Introduction: Funding regimes supported by the public purse allow eligible families to access public funding models (PFMs) through private providers within Australia for children and adolescents with communication and swallowing needs. Contemporary PFMs underwritten by governments promote universal access i.e. National Disability Insurance Scheme (NDIS) and Medicare’s Chronic Disease Management Plan (CDMP). However, little is known as to whether public funding provisions reflect recommended scientific evidence for speech-language pathology (SLP) management.

Aim: This study aimed to investigate whether PFMs align with best available scientific evidence for children and adolescents with swallowing and communication difficulties within Australian independent practice settings.

Methods: Australian speech-language pathologists (SLPs) servicing children and adolescents in independent practice participated in an online national survey. Quantitative data were reported using descriptive statistics and mixed effects logistic regression analyses.

Results: A total of 121 SLPs (114 females; 7 males) with divergent career experiences (range 0 to > 31 years) completed the survey. In comparing six alternate PFMs, results indicated that incongruence with recommended scientific evidence for SLP management varied across PFMs, where CDMP (68% incongruent) performed less favourably in comparison to NDIS (33% incongruent).

Conclusion: Findings from this research indicated that PFMs differ in their ability to meet rigorous scientific evidence for SLP management. Respondents identified which PFMs failed to align with the evidence base for best practice SLP management. Advancing change through health economic principles of equity, efficiency and acceptability is required for future public funding provisions to maximise alignment with best available scientific evidence for SLP management.

Key Words: quantitative methods; funding models; private-practice

Submission Statement: SLPs continually reflect on access to funding provisions for clients. As SLPs, respect of funding is embedded within our Code of Ethics: “We act with integrity, diligence and honesty when accessing and managing funding provisions...” This research responds to Speech Pathology 2030’s call for improved funding advocacy.

TITLE: Working smarter, not harder in times of low staffing

INTRODUCTION/RATIONALE: High clinical workload and reduced backfill availability negatively impacts staff wellbeing.

AIM: To explore how the acute speech pathology team can “work smarter” during times of low staffing.

METHOD: Retrospective audit of acute speech pathology staffing over a 3-month period (Feb-April 2022) at a single health service. Acute staff completed a survey (free text) on perceived impact of low staffing on acute staff and participated in a process mapping workshop. Root cause analysis was used to explore causes and identify solutions.

RESULTS: Understaffing was present 28% of days worked. Staff reported negative impacts on wellbeing and ability to complete clinically related tasks (e.g. competency training, clinical supervision). Resources such as in-house prioritisation tool and clinical demand dashboard were not being fully utilised. Solutions included reviewing and updating prioritisation tools, championing their use and building use into daily practice, resulting in a more accurate understanding of daily clinical demand.

CONCLUSION: Using the prioritisation tool to accurately represent demand and assist staff to manage and prioritise workloads, assists with overall wellbeing and ability to complete clinically related tasks in a tertiary speech pathology department, thereby positively impacting job satisfaction.

KEY WORDS: Workforce management, staffing, wellbeing

SUBMISSION STATEMENT: Reflecting on sustainability of the speech pathology workforce and responding to the evolving needs of this workforce through prioritising wellbeing and job satisfaction.

Rationale: Children who have a Speech, Language, or Communication Need (SLCN) can experience significant impacts on their Quality of Life, including their academic and financial success. Speech pathology services support children who have SLCN by reducing the impact of the SLCN on the child’s life. However, some families experience challenges with accessing services, or are unable to commence speech pathology services at all. While individual factors such as funding, distance to services, and travel are identified within the literature as affecting access to healthcare services, speech pathologists had no model to support the design and review of their service provision.

Aim(s): To investigate the factors of access to speech pathology services, with a focus on services that address the needs of children who have a SLCN living in Western Australia.

Methods: MASPS was built using a Constructivist Grounded Theory approach. Speech pathologists and caregivers of children who have a SLCN took part in semi-structured in-depth interviews focussed on perspectives and experiences of speech pathology service access.

Results: Commencement and maintenance of services is impacted in an interconnected way by families’ access to resources, the service/s they accessed, and broader contextual factors. MASPS consists of seven categories and three contextualising properties which outline the factors that impact service access for speech pathology services.

Conclusions: Clinicians, as service providers will be able to MASPS to reflect upon their service provision in a way that is respectful of their consumers and community, and subsequently ease service access through an individualised response.

ABSTRACT
Background: COVID-19 the global health pandemic has had an unprecedented impact on how speech pathologists operating private practices manage their businesses and deliver their speech pathology services. The impact on this sector is yet to be comprehensively documented with regards to the initial and ongoing challenges and opportunities that have emerged as a result of the government restrictions that were imposed in response to the event.

Aim/s: to determine the ongoing impact of the COVID19 pandemic on speech pathology business owners, their businesses and staff who work in private practice in Australia.

