Mental capacity legislation and communication disability: A cross-sectional survey exploring the impact of the COVID-19 pandemic on the provision of specialist decision-making support by UK SLTs.
Mark Jayes, Sophie Borrett, Arpita Bose
PMID 34882902WHAT IT FOUND
Most UK speech therapists felt they met legal requirements for decision-making support during the pandemic, yet 71% believed patients' rights were adversely affected.
Therapists reported barriers like PPE and remote working reduced support quality, with many patients excluded from DNACPR decisions.
Key findings
01While 78.5% of respondents felt confident legal requirements were met, 71% believed the rights of people with communication difficulties had been adversely affected.
0291.9% of respondents were not asked to support patients with communication disabilities in making decisions about Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) orders.
0393.2% of respondents had to adjust how they supported decision-making due to pandemic challenges, including PPE use and social distancing.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relies entirely on self-report from SLTs, not patient outcomes or objective measures of capacity assessment quality. The response rate was very low (estimated 1.6% of eligible SLTs), and recruitment via social media may introduce selection bias. The sample was over-represented by SLTs in England and those working with neurological conditions, limiting generalizability to other UK nations or patient groups. The survey period (August-November 2020) captures a specific phase of the pandemic and may not reflect practice throughout the entire crisis.
Declared interests
The authors have no conflicts of interest to declare.
The easy way to misread this
Do not interpret the high percentage of SLTs feeling confident that legal requirements were met as evidence that patient rights were protected. The same survey found that 71% of these SLTs believed patient rights were adversely affected, indicating a disconnect between procedural compliance and actual equitable access to support.