City Research Online

Abstract

Introduction: Over 200,000 patients are referred onto the suspected head and neck cancer (HNC) pathway annually in the UK, with around 3% receiving a cancer diagnosis. With new HNC advancements in identifying patients at low risk of a cancer diagnosis, one proposal is a SLT (Speech and Language Therapy)-led first point of contact clinic for low-risk patients presenting with voice or swallowing symptoms. This study explores Ear Nose and Throat (ENT) surgeons’ views regarding this model.

Materials and Methods: A qualitative study design, using semi-structured interviews. Transcribed responses were analysed using Thematic Analysis.

Results: 11 UK ENT surgeons participated. Themes included positives and challenges of the proposed model; existing facilitators that increase likelihood of success; and requirements for successful implementation.

Discussion: Service variation impacted on level of interest. Waiting times were problematic at some sites more than others; SLT workforce issues were of differing prevalence; SLT competence and interest differed; and support from organisational leaders varied. Participants’ personal views also varied, for example acceptability of the model to patients, or what governance structure is required. There was no single SLT-led clinic model suitable for all centres, however some general principles were identified to inform further evaluation and implementation of this model.

Conclusion: Principles included deployment of SLTs experienced in laryngeal examination and flexible nasendoscopy; dedicated job plans and workforce; professional and regulatory body recognition and support; and clear training, supervision structure and job description for the role. Service outcomes, training protocol and competencies require robust evaluation.

Publication Type:	Article
Additional Information:	This is the peer reviewed version of an article which will be published in final form at 10.1111/1460-6984.13137. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Publisher Keywords:	otolaryngology, oncology, speech therapy, interview, head and neck cancer, voice disorders
Subjects:	R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RF Otorhinolaryngology
Departments:	School of Health & Psychological Sciences School of Health & Psychological Sciences > Language & Communication Science
SWORD Depositor:	Symplectic Administrator

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