Perceptions of hospital-based clinical staff on the role of speech and language therapists in palliative care.

Background: Speech and language therapists (SLTs) are becoming increasingly involved in palliative care through the management of communication and swallowing difficulties. The role of SLTs in this area remains unclear. This research originated in response to a concern raised by SLTs regarding the withdrawal of referrals to SLTs for palliative care patients in an acute setting. Therefore, it is worth exploring how this role is perceived in order to ensure that appropriate service decisions for patients are made. Aims: To explore the perceptions of SLTs and hospital-based clinical staff (doctors, nurses, medical social workers and dieticians; the main referrers), regarding the role of SLTs in palliative care and to present an integrated overview of these perceptions. Methods: An exploratory qualitative research design was used. Access to staff was achieved via an SLT internal to the hospital who acted as gatekeeper. 7 SLTs participated in a focus group and 8 hospital-based clinical staff participated in semi-structured interviews. Data obtained were transcribed, anonymised and analysed using thematic analysis and organised according to thematic networks. Results: Three global themes were identified: SLT Role in Palliative Care; Referral Matters; and Palliative Care Considerations. Findings reflect the complex nature of palliative care. Conflicting perceptions from participants as to what SLTs can offer, SLTs’ lack of confidence, and SLTs’ role in communication often being overlooked emerged as key issues. Conclusions: A lack of certainty regarding the role of SLTs in palliative care prevents referrals to this service. Education of both SLTs and hospital-based clinical staff in the principles of this role are needed at an undergraduate level to increase confidence in this area. Intra-professional guidelines and clear referral pathways are warranted to improve service provision for patients.