COVID‐19 and ENT SLT services, workforce and research in the UK: A discussion paper

• Published in: International journal of language & communication disorders 2020-09, Vol.55 (5), p.806-817
• Main Authors: Patterson, Joanne M, Govender, Roganie, Roe, Justin, Clunie, Gemma, Murphy, Jennifer, Brady, Grainne, Haines, Jemma, White, Anna, Carding, Paul
• Format: Article
• Language: English
• Subjects: At Risk Persons; Auditory system; Clinical medicine; Collaboration; Communication Disorders - rehabilitation; COVID-19; Discussion; ENT SLT research; ENT SLT services; ENT SLT workforce; Foreign Countries; Health Services Research - trends; Health Workforce - trends; Humans; Language Therapy - trends; Laryngology; Medical research; Otolaryngology; Otolaryngology - trends; Pandemics; Patients; SARS-CoV-2; Speech Impairments; Speech Therapy; Speech Therapy - trends; Speech-language pathologists; United Kingdom; Verbal aggression; Voice disorders; Workforce
• ISSN: 1368-2822; 1460-6984
• DOI: 10.1111/1460-6984.12565

Background The COVID‐19 pandemic and the UK government's subsequent coronavirus action plan have fundamentally impacted on every aspect of healthcare. One area that is severely affected is ear, nose and throat (ENT)/laryngology where speech and language therapists (SLTs) engage in a diverse range of practice with patients with a range of conditions, including voice disorders, airway problems, and head and neck cancers (HNCs). A large majority of these patients are in high‐risk categories, and many specialized clinical practices are vulnerable. In addition, workforce and research issues are challenged in both the immediate context and the future. Aims To discuss the threats and opportunities from the COVID‐19 pandemic for SLTs in ENT/laryngology with specific reference to clinical practice, workforce and research leadership. Methods & Procedures The relevant sections of the World Health Organisation's (WHO) health systems building blocks framework (2007) were used to structure the study. Expert agreement was determined by an iterative process of multiple‐group discussions, the use of all recent relevant policy documentation, and other literature and shared documentation/writing. The final paper was verified and agreed by all authors. Main Contribution The main threats to ENT/laryngology SLT clinical services include increased patient complexity related to COVID‐19 voice and airway problems, delayed HNC diagnosis, reduced access to instrumental procedures and inequitable care provision. The main clinical opportunities include the potential for new modes of service delivery and collaborations, and harnessing SLT expertise in non‐instrumental assessment. There are several workforce issues, including redeployment (and impact on current services), training implications and psychological impact on staff. Workforce opportunities exist for service innovation and potential extended ENT/SLT practice roles. Research is threatened by a reduction in immediate funding calls and high competition. Current research is affected by very limited access to participants and the ability to conduct face‐to‐face and instrumental assessments. However, research opportunities may result in greater collaboration, and changes in service delivery necessitate robust investigation and evaluation. A new national set of research priorities is likely to emerge. Conclusions & Implications The immediate impact of the pandemic has resulted in major disruption to all aspects of clinical delivery,