Method: Ten speech pathologists in private practice were re-interviewed in a 12 month follow up study via video teleconference to learn about the ongoing impact of the COVID-19 pandemic on themselves, their private practice and their staff. Responses were transcribed and a thematic analysis conducted to determine the range of issues that evolved as the pandemic continued- what changed and what stayed the same.

Results: The business owners reported numerous changing challenges and opportunities that arose during their experiences operating their business during the pandemic.

Conclusion: The impact of a major global event on speech pathologists in business has revealed how the private sector of the profession responds to such societal changes. While new models of business practice emerged, the impact on the human resources of business was significant. Implications for the future of the speech pathology private practice sector will be discussed.

Introduction:
Childhood cancer affects around 750 Australian children aged 0-14 years annually, with incidence increasing. Cancers such as brain tumour and leukaemia, have a significant impact on a child’s development, including swallowing and communication skills. Speech pathologists are well placed to provide evidence-based specialist care (Docking et al., 2020) however access to Australian and New Zealand paediatric oncology services is variable.

Aim:
Evaluation of a pilot speech pathology oncology service through:
• Describing the characteristics of children with childhood brain tumour and leukaemia (CBTL) referred through the Children’s Cancer Centre (CCC) in a tertiary children’s hospital.
• Describing speech pathology service implementation and data collection used for service evaluation.

Methods
This mixed methods study used prospective audit and qualitative observational data conducted at a single site. Speech pathology assessment and intervention was offered to all families whose children were referred to speech pathology while under primary care of the CCC.

Patient and service data was collected over 12 months. Data analysis included descriptive statistics and thematic analysis of qualitative data.

Results: Findings highlighted communication and swallowing needs across a range of cancer diagnoses and stages of treatment, needs changed with different phases of treatment. Parents and caregivers highlighted concerns about development, communication and feeding during treatment. Quality Improvement was used to support a business case for ongoing funding.

Conclusion:
This study highlights the high and complex needs of children and families experiencing cancer treatment. Speech Pathologists can use clinical data and quality improvement to advocate for positive service change.

Keywords - Cancer, child, communication, feeding, dysphagia, quality of life.

Introduction: Health services are under increasing pressure to maximise service efficiency while providing high value care. While weekend service provision may assist patient flow and clinical outcomes, this model may be challenged by staff reluctance, higher staffing costs, and organisational factors. Little is known regarding current weekend speech pathology services across Australian health settings.
Aims: To understand the availability, models and perspectives of speech pathology managers regarding weekend speech pathology service provision.
Methods: An online, cross-sectional online survey consisting of 17 items was distributed to speech pathology managers (or their representative) working in Australian health settings. The survey used a mixed-methods design, gathering demographic and service profile data, as well as participants’ perspectives on weekend speech pathology services.
Results: From a total of 87 participants providing consent to participate in the survey, 67 unique facilities’ data were included in the final analysis (completion rate 77%). More than half (58.2%, n=39) provided a weekend speech pathology service, most commonly in metropolitan (n=41, 64.0%) and publicly funded services (n=62, 93.9%), with nearly two-thirds using a rostered SLP in a dedicated position (n=25, 65.8%). Many (n=37, 59.7%) respondents predicted a need for increased weekend services to enable equitable seven-day service provision, service subacute wards on weekends, and to provide increased access to senior SLPs and instrumental assessment.
Conclusions: Health facilities in Australia vary in their provision, access criteria, and staffing models for weekend speech pathology services. Further investigation is required to understand the benefits of this service model.
Keywords: weekend service; speech pathology; survey; health service delivery

Introduction: Australia is facing a massive shortage of Speech Pathologists (SPs) nationally, with clinicians struggling to meet requests for services. These shortages are felt heavily in regional areas and within the early intervention disability sector, with many organisations having six-to-twelve-month waitlists. Services are responding to these demands by implementing creative and innovative models of service.

Aim(s): To share The LEAP Centre’s capacity-building and consult model for providing speech pathology support to a broad range of children, through utilising Occupational Therapists (OTs) and Allied Health Assistants.

Method: Internal training was provided to upskill OTs with the aim to REFOCUS their skills to a transdisciplinary approach, to include specific communication supports within their sessions. The SP completed shadow visits to provide individual training and support for each OT to implement these strategies. Speech pathology support is now solely provided through primary and secondary consults, and blocks of intensive therapy with Allied Health Assistants.

Results: The preliminary results from this service model are promising. Families are thankful for speech support and see the benefit in being able to access the same therapists. A more equitable service is provided with numerous children receiving support, rather than only a few. After participating in the internal training, OTs reported an increase in their knowledge of speech pathology, and in their confidence in implementing speech support.

Conclusions: Reflecting on the shortages of SPs, The LEAP Centre, provides insight into their creative model for providing equitable speech pathology services. Practical applications are discussed for other organisations to consider.

Submission Statement: Speech pathologists are encouraged to reflect on service shortages and re-think equitable access. Responding to these shortages, The LEAP Centre provides insights into how speech services can adapt to better meet service demands. While respecting that all organisations are unique, this model offers other organisations practical applications to consider.