Advancing Dysphagia Practice

DYSPHAGIA

GETTING IT RIGHT FOR THE PATIENT

‘Is patient experience paramount? Managing complexity in dysphagia – inter-professional perspectives’

Balancing the evidence base with patient choice

A multi-professional CPD event – exploring the challenges of balancing patient safety with patient experience and quality of life

Thursday 8th May 2014 10am – 4.15pm

Thursday 23rd and Friday 24th June 2016

University of Central Lancashire, Preston PR1 2HE

Course feeof (including £85.00 Preston University Centrallunch) Lancashire,

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Advancing Dysphagia Team

UCLan are proud to host the Advancing Dysphagia Practice Team, in partnership with Tees, Esk and Wear Valley NHS Foundation Trust.

Tees, Esk and Wear Valleys NHS Foundation Trust

All the ADP initiatives and events are delivered by highly specialist professionals who are recognised experts in their field. These events are open to all healthcare professionals working with people who have dysphagia, with emphasis on the context of the Multi-Disciplinary Team. Our aim is to influence best practice by delivery of the highest quality, up-to-date, evidence-based professional development opportunities in dysphagia, by facilitating participants to develop their current knowledge and skills.

The Advancing Dysphagia Practice team are delighted to have active support for this event from: Pulse Allied Health Jobs https://www.pulsejobs.com/allied-health/

Conference Overview Audience: This event has been developed for a multi-disciplinary audience of practitioners working in the field of eating, drinking and swallowing difficulties with any clinical population including: • Neonates • Paediatric special needs • Adult learning disability/intellectual impairment

• Adult neurology • Head and neck cancer • End of life care

Registration is welcomed by all professionals working in this field, including but not limited to: • Speech and Language Therapists/Pathologists • Psychologists • Nutritionists/Dieticians

• Specialist Nurses • Radiographers

The conference language is English.

Advancing Dysphagia Practice

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Programmes at a glance Day One Programme

- Thursday 23rd June

9.15

Registration & Coffee

10.00

Welcome & introduction – Dr Hazel Roddam & Dr Hannah Crawford, Co-Directors, Advancing Dysphagia Practice

10.10

Keeping the client at the centre of what you do – Dr Heulwen Sheldrick, Clinical Lead for Specialist Services / Specialist Speech and Language Therapist, Bridgewater Community Healthcare NHS Foundation

10.40

Understanding of the lived experiences of dysphagia from the perspective of family carers – Dr Hannah Crawford, Consultant Speech & Language Therapist, Tees, Esk & Wear Valley NHS Foundation Trust

11.10

Refreshment break

11.40

The challenges of involving patients in complex team decisions – Dr David Hamilton, NIHR Academic Clinical Lecturer, Newcastle University

12.10

Hosted Q & A – Plenary panel of all the morning presenters

12.45

Lunch

13.45

Thickeners are an effective tool in the management of dysphagia: A debate – Tracy Lazenby-Paterson, Specialist Speech & Language Therapist, NHS Lothian & Karen Krawczyk, Specialist Speech & Language Therapist, NHS Greater Glasgow & Clyde

14.45

Break

15.15

Supporting people living with dementia at high risk on all oral intake – Lindsey Collins, Dementia Care Consultant Trainer, School of Dementia Studies, University of Bradford

16.15

Thanks and close – Dr Hazel Roddam & Hannah Crawford Co-Directors, ADP

Day Two Programme

- Friday 24th June

9.00

Registration

9.15

Workshop Part 1 Workshops will run with a maximum of 20 delegates in each group, and will allow delegates to reflect on the content on day 1 with particular reference to their own client population. The workshops will facilitate delegates in drawing out key messages from day 1, grounded in their own practice environments, and to consider plans to implement development or change in their own practice on return to the workplace. There will be one workshop for each of the following clinical areas: • • • • •

Paediatrics Adult Learning Disability Head and neck cancer Adult Neurology Dementia

10.45

Break

11.15

Workshop Part 2

12.30

Close

Advancing Dysphagia Practice

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Speaker Biographies and Session Synopses

Dr Heulwen Sheldrick, Clinical Lead (Specialist Services) and Specialist SLT, Bridgewater Community NHS Trust Heulwen has worked as an NHS Speech and Language Therapist since 1990, and has held a variety of roles over the years – clinical, managerial, academic and strategic. Heulwen completed her PhD at Liverpool University in 2007, focusing on clinical decision making within dysphagia management. She currently works as a clinical lead in a large community trust supporting NHS health care professionals from a variety of disciplines. Specifically, she seeks to challenge current ways of working and increase professional autonomy in clinical services. Heulwen’s work is founded on the belief that we need to challenge the ‘expert’ model when providing clinical services. Moving beyond the theory, she helps clinical teams to apply principles of values based decision making in a practical way and re-dress the balance of power in clinical interactions.

