Adult Speech and Language Therapy

The Acute Speech and Language Therapy team support patients on adult medical wards across the hospital, including acute medical unit (AMU), the respiratory unit and elderly care, for example. We assess and provide therapy for patients who present with swallowing and/or communication difficulties that have occurred after an acute illness. We may advise on specific consistencies of food and drink that are safe for a patient to consume and provide advice on how to support patients’ communication needs.

A Speech and Language Therapist works with patients to assess and support their swallowing and communication whilst they are on the Intensive Care Unit (ICU). This may involve working with patients who have tracheostomies. One-way valves may be used to allow patients to speak. A FEES (see below) may be completed to assess a patient’s ability to swallow. A range of low- and high-technology equipment may be used to support a patient’s communication. 

FEES is a specialist assessment which evaluates an individual’s ability to swallow. It involves passing a nasendoscope (small camera) through the nose to the back of the throat. This allows us to look at the larynx (voice box) and pharynx (throat). The patient is then given things to eat and drink to assess whether their swallowing is safe.

Your Speech and Language Therapist will refer you for a FEES if it is appropriate. We provide FEES for both inpatients on the wards and in outpatient clinics. It is often completed by two Speech and Language Therapists, however sometimes an Ear, Nose and Throat (ENT) doctor may also be present. 

Speech and Language Therapists work within the Head and Neck Cancer Multidisciplinary Team. Cancer treatments may include radiotherapy, chemotherapy or surgery. Speech and Language Therapists provide assessment and therapy for communication and swallowing difficulties, before, during and after these treatments. We work in rehabilitation and provide support during palliative care.

Assessment of Swallow may include a FEES or VF. We may advise on specific consistencies of food and drink that are safe to consume or how to manage if swallowing should become particularly difficult. Sometimes specific therapy exercises are recommended. Some types of Head and Neck cancer or treatments can alter speech or voice and we can work with you to minimise the impact of this.

Laryngectomy involves the surgical removal of the larynx (voice box) and might be offered as a treatment for some types of head and neck cancer. Speech and Language Therapists support patients in managing their stoma, swallowing and communication after this operation.

Sometimes a “valve” or “voice prothesis” is inserted to allow people to voice after their vocal cords have been removed. Speech and Language Therapists can provide advice around different types of valves and associated products. We replace valves and provide advice on emergency and day to day care post laryngectomy. We work in the Head and Neck Cancer Multidisciplinary Team and often work closely with family members or carers, seeing patients on hospital wards and in out-patient clinics. We can assist you, if you would like, in meeting other people who have had a laryngectomy.

The Neuro-rehabilitation Speech and Language Therapy team work alongside other therapists (including physiotherapists and occupational therapists) to provide therapy to our patients. We support patients who are experiencing communication and/or swallowing difficulties following a stroke, traumatic brain injury or other neurological condition. We provide a range of therapy for our patients, including group communication sessions, direct therapy sessions, and swallow rehabilitation directed by a speech and language therapist. We also work to support our patients’ families and carers throughout their neuro-rehabilitation journey.

The Acute Stroke Unit Speech and Language Therapy team work with people who are experiencing communication and/or swallowing difficulties following a stroke. This involves assessing our patients and carrying out therapy sessions with them. We work closely with patients’ family and carers, by giving them advice, support and signposting to relevant agencies. Our team also work closely with other professionals, including the medical team, the wider therapy team and neuropsychologists, among others.

Videofluoroscopy is a specialist swallowing assessment; it involves taking a video x-ray whilst an individual is eating and drinking. The food and drink is coated in barium so that it shows up on the x-ray. 
Your Speech and Language Therapist will refer you for a VF if it is appropriate. We provide VF for both inpatients and outpatients. It is completed by at least one Speech and Language Therapist and a Radiographer.  

If you are experiencing a voice difficulty (dysphonia) then a Speech and Language Therapist can help. All voice therapy referrals are via an Ear, Nose and Throat (ENT) specialist, who will have assessed your larynx (voice box). This usually involves passing a small camera down your nose to view how your vocal cords are moving. A voice therapy referral may also be made if you have other throat symptoms, such as a cough, sensation of a lump in the throat or acid reflux related symptoms.

During a voice assessment, we listen to your speaking voice and ask you to copy some voice exercises. You will be given information about caring for your voice and may be given exercises to practise at home.
In our Joint Voice Clinic, a Speech and Language Therapist and ENT Consultant work together to assess your voice and provide advice.