Nicola Bush is an Advanced Speech and Language Therapist at Lincolnshire Community Health Services NHS Trust (LCHS). When she heard about NHS Change Day from her trust’s Communications team, she was keen to showcase the changes made to services for adults who stammer in Lincolnshire.When Nicola joined LCHS, therapy for adults who stammer had stopped following the retirement of the Specialist Dysfluency Speech and Language Therapist. Recruitment challenges meant patients were only seen for assessment, information and signposting to other services. LCHS took many steps to try and re-establish a specialist service including considering buying in stammering services from neighbouring NHS Trusts. As only a quarter of patients could access out of county treatment, the team decided to focus on reviving a service in Lincolnshire – developed around the needs of the patients.
Nicola focused on meeting those who had been waiting for input and commenced therapy. It was heart-breaking to hear how the lack of specialist input had affected individuals. These stories pushed Nicola to make sure her patients were involved in the development of a new service; that they were given back their voice. Initial consultations with patients involved letters, questionnaires and informal discussions to initially shape services. She then consulted more formally through a Patient Experience Event.
Feedback Nicola gathered from patients has led to:
- an increase in stammering clinics and flexible appointment times across Lincolnshire
- development of a collection of stammering leaflets approved by adults who stammer and LCHS
- implementation of a separate bell entry system, (where patients do not have to speak in to an intercom system) where required in stammering clinics
- stammering service leaflets being sent out with patient appointment letters to reduce anxiety and improve attendance
- SMS text message appointment reminders being explored
- implementation of a web form on the LCHS Adult Speech and Language Therapy public webpage for patients to get in touch if they feel unable to ring in to amend or confirm appointments
- Nicola delivering training on Adult Acquired Neurogenic Stammering to junior therapists across Lincolnshire to improve Speech and Language Therapy skills when working with adults who stammer in the hospital setting
- Nicola looking to arrange support groups for people who stammer alongside their therapy, following comments that “Talking with other people with a similar condition has been helpful.”
Impacts of this change
There is currently no waiting list for adults who stammer in Lincolnshire and all patients are seen for individual personalised therapy. Whilst stammering affects only a small number in our communities, the impacts are far reaching on an individual’s quality of life and wellbeing. To Nicola, it has been a privilege and an honour to work with this group and it is an area of her job she feels truly passionate about. LCHS has really embraced the stammering community and are very supportive to protect the future of services for those who stammer. This work is proof of LCHS’s value and drive to ‘put patients first.’Patients have reported the LCHS SLT Stammering Service provided by Nicola has ‘made a big difference to their lives.’ An example of this can be seen in the life a patient, who after engaging in therapy for her stammer and attending a Trust Board meeting to raise awareness of the stammering service, found that she now had the speech skills and confidence to herself apply for a job within the NHS, to which she was the successful applicant. This was a very proud and happy moment for Nicola.
The stammering service is testament to what can be done when dedicated therapists, managers and patients work together with shared purpose.
You can find out more about the Speech and Language Therapy service on the LCHS website.