 Information/Support

a Provide information on role & scope of specific AHPs,referral process & development of therapeuticrelationship

b Advise on AHP clinic availability for patients requiringrapid access to supportive care

PD5 Nutrition

a Assess nutritional requirements & factors affectingpotential nutritional status

b Provide practical dietary advice

c Influence organisational approach to provision of food

PD6 Referral/Liaison

a Refer to identified AHP for assessment

b Refer using generic AHP/oncology assessment toolduring assessment by medical/nursing/AHP staff doingthe screening

Rehabilitation Care Pathway Head & Neck

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Diagnosis & Care PlanningDrop Down Pathways

Anorexia & cachexiaFatigue & energy managementMobility problems/ loss of functionDysphagia

D1 Assessment

a Undertake baseline holistic care assessmentconsidering quality of life, anxiety & depression,smoking & alcohol use, lifestyle & treat as appropriate

b Integrate with pre-treatment assessment & providefollow-up clinics

c Support patient consent process

d Ensure understanding of high risk patients & co-morbidities

e Assess speech, voice and swallowing

D2 Communication

a Establish case history, current extent of disease &proposed form of treatment.

b Screen for communication difficulties

c Liaise with previous AHPs, social services, PCTcolleagues & provide AHP differential diagnosis

d Provide pre-treatment AHP clinic

e Assess current communication skills & level of cognitivefunctioning

f Ensure onward appropriate referral to colleagues &other AHPs

g Provide equipment &/ or intervention to supportcommunication

h Liaise with medical staff on proposed cancer treatmentplan

i surgical voice restoration (SVR) programme – advisesurgeon on appropriate method of rehabilitation ofcommunication

j Provide prophylactic therapy programme beforetreatment starts

k Link with other centres / teams on hand over of care

l Facilitate contact with other patients & make referralto support groups

m Provide information & ensure patient choice indecision of treatment (advocate)

D3 Exercise & Physical Well Being

a Optimise physical & respiratory fitness prior totreatment


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D4 Nutrition

a Influence organisational approach to provision of food

b Implement nutritional screening

c Assess nutritional requirements & status

d Assess factors affecting nutritional intake

e Assess patient’s circumstances & ability to act ondietetic and SLT advice

f Provide practical dietary advice, including writteninformation tailored to individual’s needs, prognosis &circumstances

g Liaise with other health professionals in the oncologyteam

h Provide ongoing monitoring & support to patient,family & carers

i Draw up & review nutritional care plans to achieveoptimal nutritional status

j Where necessary, consider alternative methods ofnutrition support & provide advice & support forhealth care professionals, patients & relatives

D5 Referral/Liaison

a Liaise with MDT on treatment planning andmanagement of primary disease

b Attend AHP led independent or combined clinic/appointment

TreatmentDrop Down Pathways

Anorexia / CachexiaBreathlessnessDysphagiaFatigue & energy managementLymphoedemaMobility problems/ loss of functionPain

Intervention

T1 Assessment

a Provide ongoing holistic assessment of function,quality of life, anxiety & depression as appropriate

b Assess respiratory status, functional status & mobilitystatus

c Assess mobility & provide treatment

d Undertake musculoskeletal assessment

e Carry out interventional assessments

f Undertake joint dietetic & speech and languagetherapy assessments

g Undertake assessment & provide rehabilitation for allpatients with emergence of symptoms/ side effectsaffecting independent functional status


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h Undertake pre-surgical assessment in clinic asappropriate

i Undertake instrumental assessments of communication& / or swallowing

j Carry out holistic communication assessment

k Undertake airway assessment

l Re assess swallow function & instigate dysphagiatherapy (see dysphagia pathway)

