Improving dental care access for head and neck cancer patients in primary care: developing the Cancer Action Support Practice pathway in South West England

Aims
Describes the development and early implementation of the Cancer Action Support Practice (CASP) pathway in South West England, aiming to improve dental care access for head and neck cancer (HNC) survivors in the primary care setting.

Summary of CASP development
Stakeholder engagement was central to CASP's design, involving input from general dental practitioners, local dental committees, commissioners, and secondary care teams. Funding and commissioning options were explored through the regional integrated care boards (ICBs). CASP aligns with national policy, including NHS England's guidance on oral health for cancer patients. CASP provides a structured pathway enabling HNC patients to access routine and preventive dentistry in primary care to prepare them for and maintain them after oral rehabilitation. Two commissioning models (units of dental activity uplift and sessional rate approach) were proposed, allowing regional flexibility by commissioning ICBs. Consultant-led peer review, data collection, and ongoing professional development are embedded. A pilot CASP has been commissioned in Cornwall, with further strong regional interest.

Conclusion
CASP demonstrates a regionally coordinated approach to improving dental access for a vulnerable and complex patient group. The model supports integration between primary and secondary care, informed by national guidance and local clinical need, and has potential applicability to other medical conditions with significant dental involvement.