BackgroundThe traditional model of centralization of care, whilst having many advantages, also requires adaptation and upscaling to meet the requirements of both regional areas as well as the increasing urban sprawl. However, this transition when required, must be delivered in a safe and effective manner, to ensure comparable outcomes to current major centres. MethodsOur project was the first of its kind in terms of validation studies, utilizing the British Association of Oral and Maxillofacial Surgeons (BAOMS) recently published outcome data from the Quality and Outcomes in Oral and Maxillofacial Surgery (QOMS) project to benchmark data prospectively collected from a small volume emerging centre in Northern Queensland. ResultsAs expected, the small volume of our centre impacted on the ability to derive powerful statistical models and comparators, which is an intrinsic limitation to small volume centres, whilst they are developing services. However, during this evolution project, the use of comparison metrics, allowed for the detection of alert and alarm levels, which is invaluable to ensure patient safety and quality of outcome. ConclusionsOur paper demonstrated that irrespective of size or volume, the utilization of quality assurance metrics (national or international) provides for the safe and transparent upscaling of head and neck services in emerging, regional and small volume centres.