Referrals for care homes
Referral criteria
Speech and language therapists (SLTs) are specialists in oropharyngeal dysphagia.
Oropharyngeal dysphagia describes swallowing difficulties occurring in the mouth or the throat.
The Speech and Swallowing team is commissioned to provide support to people whose communication and dysphagia needs are specifically related to respiratory conditions, neurological conditions, frailty or end of life. If the difficulties are caused by another condition (for example, MND, learning disability, head and neck cancer) please see follow this link for information on alternative services: Is this service the right one for me?
Many swallowing concerns in care home residents can be managed safely and effectively within the care setting. Our website has been created to support you with this. We expect that you have used the resources provided prior to referral.
The Speech and Swallowing team will provide specialist assessment for residents who show signs of oropharyngeal dysphagia which cannot be managed safely and effectively by the care home.
Please review our e-learning toolkit prior to referral to implement support for your resident.
When considering making a referral
- Look at the existing care plan. Is it being followed properly? Is it still meeting the patient’s needs?
- Is your resident coughing or struggling on a normal diet? It is often reasonable to opt for a level 7 easy chew diet without needing to refer. Small changes may be enough to help the resident stay safe and comfortable.
Please refer to our level 7 easy chew leaflet on this website.
Think about what the resident is eating for snacks, not just for main meals.
- Have you reviewed the e-learning for health dysphagia guide? We will expect you to have tried implementing supports for your resident prior to referring to us.
Referrals considered inappropriate:
| Presenting symptom | Reason a referral would not be appropriate |
| Residents who have a “one-off” eating or drinking difficulty, for example, a single coughing or choking incident with no further signs of dysphagia | Anyone can experience a one-off swallowing difficulty at any time, for example, when rushing food or when talking with food in the mouth.
If someone has a one-off difficulty, it would be advisable to supervise eating or drinking to look out for any other signs of dysphagia. |
| Poor appetite, weight loss or refusing to eat with no signs of swallowing difficulties | If you are worried about weight loss, the resident may benefit from input from a Dietitian. However, if the resident is avoiding specific foods, a referral to our service may be appropriate. |
| Pain when swallowing with no other signs of swallowing difficulties | The resident should be seen by a GP as this is a medical issue. A referral to ENT may be appropriate. |
| Difficulties swallowing tablets but eating or drinking with no signs of dysphagia | This issue can be spoken about with a GP or pharmacist to discuss modifying medications to an alternative form.
If there are no difficulties with food and drink, this would not indicate an oropharyngeal dysphagia. |
| Oesophageal swallowing difficulties with no oropharyngeal component. For example, vomiting after eating or acid reflux | Residents should be seen by a GP where treatment options can be considered and onward referral to gastro or other services. |
| Residents known to be eating or drinking with acknowledged risk of aspiration with no change to their condition, presentation or situation | The risk of aspiration has already been acknowledged and signs of aspiration (including repeated chest infections) are to be expected.
Further input is unlikely to be beneficial for these residents. However, please refer if there has been a change to their presentation or situation, for example, increased distress. |
If you have any concerns or would like to discuss a referral, please use the care home advice line.
To make a referral please fill out our referral form adult speech and swallowing referral form
