Application of a clinical framework to map speech pathology service capabilities and potential cost savings to enhance head and neck cancer care in regional areas

Mrs Jasmine Foley2, Prof. Elizabeth Ward1,2, Dr Laurelie Wishart1,2, Dr Clare Burns2,3, Dr Rebecca Nund2, Mrs Nicky Graham6, Mr Corey Patterson4, Mrs Amy Ashley4, Mrs Julie Fink4, Mrs Emily Tiavaasue5, Mrs Wendy Comben4

1Centre for Functioning and Health Research, Metro South Health, Queensland Health, Brisbane, Australia, 2School of health & Rehabilitation Sciences, The University of Queensland, Brisbane, Australia, 3Speech Pathology, Royal Brisbane Hospital, Metro North HHS, Brisbane, Australia, 4Speech Pathology, Townsville Hospital, Townsville HHS, Townsville, Australia, 5Speech Pathology, Mt Isa Hospital, North West HHS, Mt Isa, Australia, 6Speech Pathology, Wondai Hospital, Childrens Health Queensland HHS, Wondai, Australia

Individuals who undergo head and neck cancer (HNC) treatment require ongoing support from speech pathology (SP) services. However, there are recognised challenges accessing SP services in non-metropolitan areas where infrastructure, staffing and resources can be limited.

The primary aim was to examine the utility of a task-based capability framework, specific to SP cancer care services, through mapping the service capabilities of a group of regional/rural facilities within a cancer network. The secondary aim was to model potential consumer and service cost savings if local SP service capabilities are increased.

Methods and Procedures
Four sites within a regional/rural service area participated. A mixed methods approach was used to examine the utility of applying a task-based capability framework specific to adult cancer care, to map service capabilities. From that data, potential cost savings for the health service and for people accessing HNC services was modelled.

While there were some individual differences, most tasks listed in the HNC clinical framework were able to be provided by the 4 participating non-metropolitan sites. Modelling the re-distribution of these SP HNC services away from the tertiary site to local sites (if these services were provided) for 44 regional individuals showed average potential savings of $22,278 for the health system and $31,994 for the patient.

Mapping HNC service capability using the clinical framework tool highlighted many aspects of HNC care could delivered at local SP sites. Enhancing local SP service capabilities in HNC care demonstrates potential cost savings for patients and services.


Prof Liz Ward is the Director of the Centre for Functioning and Health Research in Metro South Health and conjoint professor at The University of Queensland. She is a leading international researcher and much of her current work focuses on new models of care and enhancing service delivery models within health.

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