COVID‐19 and ENT SLT services, workforce and research in the UK: A discussion paper

Abstract

Background The COVID‐19 pandemic and the UK government's subsequent coronavirus action plan have fundamentally impacted on every aspect of healthcare. One area that is severely affected is ear, nose and throat (ENT)/laryngology where speech and language therapists (SLTs) engage in a diverse range of practice with patients with a range of conditions, including voice disorders, airway problems, and head and neck cancers (HNCs). A large majority of these patients are in high‐risk categories, and many specialized clinical practices are vulnerable. In addition, workforce and research issues are challenged in both the immediate context and the future. Aims To discuss the threats and opportunities from the COVID‐19 pandemic for SLTs in ENT/laryngology with specific reference to clinical practice, workforce and research leadership. Methods & Procedures The relevant sections of the World Health Organisation's (WHO) health systems building blocks framework (2007) were used to structure the study. Expert agreement was determined by an iterative process of multiple‐group discussions, the use of all recent relevant policy documentation, and other literature and shared documentation/writing. The final paper was verified and agreed by all authors. Main Contribution The main threats to ENT/laryngology SLT clinical services include increased patient complexity related to COVID‐19 voice and airway problems, delayed HNC diagnosis, reduced access to instrumental procedures and inequitable care provision. The main clinical opportunities include the potential for new modes of service delivery and collaborations, and harnessing SLT expertise in non‐instrumental assessment. There are several workforce issues, including redeployment (and impact on current services), training implications and psychological impact on staff. Workforce opportunities exist for service innovation and potential extended ENT/SLT practice roles. Research is threatened by a reduction in immediate funding calls and high competition. Current research is affected by very limited access to participants and the ability to conduct face‐to‐face and instrumental assessments. However, research opportunities may result in greater collaboration, and changes in service delivery necessitate robust investigation and evaluation. A new national set of research priorities is likely to emerge. Conclusions & Implications The immediate impact of the pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT/laryngology SLT. It is unclear when any of these areas will resume operations and whether permanent changes to clinical practice, professional remits and research priorities will follow. However, significant opportunity exists in the post‐COVID era to re‐evaluate current practice, embrace opportunities and evaluate new ways of working.

Fabricação E Impressão 3d De Epi’s Para as Ações De Combate Ao Covid-19

“…Desse modo, foram encontrados: um estudo caso-controle observacional (ASIAEE et al, 2020), um estudo de coorte (ROUHANI et al, 2020), um clínico-epidemiológico (LECHIEN et al, 2020), e cinco apresentaram orientações e/ou diretrizes de políticas publicas para a terapia vocal no contexto da pandemia do COVID-19. (CANTARELLA et al, 2020;CASTILLO-ALLENDES et al 2020;MATTEI et al, 2020;PATTERSON et al, 2020;ZUGHNI et al, 2020). O estudo de Asiaee et al (2020) visou comparar indivíduos infetados pelo SARS-CoV-2 com pessoas saudáveis a fim de avaliar os efeitos da doença nos parâmetros vocais.…”

“…Estes autores ainda referem a importância de os profissionais manterem uma boa comunicação com o paciente, a família e a equipe de trabalho; verificar a necessidade de encaminhamento do paciente para a psicoterapia; confirmar o recebimento de qualquer mensagem não verbal; ter em mente que o estresse nos ambientes de saúde esta elevado devido a pandemia do COVID-19 (CASTILLO-ALLENDES et al, 2020). Este artigo ainda relata que no contexto da atual da pandemia, o fonoaudiólogo precisa esta atento a voz psicogênica que pode aparecer em decorrência de experiências diretas com o COVID-19 ou pelo próprio momento da pandemia (PATTERSON et al, 2020). O estudo de Mattei et al (2020) objetivou fornecer orientações para a tomada de decisão no tratamento de pacientes acometidos por disfonia e distúrbios da deglutição.…”

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“…Traditionally, the delay attributed to the patient (patient delay) is due to a lack of knowledge, poor symptom interpretation, cultural beliefs, and self-treatment. However, during the current pandemic, cancer patients have experienced emotions such as fear, anger, anxiety, and sadness when facing COVID-related risks, and these negative emotional determinants are behaving as barriers to healthcare access [6] . Lockdowns seem to have contributed to diagnostic delay too, particularly in the case of senior individuals [6] .…”

“…However, during the current pandemic, cancer patients have experienced emotions such as fear, anger, anxiety, and sadness when facing COVID-related risks, and these negative emotional determinants are behaving as barriers to healthcare access [6] . Lockdowns seem to have contributed to diagnostic delay too, particularly in the case of senior individuals [6] . The characteristics of the tumour itself, including tumour aggressiveness and growth rate, also influence the diagnostic process, the prioritisation for treatment and, ultimately, the prognosis.…”

The Use of Medical and Non-Medical Services by the Elderly during the SARS-CoV-2 Pandemic Differs between General and Specialist Practice: A One-Center Study in Poland

“…However, regarding the main places where people can become infected, not only restaurants or shops closed down, but medical clinics also reduced the number of their consultations or introduced phone consultations and videoconferencing instead [ 6 ]. People have also avoided contact with medical staff, except for emergencies [ 7 , 8 , 9 , 10 ].…”