Title: Flexible Endoscopic Evaluation of Swallowing (FEES) service in an acute hospital: Implications for Speech & Language Therapy (SLT) and ENT departments

FEES is a well-developed instrumental assessment of dysphagia. The demand for FEES procedures at the Mater Hospital has been growing steadily over the past 10 years impacting on SLT, and ENT services. This review assesses service demands & delivery of care in 2024. We aimed to valuate activity, demographics, clinical presentations and indications for ENT consultation, to inform future service needs.
A retrospective review of all referrals made to SLT in 2024 for a FEES exam was completed. Electronic FEES reports were reviewed to gather pertinent demographic and clinical data. Incidental anatomical findings requiring ENT opinion was also reviewed.
312 patients were referred for FEES exams in 2024 across 27 wards. Median (range) age was 64 (16-95) years; 75% were males (n=226). 61% had been intubated; 38% had a tracheostomy; 62% were nil per oral (NPO) at time of referral. SLT recommended ENT referral in 64 exams (21%). FEES exam changed oral feeding regime in 63% of patients.
The Mater FEES service supports in-patients with complex medical presentations who are frequently NPO and may require ENT consultation. Further hospital development will increase demand for FEES procedures. Forward planning requires consideration of likely demands on both services.