Speech & Language Therapy (Adults)

Information

Adult Speech and Language therapists work with people 18 years and older who have problems with their swallowing, speech, language or voice. We work with a wide variety of clients, including people who have had strokes, acquired brain injuries, progressive neurological conditions, head and neck cancer, stammering, voice impairment and degenerative disease such as dementia.

Adult Speech and Language Therapy (SLT) services are provided by NHS Lothian within each Health and Social Care Partnership and the Acute Division.

There is a specific pathway for swallowing assessments in care homes, using the Manual for Mealtimes which is now available in all care homes in Lothian. Please follow this link to the introductory training manual: (please insert newest link for manual here) Manual for Mealtimes in Care Homes v1.0 (1).pdf

For general enquires please contact Lucie McAnespie, Head of Adult SLT Service on 0131 446 4151.

Who can refer:

Anyone can request Speech and Language Therapy including the individual concerned. In most cases a GP SCI Gateway referral is the most efficient way to do this.

Who to refer:

You can refer individuals to Speech and Language therapy for:

Communication issues

· if someone expresses concerns about their communication

· if someone experiences difficulties understanding what is being said to them

· if someone experiences difficulties expressing themselves or interacting with others

· to gain practical advice and support for people with communication needs to enable their decision- making capacity

Swallowing issues

· if someone expresses concerns about their swallowing (not related to oesophageal dysfunction)

· if you are concerned that swallowing function is impacting on the person’s health (e.g. repeated chest infections, unexplained weight loss, frequent choking or coughing episodes)

Care home and Nursing home patients can also be referred when self-management strategies using the Manual for Mealtimes have been unsuccessful (see below)

Who not to refer:

SWALLOWING ASSESSMENTS WITHIN CARE HOMES: – care home staff should use the protocol in the Manual for Mealtimes before requesting Speech and Language Therapy, and we ask for your support to discuss this with them before GP referral. Some problems will not require SLT intervention, and only the more severe or persistent swallowing difficulties will need an immediate referral. – staff can use the guidance in the Manual for Mealtimes to problem solve the less severe difficulties and have approval to use the documentation provided as evidence for the Care Inspectorate. If self-management strategies are not successful, and a referral is indicated, copies of the documentation should be sent with a completed referral form from the manual so that the SLT service can see what has been tried.

Voice referrals:

Please note that referrals for voice issues can only be accepted following examination by an ENT doctor, providing a detailed report based on laryngoscopic examination – see existing ENT referral guidelines Hoarseness – RefHelp

However if an individual has voice changes associated with a known neurological condition, and there are no red flag symptoms, please refer directly to Community SLT for that area

(See additional guidance for post/long COVID voice issues on separate page: ‘SLT post/long COVID symptoms’) SLT post/long COVID symptoms – RefHelp