NTSP Special Interviews (India 2026): Brendan & Sarah Part 2

The team were in India in February 2026 and had the privelege to meet patients, families and staff who were working to improve tracheostomy care. This special interview is a conversation between Prof Brendan McGrath and Prof Sarah Wallace from the NTSP, reflecting on their time in India. The team visited the Tata Memorial Hospital Mumbai, and attended the National Tracheostomy Conference hosted by TMH, the Christian Medical Centre in Vellore, and St John's Hospital in Bengaluru. Brendan & Sarah discuss some of the community work, innovation and patient contact that they were invovled in during their trip.

The UK National Tracheostomy Safety Project (NTSP) is committed to providing education, information and resources to improve patient safety and the patient experience for those with tracheostomies and laryngectomies. All of our resources are housed on our website www.tracheostomy.org.uk, accessed by over 30,000 visitors each month from around the world.

This is the only podcast to bring you literature reviews, hot topic discussions and interviews with healthcare staff, patients and families.

Our goal is to improve the safety and quality of care for patients with tracheostomies and laryngectomies through education. We work closely with patients, families and healthcare professionals to develop new resources to improve care. We’ve collaborated with key stakeholders in tracheostomy care since 2009, and developed freely accessible resources, supported by online learning developed with the UK Department of Health. We’ve worked with the Global Tracheostomy Collaborative since 2012 to improve care for patients and their families everywhere.

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Transcript

SPEAKER_00 0:08

Hello and welcome to this special episode of Tracky Talk. We're here in Bengaluru in the south part of India and I'm joined by Professor Sarah Wallace, OBE, who's a legendary speech and language pathologist that I'm sure many of you know. We're currently in the Holiday Inn near the race course in Bengaluru and we're very grateful to the staff for finding us this nice quiet space. We've got a bit of time to kill before we have to head home, so we thought it'd be a really good idea to spend a bit of time just reflecting on uh what we have uh observed and learnt, uh, and some of the people that we've met and some of the things that we've seen in India. So I hope you find that useful. This is outreach from uh CMC, wasn't it? Yeah. So tell us a bit about that, Sarah.

SPEAKER_01 1:01

Well, so what was really interesting was that at CMC College, where there is a big hospital, very big hospital, I mean 3,000 beds. Yes, hospital is the new bit, and then they have all these other old bits, older buildings as well, and and and a training college, and they have made it sort of mandatory that nurses who teach in the degree programmes and postgraduate courses all still have responsibility for wards and for community outreach, and everybody has to do uh community outreach as well. So they've got this network of um village clinics where which are uh nurse-led, and um the nurses will go to you and use you know, either to visit patients in their houses or use um a very small kind of community space um and set up sort of clinics for children for the elderly, and they'll do a bit of exercise. We joined in with the exercise class, and all of the um elderly women this was for were were just absolutely killing themselves laughing at my attempts to um do a little bit of uh you know physio.

SPEAKER_00 2:11

And if I can persuade Sarah to put our pictures on social media, I will.

SPEAKER_01 2:15

Oh, why not? Uh it it it did kind of I think we bonded over it. Um, but they also get health checks. Um, there's a lot of diabetes in India, and that's something that they are managing people with you know long-term conditions in the community, and it can and it it's it's just fantastic. So, you know, no one has to pay unless they can pay, they get their prescriptions for free, um, they give them a you know a bit of food and and and drink as well, and it's a social aspect as well, because somebody told us how um the elderly in India in the urban areas now, because of the way that people work such long hours in their jobs and and move away from families, they've got the same problem we have in the West, which is the elderly people are isolated. So having these sort of centres where they can socialise as well, they they're really placing a um a great uh sort of service there. Um, in the villages, it's it's still a lot more sort of you stay with the family, and the family then have to do all of the care. So the family have to learn how to look after a tracheostomy.

SPEAKER_00 3:24

Yeah, which is quite a big deal, isn't it? I mean, we just literally met one of the managers at the Holdy Inn as we were just coming up here, and they were finding us this lovely space, and she said, Oh, tracheostomy is my father had a tracheostomy, and she was describing how exactly as we've said, you know, there was an inpatient period, and then her father was discharged to the family, and there was a little bit of education, but uh not a lot. And she said she remembers sitting with her family looking at YouTube videos, trying to work out how to do the suctioning, and you know, she's describing all the things that that we do on a daily basis. Uh and then yeah, really scary, and that was something that really came across from our visit here. That that you know, we've got a lot of resources that are very specific to the UK and to sort of our setup, but it was very clear that that we can develop resources in partnership with our colleagues here in India that that that may well be relevant to exactly that situation because of that sort of really strong sort of family unit that that they have in India that that are essentially tasked with doing pretty complex care that in our country we'd be having sort of community district nurses going out to to deliver. So it was quite spectacular, really, that that that families can can take that word load on.

