NTSP Special Interviews (India 2026): Brendan & Sarah Part 3

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.

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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 what we have observed and learnt, 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. Lots of the research about tracheostomy care and changes and this multidisciplinary, multi-professional approach has come from University Commons, the West, hasn't it? Yeah. And obviously Australia have been strong players in the Global Tracheostomy Collaborative as well. And as you quite rightly say, it we need some data from this part of the world to reflect the challenges and the way that they manage things here.

SPEAKER_01 1:21

And they're different, they have different diseases. Yeah, different pathologies. They've got TB, lots of TB here, and other diseases that are uh pre more prevalent than than us, so different types of trachiosomy cohorts.

SPEAKER_00 1:39

Yeah. And at the head net cancers that we saw, as as you said, I mean that there's a lot of tobacco chewing. Yes. Which which I I sort of was aware of, but not aware of the scale of it. And uh, you know, some of the people met in the outpatient clinic were presented with pretty significant tumours, they'd sort of been ignoring them, they probably knew what it was, didn't want to see couldn't afford to. So very different populations. And uh, I mean, trying to get some data uh from this part of the world would be amazing, and it was great that all these hospitals that we visited. We talked a lot about the global trackers to be collaborative and and that way of trying to improve care through data. I mean, that that's how you know where you are, that's how you know where you're going, and that's how you know whether you're as good or different to other hospitals. And when you know that, you can then ask the hospital, okay, so what are you doing that I'm not, or the other hospitals say, Well, you're you're doing that really well. Can we take some information from you?

SPEAKER_01 2:36

Yeah, and I think I think we talked about the global south, didn't we, and how this it would be amazing if we could have that sort of um data to show you know what are the what are the future directions that people need to go in, and you know, they're already collaborating and they're already kind of recognising the you know many of the problems that patients with tracheostomies have, but you know, it's it's how do they use things like AI? Yeah, we went to that amazing art park as well, didn't we? Go on and tell them about that.

SPEAKER_00 3:10

So the art park is a centre for AI and and robotics, and uh it's like an innovation space, lots of work around AI applied to lots of different sectors, and and a relatively small chunk of their work was was in healthcare. But when we say that, when they told us about what they were doing, it's actually huge. Um, a lot of work in Covid, but what they've been able to demonstrate is they can access data sets, they're trying to get standardized data sets for certain things because there's lots of different pockets of data around India, but but there are some commonalities, and they were trying to piece things together and and then I mean it was predictive models we were talking about, in particular about uh dengue fever and sort of predicting outbreaks, things like that. But um, we we were then we were talking at St John's about they've got a real strong focus on uh AI in their research, and and the GTC database now has 20,000 uh cases in there with patients with tracheostomies, and that's right for applying these sort of artificially intelligent systems too to see if we can start to predict uh some of the some of the outcomes maybe or or predict which patients will benefit from certain things. Uh, but again, like you said, Sarah, and having sort of India or global south specific data in there, you know, will really help because you can't apply what we're up to in uh the north of England to what's happening in the south of India. But the you know the principles certainly were there. And I mean what I'll take away from this is you know the next steps is definitely collaboration, um, a lot of shared learning, and we were very clear to say to the guys, look, we're not here to tell you what to do, we're here to learn from what you're doing, and we're here to explain what we've picked up from working with and talking to lots of other people around the world. And that shared learning, you know, was was clearly very strong, and then that focus on you know research in this setting, collecting some data and really trying to understand what's going on now and how we can make some tweaks and see whether we can make any improvements. I wondered what your reflections were on you know the sort of the next steps perhaps for the for the speech and language therapy teams that you've met here.

SPEAKER_01 5:19

I think it's really exciting because I think um there was so much enthusiasm, wasn't there? Yeah, there's been so much enthusiasm everywhere we've gone for learning and for um pushing quality of care. Lots and lots of conversations about quality of care. But like you say at the moment, I think there's a just uh it's all a little bit of an unknown uh entity, isn't it? Around what is happening to patients, especially after hospital, yeah. Um, but even in the hospital, because many of them are not getting seen early enough or at all. Yeah, um, so I feel like um apart from the fact that we've built friendships and collaborations with people, I felt like in at Tata Memorial, that opportunity to get 250 people from all over India in one space, they were networking with each other as well. Yeah, it was really nice to see that. That was great to see because especially when so I did two presentations um jointly with, I'm gonna give a shout-out to Arun um Arun Balaji. Who is um the head of the speech therapy department in Tata, who has helped facilitate this whole thing, um, and he is he is incredible, but you know, I invited him to do presentations jointly because I can't give the Indian perspective, I can tell what we you know promote in terms of quality of care and communication and swallow, and he could then say, Um, you know, so this is how we translate this to India, and um and there was a you know a lot of people in the audience who were able to, we had a lot of panel discussions, didn't we? So there was some really what I took away most was the conversations we had in those panel discussions where people shared their setting, their challenges, but also lots of people saying, Oh, you know, I'm I'm working, I don't know, in um another part of India, you know, in Rajasthan or whatever, and you know, I I can I've actually got this, and other people saying, Oh, how did you get it? You know, how did you get that speaking variable because we can't get them? And so that I think it facilitated things to happen within India, I hope. Yeah, and you know, the support of of all of the leadership teams in these organizations has been incredible, and I think they really, really want, I feel like we've we've facilitated hopefully some some changes. Yeah, I hope.