T2 Cognitive & Psychological Factors

a Provide techniques to help manage anxiety and mood

b Provide body image management

T3 Communication

a Re assess communication status

b Work with MDT to ascertain the cause of speech,language, swallowing or voice difficulty

c Check & analyse medical & surgical notes & decide onappropriate treatment plan

d Attend theatre & liaise with surgeons on SVRtechniques

e Support, teach & advise relatives of appropriatecommunication channels

f Provide equipment & materials and teach their use topatients and carers

g Carry out voice, speech & communication therapy

h Carry out videofluoroscopy X-ray if appropriate forinvestigation of poor voicing

i Liaise with family

j Liaise with local services

k Liaise with MDT

l Instigate the whole programme for surgical voicerestoration (SVR) and prepare for voice prosthesisfitting including selection of appropriate prosthesis &preparation of patient

m Fit voice prosthesis & teach patient, family, carers,nursing staff as appropriate about care & maintenance

n Trouble shoot re voice prosthesis management & liaisewith MDT

o Give patient appropriate oro-motor range of motion &strengthening exercises in collaboration with themedical/surgical teams

T4 Exercise & Physical Well Being

a Teach exercises for neck, shoulder, facial,temperomandibular joint & any other area affected byplastic reconstruction to ensure reduction in pain,recovery of movement & improve function


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b Advise on fibrosis pre treatment & treat if appropriatewith soft tissue massage

c Undertake musculo-skeletal assessment of neck andTMJ and treat as appropriate

d Assess/ manage range of movement – assess any othermusculoskeletal problems related to any plastic surgery

e Advise on exercise programme in conjunction with SLT

f Assess & treat facial nerve palsy

g Advise on symptom control

h Advise on support services

T5 Nutrition

a Manage rehabilitation for feeding tube dependentpatients

b Manage nutritional status

c Start/continue nutritional support (oral/ enteral/parenteral nutrition)

d Advise on specific diets

e Provide advice on weaning from enteral tube feedingto oral diet

f Provide education regarding feed tube management &the administration of feed

g Coordinate enteral feeding tube discharges & ensurereferral to community services for continued support

h Provide on-going advice on diet, texture modification& quantity of food based on treatment side effects &nutritional status

i Start/continue enteral nutritional support &management for type of feeding tube & on-goingeducation regarding care

j Liaise with home enteral feeding team for changes tofeeding regime

k Influence organisational approach to provision of food

T6 Referral/Liaison

a Refer to extended members of the team

b Screen for facial problems & refer to other AHPs forassessment & management

c Contribute to complex discharge planning as part ofMDT

d Ensure dedicated oncology specialist is made availablefor all head & neck patients

e Identify complex discharge needs & instigate dischargeplanning in liaison with MDT in Assessment Clinic

T7 Respiratory

a Carry out respiratory assessment

b Assist patient to manage respiratory function includingtracheostomy care & weaning


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c Identify patient with or without pre-existingrespiratory disease if patient is to be referred forsurgery

d Commence chest physiotherapy to suit individualrequirements

e Advise on selection, care and use of laryngectomytracheostoma valves

f Advise on selection, use & care of laryngectomy stomafilters/ heat & moisture exchangers

T8 Work, Leisure & Activities of Daily Living

a Advise, assess, treat & support as indicated to maintainpatient’s independence in all activities of daily living

b Advise on compensatory techniques especiallyfollowing major head & neck reconstructions

c Assist patient to manage lifestyle & symptoms

d Provide rehabilitation classes to help improvefunctional ability

e Respond to variations in functional status

f Maintain awareness of wider issues of cancer prognosis& the impact of treatment on self image

g Provide ongoing monitoring

Post TreatmentDrop Down Pathways

Anorexia / CachexiaDysphagiaFatigue & energy managementLymphoedemaPain

Intervention

PT1 Assessment

a Provide outreach or locality based multi-disciplinaryAHP team for ongoing monitoring & reassessment ofneeds in line with changing clinical condition/functional status at home

b Undertake ongoing respiratory assessment & managerespiratory problems including tracheostomy care &weaning

c Undertake mobility assessment & treat if appropriate

d Assess for timely removal & coordination of procedurefor removal of the feeding tube

e Provide ongoing interventional assessment &therapeutic intervention for swallowing problems &communication disorders

f Undertake joint dietetic & speech & language therapyassessments including communication status


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PT2 Cognitive & Psychological Factors

a Help provide psychological support on side effects oftreatment & refer as necessary to psychological services

