Collaborative working: Speech and Language Therapy and the Stroke Association.




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Peer reviewed




INTRODUCTION The recent Care Quality Commission special review (2011 p15) suggested that only 40% of adult social services provide advice about community-based services for people with aphasia following a stroke. The Speech and Language Therapy (SLT) Department and the Stroke Association (SA) Communication Support Co-ordinator (CSC) in King’s Lynn provide communication support using a joint working approach. This SLT and voluntary sector partnership is recommended by the Royal College of Speech and Language Therapists (2007 p12) and the Department of Health (2007 p42). However the evidence base for co-ordinated community support for people with communication difficulties following stroke is limited. This study was designed to investigate the innovative collaboration between the SLT stroke team and the Stroke Association in West Norfolk. The aims of the study were to: define and evaluate this partnership and identify factors that influenced the success of this joint working approach. Approval for this research was given by the Queen Elizabeth NHS Trust Kings Lynn, Research and Development Office, the Stroke Association and De Montfort University, Leicester.

RESEARCH METHOD Four individual interviews were carried out with SLTs and CSCs in the West Norfolk Stroke service. Questions were standardised across all interviews and were designed to be open and non directive. Interviews were recorded, transcribed and then analysed using a grounded theme analysis. Simmons-Mackie et al (2007) describe grounded theory analysis as a reflexive process through which common issues and threads can be sorted into natural groups, subcategories and contrasts. This research methodology was developed in sociology and is used extensively across health professions. Skeat & Perry (2008) suggest that the use of grounded theory is particularly useful for research into topics that have restricted or absent theoretical underpinnings such as the area addressed by our study.

SUMMARY OF RESULTS AND CONCLUSIONS The results of this pilot study allowed the researchers to explore the use of grounded theory as a mechanism for uncovering, the nature of and attitudes to, partnership working between SLTs and CSCs. Interview analysis identified a simultaneous, collaborative, reciprocal, joint communication pathway that started in the acute setting and continued past discharge into the community and through to long term communication support. Interview analysis suggested that there are specific difficulties inherent in this type of independent collaboration. Analysis suggested that the West Norfolk scheme was successful because the collaboration involved active and continuous negotiation and re negotiation between the SLT service and the SA. Negotiations initiated by the CSC at the start of the SA communication support service facilitated successful start up of the collaboration. Discussions that showed, an awareness and empathy of the role and responsibilities of others, contributed to successful joint working. The teams also employed mechanisms such as: joint shadowing, two way referrals, joint projects, continuity of staff team across acute and community care. These factors appeared to engender productive working relationships. It is hoped that these initial findings can be used to promote successful collaboration between our profession and the voluntary sector. In the future it is hoped that this study will be extended to encompass the views of more participants providing different communication pathways.

REFERENCES Care Quality Commission (2011) Supporting life after stroke: A review of services for people who have had a stroke and their carers. London: Care Quality Commission.

Department of Health (2007) National Stroke Strategy. London: Department of Health.

Royal College of Speech and Language Therapists (2007) Policy statement: The contribution of Speech and Language Therapists along the care pathway of stroke survivors. London: Royal College of Speech and Language Therapists.

Simmons-Mackie, N.N., Kagan. A., O'Neill Christie, C., Huijbregts, M., McEwen, S. & Willems, J. (2007) Communicative access and decision making for people with aphasia: Implementing sustainable healthcare systems change. Aphasiology, 21, 39-66.

Skeat, J. Perry, A. (2008) Grounded theory as a method for research in speech and language therapy. International Journal of Language and Communication Disorders, 43, 2, 95-109.



grounded theory, Continuous negotiation, mechanisms for collaborations


Scantlebury, K., Bixley, M. and Smith, G. (2012) Collaborative working: Speech and Language Therapy and the Stroke Assocation. Presentation at The Royal College of Speech and Language Therapists Conference, Driving Transformation Using Evidence-Based Practice, 11-12 September 2012, p. 62.


Research Institute

Institute for Allied Health Sciences Research