SPEAKER_00 7:47

Hopefully empowering teams as well.

SPEAKER_01 7:49

We want to carry on, yeah. We're supporting them as with whatever they want to to do next, you know. I mean, yeah, we'll we'll just keep learning more, won't we?

SPEAKER_00 7:59

Absolutely.

SPEAKER_01 8:00

Yeah, but empowerment, I think, and and I think I can't imagine how how demoralized people would get working in in those settings where they are you know up against it all the time. I I was really struck um by how inspiring people were because they're working up against it and it could be quite demoralizing. You know, you can't get the piece of equipment you want, you know, you haven't got fees, or you want mobile fees, you could you have to do it in the clinic and you're stuck with that, or you've got to see 15 patients in a video phrosopy clinic in the morning, and yeah, you know, the the it it's a never-ending barrage of patients, isn't it? And you'd think it would get them down, yeah, but they were so positive, yeah, and so inspired, inspiring to me, yeah, but you know, they they just sort of get on with it and um and uh and and are making a difference to people's lives, and it you know, I find I found that inspiring personally.

SPEAKER_00 9:06

Yeah, no, I totally echo that, yeah.

SPEAKER_01 9:09

Yeah.

SPEAKER_00 9:09

So we've been in India for about 10 days, sadly, in about half an hour, we're off to the airport to go home, which will be um we've had our last curry. We have had our last curry, the last of probably about 30. Many. What will you take away from this trip, do you think, outside of the hospital stuff? I mean, a lot of the hospital staff have been with us for meals, and then we've been really well looked after, haven't we? But come on, give me some memories of of India.

SPEAKER_01 9:36

Well, this morning was fun, wasn't it? We uh we had um I think this is pretty much today has been our only day off, hasn't it? And uh we decided to go and uh to the market in um in the auto rickshaw. And the traffic of Bangalore is legendary, yeah, is it not?

SPEAKER_00 9:53

Yeah, it is, yeah. Um we thought Mumbai was busy, but the roads here, it's like all of Mumbai is on Bangalore's roads, isn't it?

SPEAKER_01 10:00

It's dodgems and it's noisy and it's like yeah, that that that's but to me I I find that fun. Yeah. Um probably wouldn't want to do it every day. But I just think Indian hospitality, yeah, of everyone you meet, um, and yeah, I'm just I'm just uh need time to process what we've seen in the hospitals. There's there's the scale of what the scale of the numbers of patients is still hard to grapple with, isn't it? I think. And just when you when I think back to Withenshore and you walk down a corridor and it's you know there are people, but yeah, not on the you know, literally no floor space everywhere, and people queuing up out, as you say, overspilling into the stairwells and sitting there and all day waiting to be seen for 15 minutes. Waiting really patiently, and waiting very patiently and quietly, and you know, it's just incredible, and um the the staff are working so very hard, and their work, yeah, their work ethic is is very admirable. Um, so yeah, I've learned I think that we can take some lessons from that, can't we? Absolutely, yeah.

SPEAKER_00 11:13

No, I've learned a lot, I've seen a lot. I think uh I probably need to just have a a day or two just chilling at home just to uh transition back from the the pace of what we've seen here, both in the hospitals, in the communities, and then just India itself. It's uh it's full on, it's a fascinating place.

SPEAKER_01 11:32

Sensory overload.

SPEAKER_00 11:33

Yeah, it is sensory overload, but in in a good way.

SPEAKER_01 11:36

In an exciting way, yeah. I mean I'm I kind of I find it I find it exhilarating, but probably not if I did it every day.

SPEAKER_00 11:45

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 opinions you just heard are our own opinions, they don't necessarily reflect the opinions of the organizations 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 12:11

Bye.