PT3 Communication

a Re-assess status of Surgical Voice Restoration

b Change prosthesis when necessary and troubleshootproblems

c Undertake assessment (endoscopy) & treat anyidentified vocal cord palsy/ dysfunction

d Ensure out-patient follow up with specialist AHP

e Train & provide support to local services

f Agree protocol with family

g Carry out assessment at X-ray for voice problems withlaryngectomy patients & advise re appropriateness ofBotox injections

h Refer to self-help group

i Continue oromotor range of motion, articulation &strengthening exercises to facilitate oralcommunication

j Provide & maintain equipment and teach patients &carers appropriate use

k Refer to other health care professionals for assessmentas necessary

l Advise MDT on signs of recurrence or complications &provide appropriate advice & interventions

PT4 Exercise & Physical Well being

a Provide exercises for neck, shoulder, facial,temperomandibular joint & relevant area of plasticreconstruction to ensure reduction in pain, return ofmovement & to improve function

b Provide advice on scar management & posture

PT5 Information/Support

a Provide SLT led clinic session

PT6 Nutrition

a Continue to monitor nutritional status & managesymptoms secondary to treatment related symptoms

b Provide rehabilitation for feeding tube dependentpatients

c Provide ongoing nutritional support & symptomcontrol with weaning from enteral tube feeding tooral diet

d Monitor ongoing changes to home enteral feedingneeds & communicate with relevant individuals

e Undertake joint dietetic & speech & language therapyassessments


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PT7 Referral/Liaison

a Attend MDT & contribute to discussions re ongoingtreatment plan

b Ensure AHP representation within the MDT Clinic(acute or community based)

c Refer to outpatient physiotherapy with specificphysical problems following treatment

d Screen for facial problems & refer to AHPs forassessment & management

e AHPs to liaise with keyworker

f Refer to local support team

g Communicate with relevant professionals involved inpatient care

h Ensure joint working between AHPs & CNS forintensive rehabilitation & ongoing assessment ofquality of life, anxiety & depression as appropriate

PT8 Work, Leisure & Activities of DailyLiving

a Respond to variations in functional status

b Maintain awareness of wider issues of cancer prognosis& impact of surgery on self image

c Provide ongoing monitoring & support to maintainpatient’s independence in all activities of daily living

Monitoring & SurvivorshipDrop Down Pathways

Anorexia / CachexiaDysphagiaFatigue & energy managementLymphoedemaPainPoor Mobility and loss of function

Intervention

M1 Assessment

a Provide ongoing assessment of quality of life, anxiety& depression as appropriate

b Undertake interventional assessments

c Undertake joint dietetic & speech & language therapyassessments

M2 Cognitive and Psychological Factors

a Complete holistic initial assessment including social,psychological, functional, cognitive & perceptual areas

b Assess & plan anxiety management programme inorder to provide confidence for patient &/ or carers inmanagement of condition


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M3 Communication

a Check for signs of recurrence & deterioratingsymptoms and refer to medical / surgical teams ifconcerned

b Liaise with core MDT clinic on regular basis to reviewpatient progress

c Liaise with work environment re communication needsand aids

d Select, provide and maintain communication aids

e Liaise to provide financial support as appropriate

f Provide ongoing support to PCT colleagues

g Link with user partnership group

h Undertake re-assessment of needs on a regular basis

i Re-assess status of Surgical Voice Restoration (SVR)

j Change prosthesis when necessary and troubleshootproblems

k Carry out assessment at X-ray for voice problems withlaryngectomy patients & advise re appropriateness ofBotox injections

l Provide & maintain equipment and teach patients &carers appropriate use

m Refer to other health care professionals for assessmentas necessary

n Advise MDT on signs of recurrence or complications &provide appropriate advice & interventions

M4 Information/Support

a Encourage links to support groups

b Manage longer term effects of treatment

M5 Nutrition

a Provide rehabilitation for feeding tube dependentpatients

b Influence organisational approach to provision of food

M6 Referral/ Liaison

a Attend MDT & make recommendations on changingtreatment plan

b Support patients to re-engage in graded socialactivities

M7 Work, Leisure & Activities of DailyLiving

a Advise on maintaining role at work or re-engaging inwork place

b Support patients to re-engage in graded socialactivities

c Encourage lifestyle modifications

d Assess patients for needs such as psychological support& other support groups


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Palliative CareDrop Down Pathways

Anorexia/cachexiaBreathlessnessCommunicationDysphagiaFatigueLymphoedemaPainMobility & loss of functionSpinal cord compression

