{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T02:51:59Z","timestamp":1776307919874,"version":"3.50.1"},"reference-count":50,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The COVID\u201019 pandemic and the UK government's subsequent coronavirus action plan have fundamentally impacted on every aspect of healthcare. One area that is severely affected is ear, nose and throat (ENT)\/laryngology where speech and language therapists (SLTs) engage in a diverse range of practice with patients with a range of conditions, including voice disorders, airway problems, and head and neck cancers (HNCs). A large majority of these patients are in high\u2010risk categories, and many specialized clinical practices are vulnerable. In addition, workforce and research issues are challenged in both the immediate context and the future.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To discuss the threats and opportunities from the COVID\u201019 pandemic for SLTs in ENT\/laryngology with specific reference to clinical practice, workforce and research leadership.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>The relevant sections of the World Health Organisation's (WHO) health systems building blocks framework (2007) were used to structure the study. Expert agreement was determined by an iterative process of multiple\u2010group discussions, the use of all recent relevant policy documentation, and other literature and shared documentation\/writing. The final paper was verified and agreed by all authors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Contribution<\/jats:title><jats:p>The main threats to ENT\/laryngology SLT clinical services include increased patient complexity related to COVID\u201019 voice and airway problems, delayed HNC diagnosis, reduced access to instrumental procedures and inequitable care provision. The main clinical opportunities include the potential for new modes of service delivery and collaborations, and harnessing SLT expertise in non\u2010instrumental assessment. There are several workforce issues, including redeployment (and impact on current services), training implications and psychological impact on staff. Workforce opportunities exist for service innovation and potential extended ENT\/SLT practice roles. Research is threatened by a reduction in immediate funding calls and high competition. Current research is affected by very limited access to participants and the ability to conduct face\u2010to\u2010face and instrumental assessments. However, research opportunities may result in greater collaboration, and changes in service delivery necessitate robust investigation and evaluation. A new national set of research priorities is likely to emerge.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The immediate impact of the pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT\/laryngology SLT. It is unclear when any of these areas will resume operations and whether permanent changes to clinical practice, professional remits and research priorities will follow. However, significant opportunity exists in the post\u2010COVID era to re\u2010evaluate current practice, embrace opportunities and evaluate new ways of working.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p>\n<jats:boxed-text content-type=\"box\" position=\"anchor\"><jats:caption><jats:title>What this paper adds<\/jats:title><\/jats:caption><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>ENT\/laryngology SLTs manage patients with a range of conditions, including voice disorders, airway problems and HNCs. The diverse scope of clinical practice involves highly specialized assessment and treatment practices in patients in high\u2010risk categories. A large majority of active research projects in this field are patient focused and involve instrumental assessment. The COVID\u201019 pandemic has created both opportunities and threats for ENT SLT clinical services, workforce and research.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This study provides a discussion of the threats and opportunities from the COVID\u201019 pandemic for ENT\/laryngology SLT with specific reference to clinical practice, workforce and research leadership.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The COVID\u201019 pandemic has resulted in major disruption to all aspects of clinical delivery, workforce and research for ENT\/laryngology SLT. Changes to clinical practice, professional remits and research priorities are of indeterminant duration at this time, and some components could be permanent. Significant clinical practice, workforce and research opportunities may exist in the post\u2010COVID era.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><\/jats:boxed-text><\/jats:p><\/jats:sec>","DOI":"10.1111\/1460-6984.12565","type":"journal-article","created":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T08:22:38Z","timestamp":1596874958000},"page":"806-817","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["COVID\u201019 and ENT SLT services, workforce and research in the UK: A discussion paper"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8898-8292","authenticated-orcid":false,"given":"Joanne M","family":"Patterson","sequence":"first","affiliation":[{"name":"Liverpool Head and Neck Centre\/School for Health Sciences University of Liverpool, Liverpool  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2249-434X","authenticated-orcid":false,"given":"Roganie","family":"Govender","sequence":"additional","affiliation":[{"name":"Head and Neck Cancer Centre and Research Department of Behavioural Science &amp; Health University College Hospitals London University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-3124","authenticated-orcid":false,"given":"Justin","family":"Roe","sequence":"additional","affiliation":[{"name":"National