Objective: To improve access to SLT for the MDT and IwP at the Royal Berkshire Hospital.

Background: A successful bid in Jan 2017 for a ‘Service Improvement Grant’ from the UK Parkinson’s Excellence Network enabled recruitment of a Speech and Language Therapist working exclusively with IwP from Aug 2017 – July 2018.

Methods: A PDSA (Plan Do Study Act) framework was used with quarterly cycles of change and impact assessment. A steering group was formed. Referrals for IwP from Aug 2017 – Jan 2018 to SLT were received via the Electronic Patient Record. Data was recorded in Microsoft Excel. This included demographics, date/time of referral and SLT assessment and referral type (communication +/- swallowing). IwP were seen for assessment +/- therapy by the recruited therapist. Training sessions for nursing staff, HCA’s and AHPs were held on Elderly Care, Respiratory and Interface wards. The project was promoted during training as well as via a poster, computer screensaver and attendance at clinical governance groups.

Results: Data is reported here for Quarter 1 (Q1) and Quarter 2 (Q2). 74 IwP (53 male, average age 78 years) were referred to SLT. An increase of 84% and 95% in Q1 and Q2 respectively compared to the three-month period immediately prior to the project – see [table1]. Time IwP awaited SLT assessment halved in Q1 and Q2 with more than 50% seen on the day of referral – see [table2]. 153 nursing staff, HCAs and AHPs received on the ward training with approximately 80 further staff from a range of disciplines attending other training events.

Conclusions: Large numbers of IwP were referred to SLT. IwP now have rapid access to SLT for assessment and treatment therefore maximising their swallowing and communicative potential. If current service provision were maintained an estimated 186 bed days per annum may be saved by reduced time awaiting SLT assessment therefore reducing the length of time IwP are kept ‘Nil by Mouth’ with changes to their medication regimes. The increased number of IwP referred for communication highlights the importance of training and access to SLT for the MDT. It raises questions about the numbers of IwP who would benefit from SLT but whom are not identified and subsequently not referred.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/speech-and-language-therapy-slt-for-inpatients-with-parkinsons-iwp-in-a-large-district-general-hospital/