Intervention

P1 Assessment

a Carry out comprehensive social assessment

b Undertake functional assessment

c Undertake assessment of cognitive & psychologicalability

d Undertake holistic needs assessment

e Provide ongoing assessment of quality of life, anxiety& depression, psychological & social needs asappropriate

f Provide ongoing assessment and feedback to multi-disciplinary team about symptoms such as pain,breathlessness, fatigue, depression, low mood

g Agree patient centred goals

P2 Cognitive & Psychological Factors

a Assess & assist in management of anxiety & refer on toappropriate specialist

b Provide anxiety management, relaxation & structuredsleep strategies

c Manage mood through compensatory strategies &engagement in meaningful occupations

d Retrain and/or educate as necessary in order to helppatient with cognitive & perceptual dysfunction

e Identify psychological needs & provide psychologicalsupport to patients & carers

P3 Communication

a Assess communication skills and capacity to makeinformed decisions

b Assess ability to communicate/ convey needs relating topain, care, place of death & drawing up will

c Educate patient, carers and healthcare professionals onoptimal communication methods for individual patient

d Implement communication strategies to optimisecommunication function

e Trial, prescribe and train in use of communication aidsif required

Rehabilitation Care Pathway Palliative & EOL

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P4 Exercise & Physical Well Being

a Assess current function, mobility, muscle power,fatigue and general weakness

b Apply restorative or compensatory therapyinterventions where appropriate

c Advise on pacing, relaxation and controlled exercise

d Provide exercise classes to maintain/improve physicaland psychological functioning and quality of life takinginto account variations in health status

P5 Equipment Provision

a Provide aids/ equipment to support daily living & selfmanagement techniques to optimise management ofactivities of daily living

P6 Fatigue

a Assessment and intervention as appropriate withenergy conservation techniques, goal planning, pacing,diet, exercise and anxiety management

b Ensure treatable causes of fatigue are ruled out byreferral to other disciplines

P7 Information/ Support

a Ensure good communication and coordinationbetween the various care settings and professions

b Be involved in discussions on preferred priorities andplace of care

c Provide education & support to patient, family & carers

d Provide information prescription & leaflet with links tocharities & support groups

e Enable informed decision making with regards totreatment & management

f Consider ethical issues & goals of treatment to improvequality of life

P8 Mobility

a Assess mobility including function, strength, sensation,joint range, coordination and potential risks (refer tomobility and loss of function pathway)

b Stabilise/immobilise unstable areas using braces, splintsand positioning

c Help patient to optimise function & assess risk assistingwith activities for the treatment of physicaldysfunction, impaired motor, sensory & selfmaintenance skills

d Carry out wheelchair assessment & prescriptionincluding associated pressure relieving cushions

e Assess for specialist & complex seating and/ orpositioning in bed

f Carry out manual handling training & assessment

g Assess the need for and provide hoists at home


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P9 Nutrition

a Implement nutritional screening at each outpatientvisit/ inpatient admission & refer on to dietitian asappropriate

b Assess nutritional status & consider nutritionalrequirements if appropriate formulating a nutritionalcare plan for the patient

c Assess factors affecting nutritional intake & barriers tooptimising nutritional intake & quality of life

d Provide practical nutritional advice including writteninformation tailored to individuals needs, prognosis &circumstances

e Consider modified consistency diet for palliative stents

f Implement dietary adaptations to optimise nutritionrelated symptom management

g Advise on symptom management, taste changes,nausea, vomiting, mouth care etc to help improvequality of life and liaise with palliative/ medical/nursing team regarding pharmacological managementof symptoms

h Work with family on understanding of & anxiety abouteating & drinking

i Provide dietetic monitoring & follow up includingdischarge planning of enterally fed patients whereappropriate

P10 Pain Management

a Identify pain issues and apply non pharmacologicalpain management techniques (refer to pain pathway)

P11 Referral/ Liaison

a Refer on to other members of the team if appropriate

b Signpost to other supportive care services as requireddependent on need

c Liaise with multi-disciplinary team and allocate keyworker

d Issues relating to sexual function and expression shouldbe referred to the most appropriate local specialist

