An investigation of SLTs' clinical decision making
An investigation of Speech and Language Therapists' clinical decision making: case selection following initial assessment and in the context of a resource shortfall
Duration of Study in the UK
0 years, 6 months, 29 days
When this research commenced, demand for Speech and Language Therapy (SLT) Services in Birmingham exceeded capacity. Waiting time was 9-12 months following initial triage before children were offered intervention. Since 2010, resource usage has been improved by rationalising and standardising decision making of the SLT team. The CI (Hesketh) developed a profiling and prioritisation tool (“PH@B” = Profiling / Prioritisation by Hesketh @ Birmingham) to assist the management of the service waiting list and to standardise the delivery of therapy. Locally devised tools such as PH@B are regularly used by SLT services, but to date none have been evaluated in terms of their reliability and validity.
Birmingham Community Healthcare NHS Trust cluster commissioners agreed a full implementation of the tool. Trust funding was obtained to evaluate PH@B’s validity and reliability and this service evaluation has been ongoing since funding commenced in March 2013. An examination of Birmingham SLTs’ rating and ranking of 6 constructed cases before and after PH@B training PH@B has taken place; this was based on retrospective data. This element of the project was considered to be service evaluation within an NHS context. The CI contacted the local NHS ethics committee and received confirmation that the project as undertaken did not require NHS ethical approval.
This current project component will prospectively recruit 35 SLTs from a maximum of 35 services outside of the Birmingham service, inviting them to complete the same constructed case rating and ranking activity. Comparison of decisions made by the Birmingham SLTs using PH@B with those made by other SLTs working in the NHS will facilitate an analysis of the validity of decisions using PH@B. Academic support is being offered by Professor Sue Roulstone and Dr Paul White from University of West of England (UWE). This component of the project has been approved by UWE Ethics Committee.