Abstract
Introduction: The UK's response to the COVID-19 pandemic presented multiple challenges to healthcare services including the suspension of non-urgent care. The impact on neurorehabilitation professions, including speech and language therapy (SLT), has been substantial.Objectives: To review the changes to SLT services triggered by the COVID-19 pandemic with respect to referral rates, service delivery and outcomes, as well as examining the contribution of SLTs to the neurorehabilitation of COVID-19 patients.Methods: Two surveys were distributed to Royal College of Speech and Language Therapists (RCSLT) members exploring experiences of service provision at 6 weeks and 22 weeks after the pandemic was declared in the UK. Responses to closed-ended questions, including questions regarding referral numbers were analyzed descriptively and compared at the two time-points. A database comprising routine clinical data from SLT services across the UK was used to compare information on patients receiving services prior to and during the pandemic. Data on COVID-19 patients was extracted, and findings are provided descriptively.Results: Referrals to SLT services during the acute COVID-19 period in the UK were substantially less than in the same period in 2019. A number of service changes were common including adopting more flexible approaches to provision (such as tele-therapy) and being unable to provide services to some patients. Database analysis suggests fewer patients have accessed SLT since the pandemic began, including a reduction in neurorehabilitation patients. For those who received SLT, the outcomes did not change. SLTs supported a range of needs of COVID-19 patients. Treatment outcomes for COVID-19 patients with dysphagia were positive.Discussion: The pandemic has affected neurorehabilitation and SLT services broadly: referral patterns are different, usual care has been disrupted and interventions have been modified affecting the impact on patient outcomes both positively and negatively. Some patients with COVID-19 require and benefit from SLT intervention.
Highlights
The UK’s response to the COVID-19 pandemic presented multiple challenges to healthcare services including the suspension of non-urgent care
This paper aims to utilize both methods to explore the changes to speech and language therapy (SLT) practice and service delivery arising from the pandemic, by asking the following two research questions: 1. How has COVID-19 impacted on SLT both generally, and in neurorehabilitation, in terms of (a) referral rates, (b) service provision and (c) therapy outcomes?
Despite the challenges posed on the UK healthcare system resulting from the COVID-19 pandemic, speech and language therapists have been able to adapt their ways of working, develop specialist skills and innovate strategies to manage the consequences of a new disease
Summary
The UK’s response to the COVID-19 pandemic presented multiple challenges to healthcare services including the suspension of non-urgent care. An important element of the multi-disciplinary approach to neurorehabilitation is speech and language therapy (SLT), which attends to the assessment and management of those with speech, language, communication and swallowing disorders. As such, this profession was affected by the demand and supply contention. The evidence indicates a large and important role of neurorehabilitation services in the response to COVID-19 It is well-documented that the virus commonly affects the functioning of the nervous system and patients sustain a degree of ill-health for several weeks post-infection [3]. Strains are put on non-COVID-19 related rehabilitation services, especially those occupying hospital bed spaces, as the need for re-organization arises following the increase in patient admittance [6]
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