P12 Respiratory

a Maintain optimal respiratory function

b Provide non-pharmacological management ofbreathlessness (refer to breathlessness pathway)

P13 Skin Care

a Manage sensory impairment and tissue viability,lymphoedema and lymphorrhoea as appropriate (referto lymphoedema pathway)


P14 Swallowing

a Assess swallow function and monitor regularly forchange

b Manage any dysphagia via compensatory strategiesand/or direct intervention (refer dysphagia pathway)

P15 Work, Leisure & Activities of DailyLiving

a Discuss lifestyle adjustment including roles, loss & selfesteem

b Assess impact illness has on occupational pursuits

c Help patient to manage lifestyle includinginvestigating meaningful hobbies, leisure, occupationalpursuits and driving

d Undertake environmental and functional assessment

e Assess and support patient to carry out personal careand domestic activities

f Provide aids/ equipment to support daily living, & selfmanagement techniques to optimise independentactivities of daily living

End of LifeDrop Down Pathways

Anorexia/cachexiaBreathlessnessCommunicationDysphagiaFatigueLymphoedemaPainMobility & loss of functionSpinal cord compression

Intervention

E1 Assessment

a Carry out comprehensive social and functionalassessment

b Assess functional & cognitive ability

c Assess & assist in management of anxiety & refer on toappropriate specialist

d Undertake holistic needs assessment


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E2 Cognitive & Psychological Factors

a Identify psychological needs

b Undertake pre bereavement work with family

c Apply spiritual care taking multi-disciplinary teamapproach

d Provide ongoing psychological support with regards toadjusting to loss, deteriorating function, grief response

e Assist in management of low moods

f Apply sleep and relaxation techniques

g Apply restorative or compensatory therapyinterventions

E3 Communication

a Assess communication skills and capacity to makeinformed decisions

b Assess ability to communicate/ convey needs relating topain, care, place of death & drawing up will

c Educate patient, carers and healthcare professionals onoptimal communication methods for individual patient

d Implement communication strategies to optimisecommunication function

e Trial, prescribe and train in use of communication aidsif required

E4 Equipment Provision

a Provide mobility aids for safe moving & handling ifappropriate and manage deteriorating function

E5 Fatigue

a Assessment and intervention as appropriate withenergy conservation techniques, goal planning, pacing,diet, exercise and anxiety management (refer tofatigue care pathway)

b Ensure treatable causes of fatigue are ruled out byreferral to other disciplines

E6 Information/ Support

a Ensure good communication and coordinationbetween the various care settings and professions

b Provide education & support to carers

c Provide information prescription

d Consider sudden events, scenario planning

e Identify and help to facilitate preferred place of care(preferred place of dying) where this is home

f Attend case conferences when complex discharge isapparent

g With the MDT/key worker, identify the dying processand implement Liverpool Care Pathway ensuring thatunnecessary and invasive treatment is avoided


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E7 Mobility

a Carry out risk assessment to optimise comfort (refer tomobility and loss of function pathway)

b Prevent complications of inactivity

c Provide seating, position & manual handling advice forpatient & carers

E8 Nutrition

a Influence organisational approach to provision of food

b Assess patients nutritional status, history & recenthistory & oral intake

c Address concerns expressed by patient and their familyregarding food and fluids.

d Implement dietary adaptations to optimise nutritionrelated symptom management

e Address feeding & hydration issues with patient, carer& relatives, MDT in conjunction with palliative care/medical team

f Advise & encourage on mouth care strategies toreduce the use of artificial hydration

g Make decisions with multi-disciplinary team aroundethics for feeding & feeding withdrawal

E9 Referral/ Liaison

a Multi-disciplinary team liaison/ referral to otherspecialist professions

b Address & support symptom control & quality of lifeissues as appropriate on an individual basis inconjunction with Palliative Care MDT, carers, patients &relatives

c Ensure appropriate withdrawal of intervention inliaison with multi-disciplinary team

d Show awareness of advance of symptoms, need forfurther palliative/ surgical intervention such asparacentesis, stenting & debulking & how this furtheraffects quality of life