Centre for Airway Reconstruction Department of Otolaryngology, Head and Neck Surgery Imperial College Healthcare NHS Trust  London UK"},{"name":"Department of Surgery and Cancer Imperial College  London UK"},{"name":"Department of Speech, Voice and Swallowing The Royal Marsden NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1796-731X","authenticated-orcid":false,"given":"Gemma","family":"Clunie","sequence":"additional","affiliation":[{"name":"National Centre for Airway Reconstruction Department of Otolaryngology, Head and Neck Surgery Imperial College Healthcare NHS Trust  London UK"},{"name":"Department of Surgery and Cancer Imperial College  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1397-3587","authenticated-orcid":false,"given":"Jennifer","family":"Murphy","sequence":"additional","affiliation":[{"name":"Department of Speech, Voice and Swallowing, ENT Outpatients Newcastle Upon Tyne Hospitals NHS Trust Newcastle Upon Tyne  UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-1675","authenticated-orcid":false,"given":"Grainne","family":"Brady","sequence":"additional","affiliation":[{"name":"Department of Speech, Voice and Swallowing The Royal Marsden NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jemma","family":"Haines","sequence":"additional","affiliation":[{"name":"Wythenshawe Hospital Manchester University NHS Foundation Trust University of Manchester NIHR Manchester Biomedical Research Centre Northwest Lung Centre  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5622-399X","authenticated-orcid":false,"given":"Anna","family":"White","sequence":"additional","affiliation":[{"name":"Department of Ear, Nose and Throat, Queens Medical Centre Nottingham University Hospitals NHS Trust  Nottingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4206-1827","authenticated-orcid":false,"given":"Paul","family":"Carding","sequence":"additional","affiliation":[{"name":"Oxford Institute of Nursing, Midwifery and Allied Health Research Faculty of Health &amp; Life Sciences Oxford Brookes University  Oxford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.05.028"},{"key":"e_1_2_8_3_1","unstructured":"Bolton L. Brady G. Coffey M. Haines J. Roe J.andWallace S. 2020 Speech and Language Therapy Led Endoscopic Procedures in the COVID\u201019 Pandemic. RCSLT [online]. (available athttps:\/\/www.rcslt.org\/-\/media\/docs\/Covid\/RCSLT-COVID-19-SLT-led-endoscopic-procedure-guidance)(accessed on 18 May 2020)."},{"key":"e_1_2_8_4_1","unstructured":"British Association of Head and Neck Oncologists (BAHNO)Statement on Covid\u201019 [online](available at:https:\/\/www.bahno.org.uk\/bahno_statement_on_covid-19.aspx)(accessed on 18 May 2020)."},{"key":"e_1_2_8_5_1","unstructured":"British Psychological Society 2020 The psychological needs of healthcare staff as a result of the Coronavirus pandemic [online] (available at:https:\/\/www.bps.org.uk\/sites\/www.bps.org.uk\/files\/News)(accessed on 18 May 2020)."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003368"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215113002478"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24706"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000362"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjaed\/mku047"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104684"},{"key":"e_1_2_8_12_1","first-page":"39","volume-title":"Referral Guidelines for Suspected Cancer","author":"Department of Health","year":"2000"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0037-1601403"},{"key":"e_1_2_8_14_1","unstructured":"European Medicines Agency (EMA).Coronavirus disease (COVID\u201019) [online](available at:https:\/\/www.ema.europa.eu\/en\/human-regulatory\/overview\/public-health-threats\/coronavirus-disease-covid-19)(accessed on 12 June 2020)."},{"key":"e_1_2_8_15_1","unstructured":"NHS Employers 2020 COVID\u201019 guidance for NHS workforce leaders. [online] (available at:https:\/\/www.nhsemployers.org\/covid19) (accessed on 18 May 2020)."},{"key":"e_1_2_8_16_1","unstructured":"ENT UK.Covid\u201019 Guidelines [online](available at:https:\/\/www.entuk.org\/covid-19)(accessed on 18 May 2020)."},{"key":"e_1_2_8_17_1","first-page":"1","volume-title":"Speech Science","author":"Hirano M.","year":"1985"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/02770903.2014.982288"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/1460-6984.12457"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2013.03.001"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2020.05.012"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","unstructured":"Mcgrath B. A. Wallace S.andGoswamy J. 2020 Laryngeal oedema associated with COVID\u201019 complicating airway management. Anaesthesia (on line first).","DOI":"10.1111\/anae.15092"},{"key":"e_1_2_8_23_1","unstructured":"MHRA guidance on coronavirus (COVID\u201019) 2020 [online](available at:https:\/\/www.gov.uk\/government\/collections\/mhra-guidance-on-coronavirus-covid-19) (accessed on 12 June 2020)."},{"key":"e_1_2_8_24_1","unstructured":"NHS England News 2020 [online] (available at:https:\/\/www.england.nhs.uk\/2020\/04\/help-us-help-you-nhs-urges-public-to-get-care-when-they-need-it\/)(accessed on 16 June 2020)."},{"key":"e_1_2_8_25_1","unstructured":"NHS Health Research Agency (HRA)Covid\u201019 Research 2020 [online] (available at:https:\/\/www.hra.nhs.uk\/covid-19-research\/)(accessed on 12 June 2020"},{"key":"e_1_2_8_26_1","unstructured":"NHS Improvement Plan 2020[online] (available at:https:\/\/improvement.nhs.uk\/home\/)(accessed on 18 May 2020)."