Exploring accounts of collaborative working between speech and language therapists and stroke association communication support coordinators following stroke

ABSTRACT

In the United Kingdom, speech and language therapists (SLTs) and Stroke Association communication support coordinators (CSCs) are both employed to provide services for people with communication difficulties following stroke. There is very little literature of this type of collaborative working. This research is unique because it explores collaborative working between SLTs who are employed by the National Health Service and CSCs who are employed by the Stroke Association. Five CSCs and seven SLTs from the East of England participated in a series of in-depth interviews. Data were analysed using thematic analysis informed by an interpretative phenomenological approach. The analysis suggested complex negotiation processes occur at a number of different levels. These levels include negotiation of individual relationships between SLTs and CSCs, negotiating the particular challenges involved in working across organisations and professions, and the need for both roles to negotiate and promote the value of their services at a societal level. The findings of this research are discussed in relation to existing theories and research within the field of collaborative working. Clinical applications are suggested for collaborative working within communication services. We propose that our findings may have relevance to other individuals and organisations delivering services collaboratively.

KEYWORDS:

• Aphasia
• collaborative working
• communication support coordinator
• Speech and language therapy
• stroke association
• voluntary sector

Acknowledgments

The authors wish to acknowledge the support of the Research and Development Departments at Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, Hertfordshire Community NHS Trust (HCT), Cambridgeshire Community Services NHS trust and South Essex Partnership University NHS Foundation Trust (SEPT). We also thank the SA for their ongoing support with the study.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Notes

1. The vocabulary that surrounds collaborative working is complex and can be confusing. It has been referred to as a terminological quagmire (Leathard, 2003) with terms such as multidisciplinary working, interprofessional working, partnership working and joint working often used interchangeably. Throughout this paper, we have used the term collaborative working to describe the way in which SLTs and Stroke Association (SA) CSCs can work together. We have also selected to use the term voluntary sector throughout our article, when referring to the SA and the CSC role. The voluntary sector (also known as the third sector) refers to a group of diverse organisations which share various characteristics: they are formal, private, not-for-profit, self-governing, and involve a significant degree of voluntary participation (Billis & Glennerster, 1998). In the UK, the voluntary or third sector works extensively in the provision of health and social care, and includes both paid and voluntary roles within its organisations. CSCs are paid employees of the SA and are therefore referred to throughout this paper as members of the voluntary sector. Another term which needs clarification is our use of the word ‘professional’. The traditional definition of a professional might include membership of a regulated professional association, an extensive period of education and qualification prior to practising, and a specific body of knowledge, skills, and expertise (Day, 2013). Using this definition, the role of the voluntary sector CSC would be excluded from this use of the term. However, some authors suggest an alternative view, promoting the inclusion of a wide range of workers under the term ‘professionals’, both those with more traditional qualifications and those without (Day, 2013; Rawson, 1994). We have chosen to use this looser definition of the term, referring to both SLTs and CSCs as professionals.

Additional information

Funding

The authors gratefully acknowledge the contributions of the RCSLT Minor Award Scheme and The Friends of the Stroke Unit (Queen Elizabeth Hospital, King’s Lynn) towards the funding of this research project.