E10 Respiratory

a Apply breathing strategies (refer to breathlessnesspathway)

b Carry out respiratory & airway management


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E11 Skin Care

a Assess positioning & provide simplemassage/movement/comfort measures

b Identify soft tissue viability & refer on as necessary

c Assess & manage sensory changes and advise onsuitable clothing

d Manage ascites as appropriate

e Manage lymphorrhoea (refer to lymphoedemapathway)

E12 Swallowing

a Assess swallow function and monitor regularly forchange

b Manage any dysphagia via compensatory strategiesand in accordance with patients wishes (refer todysphagia pathway)

E13 Work, Leisure & Activities of DailyLiving

a Undertake environmental and functional assessment

b Manage deteriorating function

c Assess and support patient to carry out personal careand domestic activities

d Provide aids/ equipment to support daily living, & selfmanagement techniques to optimise independentactivities of daily living


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Professional intervention matrix

The rehabilitation interventions listed in the carepathways can either be carried out by a single professionor could be carried out by a number of professions. Thereis the potential for different professions to be involved indelivering some of the interventions for a number ofreasons.

• Unique skills are required which are within the scopeof a single allied health profession eg videofluoroscopyis only carried out by Speech and Language Therapists

• The intervention listed may be approached in differentways. For example P9b (Assess the factors affectingnutritional intake and barriers to optimisingnutritional intake and quality of life) could involve:

• the Dietitian focusing of nutritional intake andphysiological barriers.

• the Occupational Therapist focusing on cutlery,seating position and equipment that may helpduring feeding and

• the Physiotherapist looking at postural stability andphysical capacity

SALT – Speech and Language TherapistsOT – Occupational TherapyOther – Other professions including Clinical NurseSpecialists, Lymphoedema Practitioners


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AHP Intervention Number

Physio PD1 (a/ b)PD4 (a/ b)PD6 (a/ b)

D1 (a/ b/ c/d)D2 (a)D3 (a)D5 (a/ b)

T1 (b/ c/ d/ e/g/ h,k)T4 (a/ b/ c/ d/e/ f/ g/ h)T6 (a/ b)T7 (a/ b/ c/ d)T8 (a/ b/ c/ d/e/ f/ g)

PT1 (a/ b/ c)PT4 (a/ b)PT7 (a/ b/ c/ d/e/ f/ g/ h)PT8 (a/ b / c)

M1 (a/ b)M4 (a/ b)M6 (a)M7 (c/ d)

P1 (a/ b/ c/ d/ e/ f/ g)P2 (a/ e)P4 (a/ b/ c/ d)P5 (a)P6 (a/ b)P7 (a/ b/ c/ d/ e/ f)P8 (a/ b/ c/ d/ e/ f/ g)P10 (a)P11 (a/ b/ c/ d)P12 (a/ b)P13 (a)P15 (d/ e/ f)

E1 (a/ b/ c/ d)E2 (a/ b/ c/ d/ e/ f)E3 (a/ b/ c/ d)E4 (a)E5 (a/ b)E6 (a/ b/ c/ d/ e/ f/ g)E7 (a/ b)E9 (a/ b/ c/ d)E10 (a/ b)E11 (a/ b)E13 (b/ d)

OT PD1 (a/ b)PD2 (a)PD4 (a/ b)PD6 (a/ b)

D1 (a/ b/ c/d)D5 (a/ b)

T1 (a/ c/ e/ g/h)T2 (a/ b)T5 (a)T6 (a/ c/ d/ e)T8 (a/ b/ c/ d/e/ f/ g)

PT1 (a/ c)PT2 (a)PT7 (a/ b/ e/ f/g)PT8 (a/ b/ c)

M1 (a/ b)M2 (a/ b)M4 (a/ b)M6 (a)M7 (a/ b/c/ d)

P1 (a/ b/ c/ d/ e/ f/ g)P2 (a/ b/ c/ d/ e)P3 (a)P4 (a/ b/ c/ d)P5 (a)P6 (a/ b)P7 (a/ b/ c/ d/ e/ f)P8 (a/ b/ c/ d/ e/ f/ g)P9 (a/ b/ c/ h)P10 (a)P11 (a/ b/ c/ d)P12 (b)P13 (a)P15 (a/ b/ c/ d/ e/ f)

