Objective: To enable access to SLT for patients with Parkinson’s (PwP) in the MDC at the Royal Berkshire Hospital (RBH).

Background: A successful bid in Jan ‘17 for a ‘Service Improvement Grant’ from the UK Parkinson’s Excellence Network enabled recruitment of a Speech and Language Therapist working to improve care for PwP at the RBH from Aug ‘17 – July ’18. In the weekly MDC PwP are seen by the Consultant Geriatrician or Specialist Registrar, Nurse and Occupational and Physiotherapists. The grant enabled access to SLT for the first time in the MDC.

Methods: PwP attending the MDC between Nov 2017 – Jan 2018 were seen by SLT. Case histories and assessment measures were collected using a pro-forma derived from best practice guidelines. The therapist provided verbal and written explanations of the effects of Parkinson’s on swallowing/communication and advice on managing these where appropriate. The therapist signposted to services and referred onto community SLT as needed. Clinic letters for PwP attending in the months prior to the addition of SLT were reviewed for mention of communication/swallowing difficulties. Data was input into Microsoft Excel and comparisons made to the data obtained following the addition of SLT.

Results: 32 PwP (14 males, 18 females, average age 79 years, range 64-91) were seen by SLT in the MDC. Communication +/- swallowing difficulties were identified in many PwP. The numbers increased after the addition of SLT – see [table1]. After the addition of SLT most PwP had documented written and verbal explanations of the effects of Parkinson’s on communication and swallowing – see [table2].

Conclusions: PwP attending the MDC now have access to SLT for specialist assessment and advice, maximising their swallowing and communicative potential. Many PwP attending the MDC presented with communication +/- swallowing difficulties, more so than were identified prior to the addition of SLT. This suggests a need for closer MDT working to ensure that professionals involved in the care of PwP understand which patients would benefit from SLT and referrals are made. The MDC model puts the patient first helping to bridge the gap between services with around a third of PwP attending the clinic referred directly to community SLT, avoiding potentially lengthy delays awaiting a GP referral.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/accessing-speech-and-language-therapy-slt-in-a-multi-disciplinary-movement-disorders-clinic-mdc/