Impact of COVID‐19 on digital practice in UK paediatric speech and language therapy and implications for the future: A national survey

Patel, Rafiah; Loraine, Elena; Gréaux, Mélanie

doi:10.1111/1460-6984.12750

Cited by 9 publications

(15 citation statements)

References 28 publications

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“…The outcomes indicated emerging trends in UK paediatric SLTs' perceptions of telehealth, and SLTs perceived that a hybrid approach to service delivery, combining mostly face-to-face services with some telehealth, was likely to continue in the future, supporting the findings of a similar national survey of paediatric SLTs (Patel et al, 2022).…”

Section: Discussionsupporting

confidence: 59%

“…As telehealth services continue to develop, SLTs placed importance on managers addressing the practical impacts (both positive and negative) of telehealth on their organisation and practitioners' workload, and prioritising which activities telehealth is most practicable for. The importance of leadership at an organisation level for telehealth implementation was also highlighted in Patel et al (2022).…”

Section: Discussionmentioning

confidence: 99%

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UK paediatric speech and language therapists’ perceptions on the use of telehealth in current and future clinical practice: An application of the APEASE criteria

Charlton,

Gréaux,

Kulkarni

et al. 2023

Intl J Lang & Comm Disor

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BackgroundTelehealth for paediatric speech and language therapy became one of the most salient modes of service delivery during the COVID‐19 pandemic. Evidence for speech and language therapy services via telehealth in comparison to face‐to‐face delivery demonstrates promising outcomes, and studies have begun to explore practitioner and client experiences. However, across the literature, many critical elements of services are overlooked, and there is a need to frame the evidence base within a theoretical model that can draw out practical implications that consider the range of factors having an impact on clinical implementation in real‐world contexts. The APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria offer such a model. The current study explored practising UK speech and language therapists’ (SLTs) clinical experience of telehealth through the lens of the APEASE criteria and aimed to identify recommendations for future service provision from the practitioner perspective.MethodsAn online survey structured using the APEASE criteria was developed in collaboration with the UK Royal College of Speech and Language Therapists. Quantitative data were analysed using descriptive statistics and qualitative data were analysed using reflexive thematic analysis.ResultsFour hundred and thirty‐eight qualified and practicing UK paediatric SLTs completed the survey. Telehealth was broadly acceptable and practicable to SLTs yet there remains some uncertainty about its efficacy and cost‐effectiveness compared to face‐to‐face interventions and how equitable it is for different population groups. SLTs reported that effective implementation of telehealth services was dependent upon several contextual factors; affordability was a perceived barrier to clients having access to telehealth resources, intervention via telehealth was perceived as more acceptable than assessment, and whilst many SLTs welcomed aspects of telehealth, there were concerns about the physical and mental health consequences for practitioners. Six themes for the future development of telehealth in paediatric speech and language therapy were identified: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance.ConclusionsOutcomes highlight promising, concerning and uncertain aspects of telehealth in paediatric speech and language therapy. SLTs value a flexible and tailored approach to service delivery and recommend that effective leadership, clear communication, ongoing policy and guidance development, upskilling of users and careful evaluation of impact are required to ensure optimal implementation. The APEASE criteria offer a valuable opportunity to enhance and streamline practice and research to ensure sustainable implementation of telehealth in the paediatric speech and language therapy services of tomorrow.WHAT THIS PAPER ADDSWhat is already known on this subject The COVID‐19 pandemic led to the increased use of telehealth as a main mode of service delivery in paediatric speech and language therapy. Pre‐COVID‐19, evidence for the use of telehealth in this field included small‐scale experimental studies that reported on children with particular disorders and explored telehealth outcomes in comparison to face‐to‐face delivery. The realities of at‐scale clinical practice were not well‐represented, and critical elements of service such as cost‐effectiveness were often overlooked in the paediatric literature. Furthermore, despite emerging global evidence for temporary telehealth responses to the crisis in speech and language therapy, the long‐term and future use of telehealth remains unclear.What this paper adds to existing knowledge The current study applied the lens of the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Side‐effects, and Equity) criteria, which were used in this case to consider socioeconomic, ecological and cultural factors to capture an overarching understanding of the use of telehealth in paediatric speech and language therapy, and to inform the role of telehealth in future, longer‐term and at‐scale service development. Results indicated emerging trends in UK paediatric speech and language therapists’ (SLTs’) perceptions of telehealth and SLTs perceived a hybrid approach to service delivery, combining mostly face‐to‐face services with some telehealth, was likely to continue in the future. We identified six themes to guide the future development of telehealth in paediatric speech and language therapy services: (1) balanced and tailored services; (2) technology and equipment; (3) information and communication; (4) capacity building; (5) monitoring and evaluation; and (6) leadership and governance.What are the potential or actual clinical implications of this work? UK SLTs believe that speech and language therapy services using telehealth should be reflective, tailored and flexible to meet the requirements and circumstances of the children, young people and families served, as well as the physical and emotional needs of practitioners. SLTs recommend that this service development is clearly communicated to all stakeholders and suggested that those using telehealth should be supported through appropriate training, and ongoing effectiveness should be monitored. Telehealth is here to stay and the APEASE criteria offer a unique opportunity to ensure sustainable models of service delivery; to support co‐ordinated leadership at the local, national and international levels and the development of policy and clinical guidance.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