E1 (a/ b/ c/ d)E2 (a/ b/ c/ d/ e/ f/ g)E3 (a/ b/ c/ d/ e)E4 (a)E5 (a/ b)E6 (a/ b/ c/ d/ e/ f/ g)E7 (a/ b/ c)E8 (c/ e)E9 (a/ b/ c/ d)E11 (a/ b/ c/ d)E13 (a/ b/ c/ d)


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AHP Intervention Number

Dietetic PD1 (b)PD4 (a/ b)PD5 (a/ b/c)PD6 (a/ b)

D1 (a/ b/ c/d)D4 (a/ b/ c/d/ e/ f/ g/h/ i/ j)D5 (a/ b)

T1 (e/ f/ h)T5 (a/ b/ c/ d/e/ f/ g/ h/ i/ j/k)T6 (a/ c/ d)T8 (a/ b/ c)

PT1 (a/ d/ f)PT6 (a/ b/ c/ d/e)PT7 (a/ b/ e/ f/g/ h)PT8 (b)

M1 (a/ b/ c)M4 (a/ b)M5 (a/ b)M6 (a)

P1 (d/ e/ f/ g)P2 (a/ e)P5 (a)P6 (a)P7 (a/ b/ c/ d/ e/ f)P9 (a/ b/ c/ d/ e/ f/g/ h/ i)P11 (a/ b/ c)P15 (a/ b/ c)

E1 (b/c)E2 (a/ b/ c/ d/ e/ f)E3 (a/b)E6 (a/ b/ c/ d/ e/ f/ g)E8 (a/ b/ c/ d/ e/ f/ g)E9 (a/ b/ c/ d)E11 (d)

SALT PD1 (b)PD3 (a)PD4 (a/ b)PD6 (a)

D1 (a,b/ c/d/ e)D2 (a/ b/ c/d/ e/ f/ g/h/ i/ j/ k/ l/m)D4d,e,g,h,jD5 (a/ b)

T1 (a, e/ f/ g/h/ i/ j/ k, l)T2 a,bT3 (a/ b/ c/ d/e/ f/ g/ h/ i/ j/k/ l/ m/ n/ o)T4 (e/ f/ g/ h)T5 a,c,d,e,hT6 (a/ b/ c/ d/e)T7 b,e,fT8 (a/ e,f,g)

PT1 (a/ b/ d/ e/f) PT2 (a)PT3 (a/ b/ c/ d/e/ f/ g/ h/ i/ j/ k/l)PT4 (a)PT5 (a)PT6 (a,b,c/ e)PT7 (a/ b/ d/ e/f/ g/ h)PT8 (a,b,c)

M1 (a/ b/ c)M2 aM3 (a/ b/ c/ d/f/g,h,i,j,k,l,m,n)M4 (a/ b)M5 (a,b)M6 (a)M7 (a/ b/ c/ d)

P1 (b/ d/ e/ f/ g)P2 (a/ e)P3 (a/ b/ c/ d/ e)P7 (a/ b/ c/ d/ e/ f)P9 (a/ c/ g/ h)P11 (a/ b/ c)P14 (a/ b)P15 (a/ b)

E1 (b/ c/ d)E2 (a/ b/ c/ d/ e/ f/ g)E3 (a/ b/ c/ d/ e)E6 (a/ b/ c/ d/ e/ f/ g)E8 (c/ d/ e/ f/ g)E9 (a/ b/ c/ d)E12 (a/ b)

Other PD1 (b)PD4 (a/ b)PD6 (a/ b)

D1 (b/ c/d)D5 (a/ b)

T1 (e/ h)T5 (a/ b)T7 (a/ c/ e,f)

PT1 (a)PT7 (a/ b/ e/ f/g)PT8 (b)

M1 (b)M3 (a/ b)M5 (a)

P1 (d/ e/ f/ g)P2 (a/ e)P7 (a/ b/ c/ d/ e/ f)P8 (h)P11 (a/ b/ c)P13 (a)

E1 (a/ b/ c)E2 (a/ b/ c/ d/ e/ f)E3 (a/ b/ c/ d)E6 (a/ b/ c/ d/ e/ f/ g)E9 (a/ b/ c/ d)E11 (a/ b/ e)E13 (b)

rehabilitation care pathway - cancerni.netcancerni.net/files/file/ahp/ncat_rehab_headandneck.pdf ·...

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