If you are referring someone for a communication difficulty, please note anyone can refer. If you are referring someone for a swallowing difficulty, please not you must be a registered healthcare professional such as GP, registered nurse (excluding nursing homes unless named referrer), specialist nurse, advanced practitioner, allied health professional, or a named referrer that has completed the Dorset Healthcare Dysphagia and referral training (DART)’.
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 the SLT team for advice.
- frequent coughing or spluttering specifically when eating or drinking
- recurrent chest infections or pneumonia where aspiration is suspected as the cause
- neurological diagnosis causing swallowing or communication problems e.g. MS/Parkinson’s disease
- speech or language problems where no advice has been given previously e.g. dysphasia, dyspraxia, dysarthria or stammering
- communication or swallowing problems where advice has been followed but the client’s presentation has changed i.e. a significant improvement or deterioration.
- mental health diagnosis causing swallowing or communication problems (both inpatient and community) e.g. schizophrenia, personality disorder etc (pilot until March 2023)
Pending swallow review/assessment by SLT, it may be decided to offer modified diet or fluids. The responsibility for this lies with the team making that decision. If you require advice whilst waiting for SLT input please contact the SLT team.
The following list gives examples of inappropriate referrals. In these instances the client’s needs would be more effectively met by some other means and suggestions for action are given where possible. For client specific advice, please contact the client’s GP.
Insufficient information on the referral form. ACTION the referral will be returned to you to complete in full before being accepted by the SLT service.
SLT cannot support with adverse behaviours that affect oral intake e.g. refusing diet, mouth holding diet/fluids (chewing for a long time and needing prompts to swallow) or spitting out bits/lumps in their food. Therefore consider whether observed difficulties are related to swallowing rather than behaviour(s) known to occur with eating and drinking e.g. in dementia.
Problems swallowing tablets. ACTION consider liquid/dispersible medications or consult pharmacist to see whether the tablets can e.g. be crushed/cut or for any further advice about making them easier to swallow.
- Clients who have a speech/swallowing difficulty as a result of a learning disability. ACTION refer to the Adult Learning Disability SLT service on 01202 636174.
- Children under 16 years old. ACTION refer to children’s SLT services: East Dorset 01202 443208; West Dorset 01305 254743.
- Clients are not routinely reviewed – SLT reviews are ONLY indicated when there has been a change in their presentation.
- Clients who have capacity to make choices about their own health and have refused SLT input.
- Voice problems e.g. loss of voice. ACTION refer to ENT at the client’s local hospital.
- Clients with head/neck cancer or a tracheostomy. ACTION should be seen by relevant local inpatient SLT service.
- Difficulty chewing because the client has no or poor dentition. ACTION consult a local dentist.
- If a decision for a client to “feed at risk” has been made, SLT will only review if this decision is no longer deemed appropriate.
- Clients who have developmental dyslexia from childhood.
- Clients who have communication impairment secondary to a diagnosis of Asperger’s/autism.
- Where difficulties are only related to learning English as a second language.
- Transgender voice referrals.
For clinical enquiries, please call 01202 307766 Monday-Friday, 9-10am or 1-2pm.