UK paediatric speech and language therapists’ perceptions on the use of telehealth in current and future clinical practice: An application of the APEASE criteria

Charlton,

Gréaux,

Kulkarni

et al. 2023

Intl J Lang & Comm Disor

Self Cite

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“…As highlighted by Patel et al. (2022), specialist training is essential for post‐pandemic telepractice and hybrid service delivery. Our study shows the need for support to develop expertise in identifying who can benefit from telepractice, including how to conduct assessments online, how to provide caregiver coaching and build relationships, as well as basic technical skills.…”

Section: Discussionmentioning

confidence: 99%

“…Grillo, 2017; Hines et al., 2015; Pitt et al., 2018) and during the COVID‐19 pandemic (e.g. Biggs et al., 2022; Hao et al., 2021; Kwok et al., 2022; McCaslin, 2021; Patel et al., 2022; Tambyraja et al., 2021) have been conducted in Global North settings. Given the difficulties related to telepractice provision identified in resource‐rich areas of the world, it is important to explore the experiences of SLTs working in contexts that already face barriers such as those related to technological access and internet connectivity.…”

Section: Introductionmentioning

confidence: 99%

Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

Gallant

Watermeyer

Sawasawa

2023

Intl J Lang & Comm Disor

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BackgroundThe COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs’ experiences of implementing telepractice in the Global South during this time is available.AimsTo explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic.Methods & ProceduresSLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles.Outcomes & ResultsWe describe participants’ reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online.Conclusions & ImplicationsTelepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs’ confidence in providing telepractice whilst delivering quality services in an accessible and safe manner.WHAT THIS PAPER ADDSWhat is already known on the subject Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs’ experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners.What this paper adds to existing knowledge Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic.What are the potential or actual clinical implications of this work? Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients.

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“…Other research has identified that SLTs employed changes to practice in the initial response to COVID-19 that were favourable and that they wish to maintain, for example an increase in use of telehealth and greater contact with service user's families (Morgan et al, 2023). A recent survey of practice of UK SLTs specifically explores the changes in practice around telehealth since COVID-19 and signals a positive shift in SLTs' recognition and acceptance of technology use in practice (Patel et al, 2022). Extending the scope of our survey to capture positive effects way would have strengthened the study and enriched the contribution through potentially offering new solutions that could be applied in clinical practice.…”

Section: Speech and Language Therapy After Covid-19mentioning

confidence: 99%

Impact of the initial COVID-19 response in the UK on speech and language therapy services: a nationwide survey of practice

Chadd,

Chalmers,

Harrall

et al. 2024

JHOM

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PurposeGlobally “non-urgent” health care services were ceased in response to the 2020 outbreak of COVID-19, until 2021, when restrictions were lifted. In the UK, this included speech and language therapy services. The implications of COVID-19 restrictions have not been explored. This study aimed to examine the impact of the UK’s COVID-19 response on speech and language therapy services.Design/methodology/approachAn online survey of the practice of speech and language therapists (SLTs) in the UK was undertaken. This explored SLTs’ perceptions of the demand for their services at a time when COVID-19 restrictions had been lifted, compared with before the onset of the pandemic. The analysis was completed using descriptive statistics and content analysis.FindingsRespondents were mostly employed by the UK’s National Health Service (NHS) or the private sector. Many participants reported that demands on their service had increased compared with before the onset of the pandemic. The need to address the backlog of cases arising from shutdowns was the main reason for this. Contributing factors included staffing issues and redeployment. Service users were consequently waiting longer for NHS therapy. Private therapy providers reported increased demand, which they directly attributed to these NHS challenges.Originality/valueThis presents the only focused account of the impact of the national response to COVID-19 on speech and language therapy services in the UK. It has been identified that services continue to face significant challenges, which indicate a two-tier system is emerging. Healthcare system leaders must work with service managers and clinicians to create solutions and prevent the system from being overwhelmed.

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Impact of COVID‐19 on digital practice in UK paediatric speech and language therapy and implications for the future: A national survey

Cited by 9 publications

References 28 publications

UK paediatric speech and language therapists’ perceptions on the use of telehealth in current and future clinical practice: An application of the APEASE criteria

UK paediatric speech and language therapists’ perceptions on the use of telehealth in current and future clinical practice: An application of the APEASE criteria

Experiences of South African speech–language therapists providing telepractice during the COVID‐19 pandemic: A qualitative survey

Impact of the initial COVID-19 response in the UK on speech and language therapy services: a nationwide survey of practice

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