},{"key":"e_1_2_8_27_1","unstructured":"National Institute for Health and Clinical Excellence 2004 Improving outcomes in head and neck cancers. [online] (available atwww.nice.org.uk\/headandneckcancer) (accessed 18 May 2020)."},{"key":"e_1_2_8_28_1","unstructured":"National Institute for Health Research Covid 19 Guidelines 2020a [online] (available at:https:\/\/www.nihr.ac.uk\/documents\/covid-19)(accessed on 18 May 2020)."},{"key":"e_1_2_8_29_1","unstructured":"National Institute for Health Research Commissioned Call for Research 2020b [online] (available at:https:\/\/www.nihr.ac.uk\/documents\/nihr-commissioned-call-specification-document-covid-19-recovery-and-learning\/24969)(accessed on 16 June 2020)."},{"key":"e_1_2_8_30_1","doi-asserted-by":"crossref","unstructured":"Paleri V. Hardman J. Tikka T. Bradley P. Pracy P.andKerawala C. 2020 Rapid implementation of an evidence\u2010based remote triaging system for assessment of suspected referrals and patients with head and neck cancer on follow\u2010up after treatment during the COVID\u201019 pandemic: Model for international collaboration. Head Neck (accessed on 06 May 2020)https:\/\/doi.org\/10.1002\/hed.26219(on-line).","DOI":"10.1002\/hed.26219"},{"key":"e_1_2_8_31_1","unstructured":"Public Health England 2020 COVID\u201019: guidance on shielding and protecting people defined on medical grounds as extremely vulnerable. [online] (available at:https:\/\/www.gov.uk\/government\/publications\/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19)(accessed 18 May 20)."},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.29241"},{"key":"e_1_2_8_33_1","unstructured":"Royal College of Speech and Language Therapists 2020a COVID\u201019: Maximising the contribution of the speech and language therapy workforce. [online] (available at:https:\/\/www.rcslt.org\/-\/media\/docs\/Covid\/Redeployment-of-SLTs)(accessed 18 May 2020)."},{"key":"e_1_2_8_34_1","unstructured":"Royal College of Speech and Language Therapists 2020b Impact of the COVID\u201019 pandemic on the speech and language therapy profession. [online] (available at:https:\/\/www.rcslt.org\/-\/media\/docs\/Covid\/RCSLT-Survey--impact-of-COVID--FINAL.pdf?la=en&hash=051489D0F453888E4983AAD01C14C6BD63512991)"},{"key":"e_1_2_8_35_1","unstructured":"Royal College of Speech and Language Therapists 2020d Speech and language therapist\u2010led endoscopic procedures in the COVID\u201019 pandemic. [online]. (available at:https:\/\/www.rcslt.org\/-\/media\/docs\/Covid\/RCSLT-COVID-19-SLT-led-endoscopic-procedure-guidance_FINAL-(2).PDF?la=en&hash=8101575091FE8F1ABA41B4B472387DAFB023A39D)(accessed on 9 June 2020)."},{"key":"e_1_2_8_36_1","unstructured":"Royal College of Speech and Language Therapists 2019 OICE Position Paper [online](available at:https:\/\/www.rcslt.org\/-\/media\/docs\/clinical-guidance\/voice-position-statement.pdf)(accessed on 25 April 2020)."},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1297"},{"key":"e_1_2_8_38_1","unstructured":"Slade S. Mcglashan J. 2018 \u201cCan Speech and Language Therapists manage hoarse voice patients on the Two Week Wait Head and neck cancer referral pathway?\u201d [Poster] exhibited at European Laryngology Society meeting London."},{"key":"e_1_2_8_39_1","first-page":"CD013067","article-title":"Speech and language therapy for management of chronic cough","volume":"7","author":"Slinger C.","year":"2019","journal-title":"Cochrane Database of Systematic Review"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817751030"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489418823797"},{"key":"e_1_2_8_42_1","unstructured":"The Health Protection (Coronavirus) Regulations 2020 [online](available at:http:\/\/www.legislation.gov.uk\/uksi\/2020\/129\/regulation\/1\/made)(accessed on 18 May 2020)."},{"key":"e_1_2_8_43_1","doi-asserted-by":"crossref","unstructured":"Tysome J. R.andBhutta M. F. 2020 COVID\u201019: Protecting our ENT Workforce. Clinical Otolaryngology. First published: 04 April 2020.https:\/\/doi.org\/10.1111\/coa.13542","DOI":"10.1111\/coa.13542"},{"key":"e_1_2_8_44_1","unstructured":"UK Research and Innovation 2020 [online](available at:https:\/\/www.ukri.org\/)(accessed 18 May 2020)."},{"key":"e_1_2_8_45_1","first-page":"492","article-title":"Self\u2010care for doctors during the COVID\u201019 crisis","volume":"2020","author":"Unadkat S.","year":"2020","journal-title":"BMJ"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2013.0198"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1044\/2019_PERSP-19-00146"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000536"},{"key":"e_1_2_8_49_1","volume-title":"Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: WHO's Framework for Action","author":"WHO"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1117"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599811414506"}],"container-title":["International Journal of Language &amp; Communication Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2F1460-6984.12565","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.12565","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1460-6984.12565","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1460-6984.12565","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T19:25:23Z","timestamp":1693941923000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1460-6984.12565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,8]]},"references-count":50,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1111\/1460-6984.12565"],"URL":"https:\/\/doi.org\/10.1111\/1460-6984.12565","archive":["Portico"],"relation":{},"ISSN":["1368-2822","1460-6984"],"issn-type":[{"value":"1368-2822","type":"print"},{"value":"1460-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,8]]},"assertion":[{"value":"2020-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}