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One Voice: Bringing the hospital home post laryngectomy – best practice example

The NELFT Quality Improvement Team have been working closely together with the Adult Speech and Language Therapy Team on an innovative co-produced approach to explore where areas of improvement might be needed within the service, with the aim of creating a service that truly is patient led.

During the pandemic, the team established the UK’s first comprehensive domiciliary service for people after laryngectomy. Using QI methodology, they were able to collect data demonstrating improved accessibility, reduced environmental impact, and high levels of safety and patient satisfaction.  In 2022, the decision was made to build on this innovation and investigate how the service could be further improved, particularly drawing on the additional resources available in community settings. The project, “One Voice: Bringing the hospital home post laryngectomy” is becoming cited as a best practice example in redesigning the landscape of post-laryngectomy care locally. The project’s recent achievement of winning a grant to present at the Billroth Memorial International Laryngectomy conference in Amsterdam, is another example highlighting the project's calibre. This recognition validates the team's efforts and positions them as leaders in the field of patient led laryngectomy care.

Podcast Feature by The Point of Care Foundation:

A notable milestone for the project is the release of a podcast by The Point of Care Foundation, featuring Patrick Onyema from the Quality Improvement (QI) team and Rhiannon Haag (Clinical Lead Speech and Language Therapist). The podcast discusses the team's experience with coproduction – a collaborative approach involving patients and healthcare professionals in decision-making. This spotlight on coproduction sheds light on the importance of patient involvement in shaping the trajectory of healthcare projects. It also speaks to the way QI and coproduction can support staff wellbeing through increased autonomy and involvement in patient-centred service improvement. You can access the podcast here: ‎The Humanising Health and Care podcast: How to use EBCD for quality improvement on Apple Podcasts

Contributions to Laryngectomy Position Paper:

Rhiannon Haag's role as a co-author of the recently published laryngectomy position paper and head and neck cancer guidance by the Royal College of Speech and Language Therapists (RCSLT) further underscores the project's influence. These documents, released a few weeks ago, encourage services to actively consider non-traditional service models, particularly with a view to supporting people as they age.  Clinicians are also actively encouraged to pursue formal QI methods and co-design as approaches to developing new ways of working.

RCSLT Case Study:

The Royal College of Speech and Language Therapists (RCSLT) have also chosen the Laryngectomy Project as a case study on their website, showcasing it as an innovative service model for other teams to emulate. This endorsement emphasises the significance of this work and encourages healthcare professionals to consider developing similar community services.

Future developments:

In line with the EBCD model, the team are continuing to use QI methodology to redesign aspects of the service with the collaboration of their service users and other professionals.  These projects are targeting improvements in the transition from hospital to home, supporting wellbeing and holistic care, improving access to primary care services, and improving access to communication therapy across the lifespan.  So far, the projects have involved not only patients and their loved ones, but also SLTs from multiple organisations, a GP, voluntary sector representatives, psychology services, occupational therapy, community nursing, community respiratory therapy, and the expert patient programme.

One Voice's ability to engage stakeholders, employ coproduction, and deliver tangible benefits to patients highlights what can be achieved through innovative and continuous healthcare improvement. As other healthcare teams look to replicate its success, the One Voice Project's legacy continues to shape the future in this service.

If you’d like to learn more about the project, please see: Co-Design and Co-Production in Adult Speech and Language Therapy | NELFT NHS Foundation Trust

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