Co-design and co-production in Adult Speech and Language Therapy
NELFT Quality Improvement Services have been working closely together with the Adult Speech and Language Therapy Team on an innovative co-produced piece of work to explore where areas of improvement might be needed within the service, with the aim of creating a service that truly is patient lead, where patients voices are heard and change is made as a result.
This project was born as a result of a quality improvement project led by Rhiannon Haag (Clinical Lead Speech and Language Therapist) which came about due to the onset of the Covid-19 pandemic. Find out more about the orginal quality improvement project, and how this has developed into the co-production piece of work below.
Original QI Project: Bringing the hospital home post laryngectomy
Introduction to project:
The Speech and Language Therapy (SLT) department at North East London NHS Foundation Trust (NELFT) offers specialist laryngectomy rehabilitation in North East London. A laryngectomy is when an individuals voice box is surgically removed as a treatment for cancer of the larynx, which leave the individual without a voice, and therefore needs a replacement means of communicating. Part of the care post surgery is the care of the permanent neck stoma & management of surgically placed voice prostheses. Historically, clinics were offered at a local acute hospital.
However, as a result of the Covid-19 pandemic in March 2020, outpatient clinics were closed. Initially, another hospital provided emergency support, however this was unsustainable and some patients, concerned about travelling and covid exposure, declined appointments. Waiting times rose to 83 days, increasing the risk of avoidable medical complications. As suc, an alternative, innovative model of community-based provision was introduced to reduce waiting times, limit covid exposure, and re-establish local care, whilst maintaining patient safety. This was the first comprehensive domiciliary laryngectomy service to be introduced across the NHS.
This background triggered the start of a quality improvement project that has gone on to be presented at the international Institute for Healthcare Improvement conference 2022, won a NELFT Make a Difference Award, and a NELFT Quality Improvement Award due to it's innovative nature and the true difference it has made to the users of service.
Learn more about this project:
The links below will help you understand this project further:
- Poster presented at the IHI Gothenburg 2022 Conference: Speech-and-Language-Therapy---Pandemic-innovation-a-home-visiting-service-for-laryngectomees-2022.pdf [pdf] 385KB
- Storyboard presented at the NELFT Quality Improvement Services Sharing and Learning Event 2023: Project presentation - Adult Speech and Langauge Therapy.pdf [pdf] 723KB
- Video presentation from NELFT Quality Improvement Services Sharing and Learning Event 2023:
Co-Design and Co-Production Project: One Voice
Introduction to project:
The result of the above quality improvement project was so successful that the users of service didn't in fact want to return to hospital for appointments after the threat of Covid-19 had reduced as they saw the many benefits the at home service offered. This showed the Adult Speech and Language Therapy team that a service they previously had been running (in hospital appointments) although seemingly had not problems or particular improvements required, in fact could be improved further and indeed was. As such, the Adult Speech and Language Therapy team were understandably keen to ensure that the users of service continued to receive the care they were asking for, but also wanted to ensure that the quality of this care was as high as it could be, not making the assumption that no immediate red flags or complaints meant that the service was performing at as high a quality as possible.
As such, the team wanted to explore what other improvements might be needed and where else problems in care might be occurring. The team knew that involving the users of services not just as stakeholders, but as equal parts in the project where they could truly co-design the project was essential.
This started the journey of the project, which used the Point of Care Foundation Experience Based Co-Design Framework. Find out more about this framework and the foundation here: 1. What is Experience-based co-design? - Point of Care Foundation
Project posters and presentations:
Below you can find out more about the project below:
- Project poster that will be presented at the NELS AHP conference: Poster for NELS AHP conference 2023.pdf [pdf] 602KB
- Short presentation by Clare Linger (Quality Improvement Learning and Support Team Lead).
Staff and user of services interviews around experience of the project
Experience Based Co-Design Framework
The framework utilised to compelte this project was the Point of Care Foundation Experience Based Co-Design Framework.
Find out more about this framework and the foundation here: 1. What is Experience-based co-design? - Point of Care Foundation