Head & Neck Cancer (HNC) and its treatments create significant morbidity. With the rise of human papillomavirus-induced cancers, we have younger patients with higher survival rates. Optimising functional outcomes is crucial. Recovery necessitates multidisciplinary (MDT) care, however the optimal service model for long-term support is unknown. This retrospective audit examined patient trajectories for 12months (mths) following cancer treatment to explore factors predicting service needs. Patient-reported outcome measures (PROMs) and clinic records were analysed from pre-treatment until discharge in patients referred to one MDT HNC practice between 2015-2025 (n=223, Mean=61yrs, 14-90yrs, male=70%). Tumour sites included oral (32%), nasopharynx (23%), oropharynx (31%), other (14%). Statistical analyses explored changes over time and relationships between PROMs, endoscopic findings and oncological treatments. All patients were seen at 6mths. By 12mths, 26% were still receiving care, dropping to 20% by 24mths. PROMs were normal pre-treatment and demonstrated peak elevation at 1mth. By 12mths, median reflux and voice PROMs improved to below normative thresholds, while swallow-related PROMs and HNC Symptom Checklist scores remained elevated. 3mth PROMs were the strongest predictor of 12mth PROMs (EAT-10 R=.68, p<.001). Patients receiving primary chemoradiation and multi-treatment (surgery+adjuvant chemoradiation) had more severe 1 and 12mth scores compared with primary surgical patients (p<.05). PROMs were associated with endoscopic findings (residue ratings R=.80, p<.001) and diet modification requirements (R=.40, p<.01). This study highlights the need for responsive survivorship pathways. PROMs at 3mths are indicative of prolonged need for support and demonstrate convergent validity with endoscopic and functional outcomes emphasising their usefulness. PROMS can be completed independently and help identify patients needing greater duration of support.