Adult Speech and Language Therapy, Rotherham NHS Foundation Trust
Interviewees: Abigail Starr, Joint Clinical Lead, Georgie Walker, Senior Speech and Language Therapist, Rachel Radford, Clinical Specialist Speech and Language Therapist.
Much of the team’s work is done face to face and most of the cohorts worked with are vulnerable: head and neck cancer patients, the elderly and complex patients with neurological conditions.
The team found it difficult to plan in the first weeks of the pandemic as they thought they might be redeployed as a service. They knew that having to wear masks would be an issue for their work, and that the most vulnerable patients would be the ones they would normally call into hospital or someone would call in to visit them.
All outpatients appointments and non-urgent community visits were stopped.
Approach/Methodology
The team had piloted a project 18 months ago to deliver voice therapy remotely using MS Teams. It was done as a proof of concept within the Trust and approval had been given by the Trust to incorporate this into the service from January 2020. Health Informatics were supporting the delivery. As this work had been completed the team were in a good place to develop this way of working and this has developed into a qualitative research project.
There was a determination not to stop any services.
Video calls were used extensively for triage and MDT consultations. Phone reviews were introduced for those for whom regular therapy had to stop.
Voice Exercises were recorded on YouTube for patients to access.
Resources were adapted and linked to text messages so that patients could access what they needed remotely.
The team worked closely with the Royal College of Speech & Language Therapists on risk assessments while using video consultations for swallowing assessments. This is due to be published.
“Here’s how to use this sessions” and pathway demos for AHP were delivered.
Staff have been surveyed about the use of virtual appointments and the feedback is positive, some even commented that they felt the intervention was as good as an in-person appointment.
Impact
Carers had to become more proactive in supporting patients with assessments. This has meant additional work but has helped their understanding of the patient’s needs.
Patients have really liked the option of virtual appointments though would like a face to face one every 6-8 weeks or so.
Families and carers were better supported in caring for end of life patients in care homes getting advice from the S< team.
Patients took more ownership of their treatment. Particularly with regard to voice exercises.
Next Steps
There are a lot of learnings to share across the ICS, for example around rewriting telehealth guidelines.
Patient experiences are to be collected to support learning and confidence going forward.
Availability of technology needs addressing. Even some patients with smartphones find the screen too small to interact.
During the pilot there had been a discussion about the need to fund the loan of iPads in the same way that communication aids are loaned out. There is discussion about making a room available in community health centre for patients to use a computer safely.
Some care homes need a lot of support in feeling comfortable with using technology.
Key Learning Points
- Things were already in place regarding the use of virtual consultations, so it was relatively easy to build on this.
- Confidence can be an issue so support has been put in place to help people feel more comfortable using technology.
- Training and support need to be ongoing for things to continue to change. People need to share good practice so that services can continue to improve.
- For as long as the barriers are down, do everything you can to get things implemented quickly and try new things.