BRISTOL, England: People who have completed treatment for head and neck cancer may require long-term dental maintenance and preventive care. In South West England, however, this need coincides with persistent difficulties in accessing National Health Service (NHS) primary dental care, leaving some patients without a clear path to routine dental support after hospital-based treatment. The Cancer Action Support Practice (CASP) pathway has been developed to address this long-standing gap.
Acting as a vital clinical safety net, this newly structured framework bridges the historic operational gap between secondary hospital settings and general dental practices. It is intended to ensure that vulnerable individuals who have completed oncology treatment can transition more safely to routine and preventive dentistry within local primary care networks.
The steadily rising incidence of head and neck cancer across the UK presents immense long-term healthcare challenges for the NHS. Treatment involving complex surgery, chemotherapy and radiotherapy can result in significant oral and functional complications, including xerostomia, trismus and osteoradionecrosis, adding to the importance of accessible maintenance and preventive care in primary dental practice.
Adult NHS dental access in South West England has been reported to be below the average for England, leaving many patients with substantial post-treatment oral healthcare needs without primary care dental access. In response, an NHS regional restorative dentistry advisory network in South West England joined forces with the regional chief dental office and restorative dentistry specialists involved in head and neck cancer care to engineer the CASP pathway. Input from primary care dentists and local NHS bodies responsible for planning and funding dental services helped refine the clinical pathway by streamlining administrative triage workloads and establishing transparent referral criteria.
Crucially, CASP does not manage prehabilitation—that is, specialist-led dental assessment and planning before cancer treatment. Instead, it focuses on stabilising oral disease before rehabilitation can proceed and preserving long-term health once complex hospital-based oral rehabilitation has been completed.
The funding offers local NHS bodies flexibility: they can support participating practices either through existing NHS dental contracts or by paying them for dedicated CASP sessions. A pilot programme launched in Cornwall under the dedicated-session option is actively collecting data on patient numbers, treatment complexity and costs to refine future rollouts.
Consultant-led peer review is embedded in the CASP model and provides ongoing specialist support, training and quality assurance for participating primary care dental teams. In this way, this integrated pathway provides a scalable, sustainable solution for improving access to dental care for patients with substantial oral healthcare needs after head and neck cancer treatment.
The need for structured post-treatment dental pathways is increasingly recognised across England. A recent study reported on the introduction and ongoing operation of a care network in West Yorkshire designed to overcome persistent barriers to routine dental care for head and neck cancer patients through coordinated collaboration between hospital specialists and primary care dental teams. The West Yorkshire model and the CASP pathway highlight a broader movement towards coordinated post-treatment oral healthcare.
The article, titled “Improving dental care access for head and neck cancer patients in primary care: Developing the Cancer Action Support Practice pathway in South West England”, was published on 22 May 2026 in the British Dental Journal.
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