Background: Demand for head and neck cancer (HNC) surveillance is increasing due to improved survival and complex survivorship needs, placing pressure on existing ENT outpatient services. An Advanced Scope of Practice (ASP) Speech Pathology (SP) led surveillance clinic was piloted in 2025 to replace 5th year medical surveillance for low-risk groups. This represents an innovative shift from traditional consultant-led follow-up to a risk-stratified approach. Aims: To evaluate patient and service-related outcomes, feasibility and acceptability of an ASP SP delivering HNC surveillance. Method: A retrospective pilot study was conducted with 50 patients meeting inclusion criteria. Variables charted included patient demographics, patient reported outcome measures (PROMS - current function and quality of life impact), and service-related outcomes (discharge rate, proportion referred to ENT, and complication rates). Patient reported experience measures were taken post review via anonymous questionnaires. Results: This cohort included 44 males (88%), 6 females (12%) with a mean (SD) age of 63.5 (11.4) years. Treatment modalities included surgery (n= 25, 50%), definitive chemoradiotherapy (n=24, 48%), definitive radiotherapy (n=3, 6%), and adjuvant chemoradiotherapy (n=19, 38%). The discharge rate following ASP SP review was 94% (n=47) with 6% (n=3) referred to ENT due to suspicious findings. There were no complications or adverse events. PROMS revealed chronic symptoms such as xerostomia, reduced appetite, excess mucous production, and dysphagia. The response rate for the patient experience questionnaire was 40% (n=20). All patients either “agreed” or “strongly agreed” when asked if they were satisfied with an SP completing their 5th year surveillance. Conclusion: Preliminary findings demonstrate that this novel approach to HNC surveillance is beneficial, safe, and feasible. Future aims will evaluate the cost effectiveness of implementing this model of care.