Speech and Language Therapy
Community
A service for adults who have difficulty with communication or eating, drinking and swallowing.
About our service
We provide a comprehensive service to adults who have difficulty with eating, drinking, swallowing and communication, including developmental stuttering.
Who is it for?
We provide services to clients over 16 years of age registered with a GP in Birmingham who have communication or swallowing difficulties due to:
- Acquired neurological conditions, i.e. stroke, Parkinson's Disease, multiple sclerosis, motor neurone disease and dementia.
Please note there are separate services for Adults with Learning Disabilities, and Specialist Voice Difficulties. We are unable to provide a service for clients with Predominant Mental Health-Related Difficulties.
Who provides it?
HCPC registered Qualified Specialist Speech and Language Therapists, with relevant dysphagia /dysfluency training.
Therapy assistants, Administrative staff, Speech & Language Therapy Students.
The service is provided in clinics, domiciliary settings, residential and nursing homes, hospices, or Rehabilitation centres.
All dysfluency clients are seen at Stockland Green Primary Care Centre.
What happens at your appointment?
You or your carer or Nurse will be contacted by telephone for an initial triage. Following discussion about your referral, we will prioritise the need and endeavour to see you within the categorised priority times for an initial assessment.
This assessment of your needs usually takes about 45 minutes to 1 hour. If it is felt that you need Speech and Language Therapy, you will be offered an agreed number of appointments.
This will be provided at Stockland Green clinic in Erdington, or at your home if you are not mobile.
Dysfluency waiting times may be longer, you will have initial assessment, followed by individual or group therapy sessions.
What can I do to help myself?
This depends upon your individual difficulties. Your speech and language therapist may suggest strategies to help with your communication or swallowing.
You may given certain exercises or tasks to carry out in-between therapy sessions.
It is important for you to follow the advice given in order to get maximum benefit from Speech and Language Therapy.
Referrals
Clients, carers and family members
Please complete the Adult Speech and Language Therapy referral form . If you have difficulty completing the referral form, or any general queries, please call the department on 0121 466 2150 for help and advice.
Professionals:
Please ensure all areas of the referral form are completed. Telephone referrals cannot be accepted
Please call us on 0121 466 2150 if you have any queries relating to a referral.
Referral criteria
Appropriate referrals
The following list gives some examples of appropriate referrals. It is not exhaustive so if, after reading this list, you are still unsure whether your referral is appropriate, please contact SLT on 0121 466 2150 to discuss it before referring.
- Acquired conditions, resulting in neuromuscular problems associated with swallowing or communication problems.
- Frequent coughing or choking specifically when eating or drinking, connected with the above.
- Recurrent chest infections or pneumonia where aspiration is suspected as the cause, due to the above.
- Weight loss connected with the above.
- Neurological diagnosis associated with swallowing or communication problems, for example MS or Parkinson's Disease. NB these patients should be under the appropriate care team.
- Further changes in the underlying condition affecting the swallowing.
- Acquired communication problems where previous advice has been followed but the client's presentation has changed, i.e. deterioration in their speech and / or language due to their underlying condition.
- NB: avoid giving the same textured foods if a client is having difficulty or choking on certain foods; seek initial advice from GP until SLT contacts.
Inappropriate or other referrals
The following list gives examples of inappropriate referrals. In these instances, the clients' needs would be more effectively met by some other services and suggestions for action are given where possible. For client specific advice, please contact the client's GP.
- Insufficient information on the referral form: the referral will be returned to you to complete in full before being accepted by the SLT service.
- Symptoms of reflux: dry mouth or throat, globus (feeling of lump in throat), throat clearing, hoarse voice, dry cough after eating and through the night, heartburn/chest pain or indigestion: talk to your GP about some reflux meds (PPI) and Gaviscon Advance or referral to Gastroenterology if symptoms persist.
- Problems swallowing tablets: talk to GP or consult your pharmacist to see how best to take them as SLT is unable to advise on modification of medicines.
- Mental health in-patients: they are seen by mental health acute SLT Service.
- Clients in the community with SLT issues associated to other health attributes such as those listed in the Appropriate Referral list on page 5, can be seen by our team providing the underlying Mental Health condition is stable.
- Clients who have a speech/swallowing difficulty related to a learning disability - refer to the Learning Disability SLT service (0121 466 4980)
- Children under 16 years old or still in school education: - refer to children's SLT services (0121 466 3370).
- Clients previously known to SLT who are managing on their previous recommendations and are not likely to change. In these cases, further SLT input is not indicated.
- Clients who have capacity to make choices about their own health and have refused SLT input.
- Stroke (CVA) diagnosed in the last 6 months: refer to the Birmingham Community Stroke Team (0121 466 2130).
- Voice problems (not associated to Parkinson's' Disease): refer to ENT at the client's local hospital, as it requires a Voice Specialist SLT to see the clients after an ENT examination.
- Bell's Palsy: refer to specific Bell's Palsy MDT service at QEH Physiotherapy.
- EDAR: patients who have previously been placed on eating and drinking with accepted risk by SLT or medical staff (EDAR), unless the decision for this has changed.
- We are unable to accept referrals for clients who have communication issues related to Autistic Spectrum Disorder (ASD) or Attention Deficit Hyperactivity Disorder (ADHD).
- If the patient has a South Birmingham GP and can attend clinic appointments (fully mobile / attended previous appointments): the clients GP or UHB Consultant ONLY are to refer the client to the QEH SLT Outpatient Service via the Choose & Book system. (0121 371 3483)
Please note there are separate SLT community services for:
- Solihull area SLT: 0121 424 4126
- Sandwell area SLT: 0121 507 2664
- Walsall and Black Country area
Food and drink descriptors for people with dysphagia
The International Dysphagia Diet Standardisation Initiative (IDDSI) is a project aimed at standardising the terms we use to describe food and drink textures. The IDDS has introduced a set of descriptors, covering all drinks and foods:
International Dysphagia Diet Standardisation Initiative Descriptors
Dysphagia food and drink descriptors
The International Dysphagia Diet Standardisation Initiative (IDDS) is a project aimed at standardising the terms we use to describe food and drink textures.
The IDDS descriptors have seven levels, covering all drinks and foods:
What do I need to do?
If you support people with eating, drinking or swallowing difficulties and you are unsure about what to do, seek advice from your local healthcare professional.