Attitudes to the Implementation of Speech and Language Therapist Led Low Risk Two Week Wait Clinic in the UK: A Survey Exploration Using Normalization Process Theory.

Objectives: The aim of this study was to identify the factors which might shape the implementation of speech and language therapist led low risk 2 week wait clinic (SLTLR-2WW).
Study Design: An online survey was designed, piloted, and disseminated through UK speech and language professional groups. The survey asked questions about, the skills of, and equipment available, to SLT respondents. Using a modified NoMAD instrument (based on Normalization Process Theory) the survey explored attitudes to the prospect of the development of the SLTLR-2WW clinical model in the UK. Responses were tallied and calculated as percentage of responses. The free text question responses were analyzed using a qualitative content approach, responses were coded and grouped into categories and mapped onto the Normalization Process Theory domains by the two authors.
Results: There were 129 responses to the survey questions from SLTs from all regions of the UK and 72 respondents supplied free text comments for analysis.
Conclusions: The collected responses indicate there is enthusiasm for the potential development of SLTLR-2WW clinics. The survey demonstrates that there are disparities in terms of resource availability, departmental, management and clinical support, around the UK. There is limited but successful experience of SLTLR-2WW in the UK but the survey responses indicate there is potential for expanding the scope of practice for SLTs into the delivery of clinical care for patients referred as suspected cancer with hoarseness and swallowing issues. The responses to the NoMAD derived questions and free text analysis identify some factors which could impede the development of this new service model include, resistance, lack of training, supervision, and support from colleagues and management.
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