SPEAKER_01 4:41

And I think I mean she actually said, didn't she? Well, what was I supposed to do? I had no choice. Of course I'm gonna look after my father, and that you know that's the strength of I think in India what we've been the hospitality has been incredible, hasn't it? And that and that um sort of obviously family is incredibly important, isn't it? And the family networks are obviously really strong, but yeah, I think we've already had some people offer to translate NTSP resources into Hindi, haven't we? So we we've obviously uh when we ran the course at the weekend um on trackicare with uh Dr. Bincy Pandian and and my Dr. Michael Brenner from the States, we we did a lot of shared, you know, sharing of um you know discussions, didn't we? And um yeah, some we said, wouldn't it be great if someone could now follow on from our Portuguese and Spanish versions and and have something in Hindi and two people come up to you within five minutes saying?

SPEAKER_00 5:42

Yeah, so I mean it's it's fantastic, and and and that's what we're hoping to get is it's a collaboration and trying to work out how we can work together going forward to develop sort of India-specific resources, I guess, but then that would be more sort of relevant to this part of the world, sort of taking those principles of outstanding care that we've seen and adding in what we've learned.

SPEAKER_01 6:04

We had a lot of conversations with everyone we've met, haven't we, about just not reinventing the wheels and not doing things our way because that's not appropriate for India, the different different challenges, different healthcare uh setup organizations are set up differently. But don't reinvent the wheel here, use this as a template, and and we talked a lot about collecting data, and people are really you know, how they find time to do that is another thing, but everybody's incredibly keen on producing more um research in India on the in on the um subject of tracheostomy management. I spoke to lots of speech therapists about you know how do you how do you um still primarily work as a clinician but do clin do clinical research as well, and you know that's what I did most of my career until I got protected time, so I don't have their case over sizes, but I think they are they're so passionate and key. Everyone we met, yeah, I mean it's all I suppose the the it it's all about goodwill and compassion and and dedication, isn't it? I've been so impressed. Yeah, and then at um St John's that was a different experience again, wasn't it?

SPEAKER_00 7:22

Yeah, very much so, and and it's again a slightly different funding model again, but the uh you know we were lucky enough to be taken around to the wards, we went to the very impressive intensive care unit, and then we got taken to a brand new sort of purpose-built geriatric unit, which again builds on those sort of Indian values, you know, there's lots of space, space for families to come, uh opportunities for sort of respite care. They had patients. Oh, yeah, yeah, yeah, yeah. Yeah, and they'd had a few patients through with tracheostomies, and on that sort of transition from acute hospital care, you know, obviously, the older you are, the more likely it is you're going to take a bit more time to either come to terms with the tracheostomy and learn how to look after it, or to even potentially be decannulated. We were talking about you know getting speech and language therapy involved in in some of those patients because it's likely not all will need a tracheostomy long term.

SPEAKER_01 8:17

Yeah, but I think there's I mean it's such a massive unmet need here because like at St John's Hospital, I think they had four speech therapists for a thousand three thousand beds. Yeah, um, and so they they'd sort of had to one just did sphage and one just did stroke, one just did communication, and you know, of course they haven't got the capacity to get involved early enough. Um but I think that you know there's a and I think there's still they're still at the point where uh there's a bit of a lack of awareness of what we can do for patients and why why we should be seeing them early with tracheostomies not not waiting until they've got you know almost discharged. So there's I think um some really interesting discussions around that, weren't there?

SPEAKER_00 9:06

It probably reflects probably the journey that we've been on the last 10-15 years, isn't it? It is indeed, yeah. And you know, what we'll be trying to do is is share stuff that we're up to now and and and say, look, you know, we've had exactly these problems, and this is what we've been able to do to get speeches and other people.

SPEAKER_01 9:26

What would be great is if um Indian clinicians can collect their data and and their evidence because you know there are different problems, yeah, different clinical problems here.

SPEAKER_00 9:37

Fantastic. Alright, well, Sarah, always a pleasure to talk to you. Thank you so much for your insights. Yeah, cool. So uh that's it for this episode. Uh, as ever, the opinion you just heard are our own opinions, they don't necessarily reflect the opinions of the organisations uh which pay our wages. Uh, you can find out lots more on our website, uh, you can follow us on our social media channels. Um, thanks for listening and see you next time.

SPEAKER_01 10:02

Thank you.