Session Synopsis The presentation will ask you to reflect. Do you REALLY keep the client at the centre of what you do? Have you FULLY explored your client’s values, attitudes and beliefs so that you can understand and support the choices they make? Specifically, do you know how effective you are when you try to empower others in decision making about their health? The current context of NHS healthcare is increasingly complex and challenging. We are in a culture of high expectations and demands - in a public sector with limited resources. Given the global and national position, it is important (now more than ever) to recognise the responsibility we have to consider resources as well as clinical care, and to contribute to creating a society with increased personal ‘ownership’ of health and self care. Fostering dependence on healthcare professionals is dangerous for clients, wider communities and society at large, and we have a significant role to play in changing the ‘tone’ of healthcare delivery. The principles of values based, shared decision making will be discussed, drawing on examples in dysphagia management. The presentation will explore how clinicians can tangibly adjust their style of approach, influence commissioning and create systems to encourage greater control for clients. The ‘currency’ of measuring patient experience is no longer a ‘soft’ science and showing clinical impact in creative ways will be explored. We have a mandate to focus on what is meaningful for our clients. Let’s not miss this opportunity!

Advancing Dysphagia Practice

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Dr Hannah Crawford, Consultant Speech and Language Therapist, Tees, Esk and Wear Valleys NHS Foundation Trust Hannah Crawford is a Consultant Speech & Language Therapist working for Tees, Esk & Wear Valleys NHS FT. She is a professional advisor for the Royal College of Speech & Language Therapists in adults with learning disability and dysphagia, and has been involved in the development of their most recent professional guidance. She was a member of the NPSA working party looking dysphagia in adults with learning disabilities and dysphagia, and has consulted on dysphagia for the Healthcare Commission. She is a co-leader for the Advancing Dysphagia Practice Seminars and is also the co-leader for the Newcastle University Dysphagia CPD module. She is an active researcher in the area of adult learning disability dysphagia. Her interests include carer compliance and ageing in learning disabilities. She has just completed a PhD at the University of Edinburgh looking at the lived experiences of profound intellectual and multiple disabilities and dysphagia from the perspective of family carers . She has published in Speech & Language Therapy journals, and presents at national and international conferences in the area of Dysphagia in adults with learning disabilities.

Session Synopsis This session will describe a study that aimed to develop an understanding of the lived experiences of profound intellectual and multiple disabilities and dysphagia from the perspective of family carers. Only when we examine this and allow individuals to tell their stories can we understand and offer support accordingly and ensure more functional and beneficial interactions and interventions. Findings emerged around four themes – the meaning of food and mealtimes, relationships, roles within the family and challenges. Findings will be discussed and recommendations made for practice.

Dr David Hamilton, NIHR Academic Clinical Lecturer, Newcastle University David qualified from Newcastle University in 2004 and completed his PhD from the same university 10 years later. He now works as an NIHR Academic Clinical Lecturer and has a particular interest in patient-centred research in head and neck cancer, with a particular emphasis on decision making and organisation of care.

Session Synopsis Head and neck cancer (HNC) confers a poor prognosis and patients face complex treatment decisions. As with every cancer in the UK, recommendations for treatment are made through a multidisciplinary team (MDT). In this talk, the working of the MDT is critically analysed: data are presented from an ethnographic study of the MDT in three head and neck cancer treatment centres and various studies of decision making in head and neck cancer. Through the course of the talk, we shall discuss how although an assessment of which treatment is considered ‘best’ drives the MDT discussion, there is often disagreement or uncertainty surrounding this assessment. On delivering the recommendation to the patient, this backstage work often remains hidden, contributing to problems when offering treatment choice. Even when a choice of treatment is acknowledged, the MDT faces barriers in delivering and supporting this in the MDT clinic. For the patient, the majority of the work of decision making takes place away from the MDT clinic, a process which is not always supported by the MDT. The difficulties of actively involving patients in the MDT decision process have never been explored, but the complexities of offering treatment choice in the MDT need to be recognised to support patients in this setting. The guiding principles, purpose and limitations of the MDT meeting and the resultant treatment recommendation need to be clear. A process of collaborative MDT decision making should allow effective communication of treatment risk and uncertainty, structured elicitation of patient preferences and support for patients to make decisions in line with their preferences and values.

Advancing Dysphagia Practice

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Tracy Lazenby-Paterson, Specialist Speech & Language Therapist NHS Lothian Tracy is a Specialist Speech and Language Therapist working with adults with learning disabilities (ALD). She is an RCSLT Professional Adviser in ALD Dysphagia, and has been Chair of the Scottish SLT Dysphagia Clinical Excellence Network since 2010. Tracy has developed and lectured on a range of specialist undergraduate and postgraduate courses in dysphagia, including the MMU Advanced Clinical Practice in Dysphagia course and the UCLan Advancing Dysphagia Practice courses. Research interests and academic publications include dysphagia in Down’s syndrome, the impact of aging on eating, drinking and swallowing function in adults with learning disabilities, as well as ethical considerations in the assessment and management of dysphagia in this population. Currently Tracy is interested in current literature about the use texture modification of foods and fluids in the management of dysphagia, and how it influences changes to SLT practice.

