Division of Language and Communication Science, School of Health Sciences, City, University of London, Northampton Square, London.
Department of Otorhinolaryngology and Head and Neck Surgery, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Curr Opin Otolaryngol Head Neck Surg. 2021 Jun 1;29(3):179-186. doi: 10.1097/MOO.0000000000000713.
Spiralling numbers of patients are being referred on the two-week wait (2WW) head and neck cancer referral pathway. Only a small proportion are found to have cancer. There is a call for change in the management of these referrals, particularly following coronavirus. Allied health professionals (AHPs) are being encouraged by the NHS to extend their clinical practice to address increased demand. Speech and Language Therapists (SLTs) may offer a solution to some of the 2WW pathway's challenges.
Recent evidence highlights problems with the pathway and reasons for change. Hoarse voice is consistently found to be the most common presenting symptom. Emerging evidence suggests SLTs can extend their scope of practice to manage new hoarse voice referrals. A pilot project is described. Outcomes from this and other ongoing studies explore efficacy and investment required to make this proposal an achievable prospect for the future.
The management of 2WW referrals on the head and neck cancer pathway needs to change. Preliminary findings suggest SLTs working within the context of the multidisciplinary team can safely extended their role to improve management of these patients. Professional role outline, recognition, guidance, and training framework are needed.
目的综述:越来越多的患者通过两周等待(2WW)头颈部癌症转诊途径被转诊。但只有一小部分被发现患有癌症。有人呼吁改变这些转诊的管理方式,尤其是在冠状病毒之后。国民保健制度鼓励辅助医疗专业人员(AHPs)扩大其临床实践范围,以满足日益增长的需求。言语和语言治疗师(SLTs)可能为解决 2WW 途径的一些挑战提供了一种解决方案。
最新发现:最近的证据强调了该途径存在的问题和需要改变的原因。声音嘶哑一直是最常见的主要症状。新出现的证据表明,言语和语言治疗师可以扩大其执业范围,以管理新的声音嘶哑转诊。描述了一个试点项目。该项目和其他正在进行的研究的结果探讨了为使这一提议成为未来可行的前景而需要的疗效和投资。
总结:头颈部癌症途径的 2WW 转诊管理需要改变。初步研究结果表明,言语和语言治疗师在多学科团队的背景下可以安全地扩大其角色,以改善这些患者的管理。需要明确专业角色、认可、指导和培训框架。