Cost and Service Implications of Speech and Language Therapist-Led Clinics for Persistent Throat Symptoms: A Service...

To evaluate service outcomes and illustrative staffing cost implications of a speech and language therapy (SLT)-led clinic compared with a traditional ear, nose, and throat (ENT)-led clinic for adults with persistent throat symptoms (PTS).

A retrospective service evaluation was conducted using consecutively collected data from adults referred by primary care to an ENT outpatient service in the North-East of England (November 2022-February 2023). Patients were grouped by initial assessment in ENT-led or SLT-led clinics. All underwent endoscopic evaluation of the larynx (EEL). Outcomes included attendance, onward referral patterns, number of appointments, time to first assessment, re-referral within 12 months, and illustrative staffing cost estimates based on National Health Service (NHS) pay scales and appointment duration.

Of 329 patients reviewed, 121 met inclusion criteria (ENT-led: n = 48; SLT-led: n = 73). A greater proportion of SLT-led patients were discharged after the initial appointment compared with ENT-led patients (69% vs 50%), with no re-referrals within 12 months. Median appointments per patient were identical (median 1), with greater variability in the SLT-led pathway reflecting planned follow-up. Median time to assessment was shorter in SLT-led clinics (56 vs 120 days), with intervention commencing at the initial visit. Staffing cost estimates indicated higher inputs for sequential ENT-to-SLT assessment compared with direct SLT or ENT assessment.

In a single UK center, SLT-led clinics were associated with higher discharge rates, shorter waiting times, and streamlined pathways, without increased re-referral. Illustrative cost comparisons suggest potential efficiencies when appropriate patients are managed directly within SLT-led pathways. These findings support SLT-led clinics as a safe and efficient service model for selected patients with PTS.