OP-2 Giving voice to those with incurable head and neck cancer (HNC): understanding and identifying priorities for improving healthcare experiences

<h3>Introduction</h3> Incurable head and neck cancer (HNC) has a complex, unpredictable disease trajectory causing multiple symptoms. Patients can be from deprived backgrounds with more limited health literacy. High healthcare service use is common, even within the last month of life e.g., multiple emergency attendances compared with other cancers. Exploring experiences across the disease trajectory is an essential first step to addressing needs. <h3>Aim</h3> To understand multi-perspective experiences of healthcare services over time for incurable HNC patients and identify solutions for improvement. <h3>Methods</h3> A prospective longitudinal qualitative study, across three regions of North England, consisting of two work packages (WPs). WP1: Serial interviews (on a 4 monthly basis) with patients including after-death interviews with the bereaved family caregiver. Maximum variety sampling based on factors influencing experiences (e.g., distance from cancer centre, deprivation, whether lives alone). Online focus groups with healthcare professionals (HCP) reflecting different roles/care settings. Picker’s ‘Principles of Patient-Centred Care’ informed topic guides; framework approach used to conduct analysis. WP2: Co-design workshops, involving key stakeholders, will be conducted in autumn 2024. These will use study findings to identify priority areas for improving care. <h3>Results</h3> WP1: Eighteen patients, 6 family carers and 24 HCPs were recruited, reflecting a diverse range of individuals and experiences. Analysis demonstrates the importance of acknowledging the variability within 3 main areas – accessing medication, family caregiver preparedness, and information needs. Additionally, navigating the healthcare system was a key challenge; specific facilitators and barriers influencing health literacy are being explored. <h3>Conclusion</h3> By considering factors which drive variability in experiences, we can determine how to address issues. Co-design workshop findings will identify and prioritize potential solutions, mapping out a logic model to inform further intervention development. <h3>Impact</h3> Findings will provide a foundation to develop and test strategies to enhance services and improve experiences for this complex, vulnerable group.