While 96% reported training familiar communication partners, only 58% reported training unfamiliar communication partners. Therapists reported providing communication partner training consistent with best practice 43% of the time. Evidence-based published programmes were used by 13.8% and 19.9% of participants for training familiar and unfamiliar partners respectively. Therapists reported using outcomes for familiar and unfamiliar communication partners 83% and 78% of the time. The most frequently-reported barrier was lack of behavioural regulation (e.g., planning). Most frequent perceived facilitators were clinicians wanting to deliver communication partner training and that training was part of therapists' professional role (social professional role and identity).Conclusions: Therapists were motivated to deliver communication partner training but reduced capability affected implementation. Further support to clinicians on outcome measurement with materials to develop workplace systems to monitor implementation are needed.

database inception to February 2019. Eligibility criteria: Empirical studies on interventions for adult communication partners where the primary focus of the program (>50%) was on improving communication skills of people with TBI and/or communication partners. Data: participants, characteristics of the training, outcome measures and findings. Risk of bias: standard checklists were used for methodological quality (PEDRO, ROBiN-T) and intervention description (TIDieR). Synthesis: narrative synthesis and effect sizes (Cohen's d) for group-level studies. Outcomes: Ten articles (describing eight studies) met eligibility criteria: three randomized controlled trials, two non-randomised controlled trials and three single-case experimental designs. Studies included a total of 258 people with TBI and 328 communication partners, however all but one study had fewer than 65 participants. Methodological quality varied and intervention description poor. Three studies in the final synthesis (n=41 communication partners, n=36 people with TBI) reported positive intervention effects. Effect sizes in group studies were (d=0.80-1.13) for TBI and (d=1.16-2.09) for communication partners. Conclusions: The articles provided encouraging though limited evidence for training communication partners. Greater methodological rigour, more clearly described interventions, and consistent use of outcome measures and follow-up post-treatment are needed. Further research in this field is warranted.

Background: In the UK, there is increasing pressure on ear, nose and throat (ENT) clinicians and departments, which is anticipated to amplify in the coming months and years due to the coronavirus disease 2019 pandemic and other workforce pressures. In the context of a national drive to advance practice of Allied Health Professionals to address some key challenges facing the National Health Service, we explored whether UK speech and language therapists (SLTs) felt it is possible to utilize and extend their existing skills to patients on the urgent 2-week wait (2ww) ENT pathway. Aims: To explore SLTs' views of extending their role to work with patients referred on the ENT 2ww pathway.Methods & Procedures: Two separate focus groups were conducted using nominal group technique to generate and rank benefits and challenges of the proposed extension of role. Participants were invited to take part through Clinical Excellence Networks relevant to head and neck cancer and voice sub-specialties.Participants were competent in performing nasendscopy in at least a highly specialist role in voice or head and neck subspecialties.Outcomes & Results: Nine SLTs from England, Wales and Northern Ireland attended two focus groups. All were employed in band 8 roles in head and neck and/or voice. Eight were competent to Royal College of Speech and Language Therapists' scoping level 3. Important benefits of the proposed novel service delivery model were generated and ranked by participants, with both groups identifying improved quality and efficiency of service for patients among the most important. Disadvantages were then generated and ranked across the two groups with potential for misdiagnosis ranked as the most important by both. Conclusions & Implications: Participants responded that extending the SLT role into assessment of 2ww patients would provide benefits for quality of care, healthcare efficiency and the SLT workforce. The identified disadvantages require addressing if the proposed SLT-led model of service delivery is piloted in This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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