Karen Krawcyzk, Specialist Speech & Language Therapist, NHS Greater Glasgow and Clyde Karen has held advisory, clinical and managerial roles in the management of Adult neurological dysphagia and has taught at undergraduate and post graduate level. Karen taught on the Advanced Dysphagia Course Manchester Metropolitan University for over 12 years and also acted in the role of External Examiner for three years. She has written a number of articles and a chapter: Speech and Language Therapy: Issues in Professional Practice, Dysphagia Combining Conflicting Models? James Wiley 2005. She undertook a secondment with NHS Quality Improvement in Scotland in 2008-2009 looking to improve practice in Dysphagia management across Scotland. http://www.healthcareimprovement scotland.org/previous_resources/implementation_support/easier_to_swallow_report.aspx? theme=mobile She was on the Expert Reference Group for the National Patient Safety Agency looking at Dysphagia Diet Food Descriptors 2011.She now works for NHS Greater Glasgow and Clyde across 2 community rehabilitation teams covering younger and older adults. She holds a Life Coaching Diploma and brings those skills into her work.

Session Synopsis Thickening fluids has long been considered a core tool of the SLT and a cornerstone of dysphagia treatment and management. However the literature suggests that commercial thickeners have come under increasing scrutiny as to its potential benefits and risks. This session will be a debate of the statement: "Commercial thickeners are an effective tool in the management of dysphagia" with guest speakers arguing for or against the statement. Delegates will be asked to give their answer to this question (yes/no/not sure) at the time of registration and after the debate to gauge any general change of opinion.

Advancing Dysphagia Practice

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Lindsey Collins, Dementia Care Trainer, Bradford Dementia Group, University of Bradford Lindsey Collins is a registered Speech and Language Therapist who specialises in working with people who are living with dementia. Lindsey’s current role is as a Dementia Care Practice Development Consultant and Trainer at the School of Dementia Studies, University of Bradford, which is an internationally renowned centre of excellence in the field of dementia research, education and training. Lindsey has a particular passion for working with individuals who have a diagnosis of fronto-temporal dementia and those who experience complex eating and drinking difficulties, in particular at the end of life. In 2015 Lindsey was awarded a Clinical Training Fellowship by the Alzheimer’s Society to study for a PhD. The study focus is to understand the experience of people living with dementia and dysphagia, including people with a diagnosis of dementia, family carers, paid carers and speech and language therapists.

Session Synopsis This will be an interactive session that will give attendees the opportunity to share ideas on how best to support people living with dementia and dysphagia, in particular those who are deemed to be at high risk on all oral intake. Together we will explore the concept of “risk feeding” and the implications of this approach. Relevant case studies will be presented, however if you would like to bring along a case of your own to discuss, please do so and these will be incorporated into the session where possible.

Dr Hazel Roddam, Allied Health Research Unit, UCLan Dr Hazel Roddam is an SLT with extensive experience as a clinician working within NHS and local authority contexts, with clinical expertise in working with children who have physical disabilities and special educational needs. Hazel joined the Advanced Dysphagia Course team in 2003 as Academic Advisor and is now Co-Director of the Advancing Dysphagia Practice initiative which was launched in 2011 http://dysphagiapractice.blogspot.co.uk/ After gaining her doctorate in 2006, Hazel took up her current post as a researcher at the University of Central Lancashire, where she teaches research design and supervises postgraduate research students across allied health groups and wider rehabilitation services. Hazel’s research has focused on strategies to promote evidence-based practice and she has co-authored a book of international exemplars from SLT contributors, now also published in Danish. Hazel was the Chair of Council at RCSLT (2010-2012) and has been the UK delegate on the EU Professional Practice Commission (CPLOL) since 2008.

Advancing Dysphagia Practice

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Conference Booking and Enquiries Day One only = £80 including lunch* Day One + Day Two* = £110 PLEASE NOTE: *Payment by invoice is ONLY possible for amounts OVER £100 **Lunch is NOT included on Day Two but delegates may choose to go as a group to one of the nearby campus catering outlets Bookings for Day Two MUST specify one choice of Workshop group

To book a place at the conference please go to the conference website www.uclan.ac.uk/conferences click on the conference name and complete the expandable online Booking Form. Online payment by credit/debit card is also available at time of booking. Please note that a booking acknowledgement will be sent upon receipt of the form, but confirmation of a place will only be made once payment has been received. Formal joining instructions will be sent to you via email approximately two-three weeks before the start of the conference, using the email address supplied upon booking. Our booking terms and conditions and cancellation policy are all detailed on the conference website. At the time of booking you will be asked to provide personal contact details and to specify any dietary or mobility/access, and other needs. For conference booking enquiries please contact Liz Roberts, Conference and Events, University of Central Lancashire, Preston PR1 2HE Email [email protected] Tel +44 (0)1772 892650 For enquiries about the conference programme please contact [email protected]

Advancing Dysphagia Practice Preston PR1 2HE Telephone (01772) 201201 www.uclan.ac.uk

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