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1 What Causes Speech and Language Problems?
Communication plays a part in every aspect of our lives. Problems can occur at any age, as a result of:-
- stroke
- learning disability
- neurological disorders such as Parkinson's disease, multiple sclerosis or developmental difficulties
- cancer of the head or neck
- head injury or surgery
- hearing loss
- cleft palate
- physical disability such as occurs with cerebral palsy
- dementia
- psychiatric disorders
- stammering
- voice disorders
- feeding and swallowing difficulties
- dyslexia
If you have any difficulty in communicating, you may need help or advice from a speech and language therapist [SLT]. If you are at all worried, ask for help.
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2 Finding a Speech and Language Therapist [SLT]
Ask your consultant, GP or district nurse to refer you to the local Speech and Language Therapy service; many SLT services also operate a self-referral system so you can contact them directly and ask for an appointment.
- You may be seen as an out-patient at your local hospital or clinic.
- It may be possible to arrange transport for the appointment.
- It may be possible to arrange to see you in your home.
- It may be possible to refer you to a specialist centre, for example, for intensive rehabilitation or a communication aid.
NHS Speech and Language Therapy Provision
Your health authority is responsible for purchasing speech and language therapy to meet the needs of the local population. The NHS Trusts and soon the Primary Care Groups and Trusts are the service providers.
Private Speech and Language Therapy
Details of independent therapists can be obtained from ASLTIP www.asltip.co.uk - Association of Speech and Language Therapists in Independent Practice.
Charities
There are a number of organisations which complement NHS services through helplines and self-help groups. Other organisations can give information on specific communication difficulties and advise on seeking services. See the Organisations that can help section.
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3 Visiting the Speech and Language Therapist
The therapist will be able to tell you:-
- whether Speech and Language Therapy may help you
- how often you need therapy sessions
- how long you will need therapy for
- how you may benefit from therapy sessions.
The Speech and Language Therapist will assess your difficulties by talking to you and those who help you. They may take a case history and may use some speech and language tests. Therapists should involve you and those helping you, in deciding on the type and amount of help you need.
After the visit to the Speech and Language Therapist you can expect that either:-
- Speech and Language Therapy starts, or
- you are told why you are waiting and how long you will have to wait, or
- you are told that help is not needed
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4 Therapy
Speech and Language Therapy might include:-
- Individual or group therapy sessions with the Speech and Language Therapist. Sometimes you may work with assistants or volunteers supervised by the Speech and Language Therapist.
- Counselling, support or advice for you and your carers. This may include relatives, partners and staff involved in your care.
- Monitoring your progress with review appointments. Sometimes periods of resting from therapy are recommended.
- Referral to a specialist for another opinion. For example to an audiologist for a hearing test, to a communication aid centre.
- Assessment, monitoring or training with communication aids.
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5 Speech and Language Therapy Standards
MRCSLT
The initials Reg. MRCSLT show that a therapist is a registered member of the Royal College of Speech and Language Therapists, the professional body which sets standards for the practice of speech and language therapy.
SRSLT
The initials SRSLT (State Registered Speech and Language Therapist) indicates that the therapist is registered with the Health Professions Council, the regulatory body set up to protect the public and approve and monitor standards of education and training for courses leading to registration. They also monitor continued professional development of the individual speech and language therapist.
Communicating Quality
There are professional standards and guidelines laid down in "Communicating Quality", available from the Royal College of Speech and Language Therapists. Members have agreed to abide by these standards.
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6 Rights and Expectations
The Patients' Charter says:-
"You have the right to receive health care on the basis of your clinical need..."
"Before you are discharged from hospital you can expect a decision to be made about how to meet any needs you may continue to have..."
There may also be a local charter or quality standards which set out what you can expect from your Speech and Language Therapy Service. Ask your GP, local hospital, Trust or Health Authority.
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7 Not Enough Help? What You Can Do
1 If you feel you are not getting enough help, discuss your programme of care with the Speech and Language Therapist. If you disagree with the plan you can ask for another opinion or you can ask to discuss your needs with the Service Manager.
2 If the problem is not sorted out, write a formal letter of complaint. This will ensure your views are known. and should be dealt with promptly. Keep a copy.
3 If you are still not satisfied with the amount of delivery of Speech and Language Therapy, contact your local Independent Complaints Advocacy Service. They may be able to offer help and advice about your rights and how best to approach the health authority about your concerns.
4 You have the right to complain to the service provider (for instance, the hospital complaints officer), and the right to certain investigations and explanations, within a time limit.
5 If you are not satisfied after that, you can ask the local NHS Trust or Health Authority for a review of your complaint by an independent panel.
6 You can ask for help from your local Citizens Advice Bureau or your Member of Parliament.
7 If you are unable to resolve the complaint locally you can ask for help from your Health Service Ombudsman.
If you want more information or help, see the Organisations that can help section.
Send details of any problem to:
8 These Organisations Will Be Able to Give You Help
In addition to members of the Communications Forum catering for adults, the following organisations offer help:-
David Lewis Centre (epilepsy)
Mill Lane, Warford nr Alderley Edge, Cheshire SK9 7UD
Tel: 01565 640 000
Health Service Ombudsman (England & Wales)
11th Floor, Millbank Tower, Millbank, London SW1P 4QP
Tel: 020 7276 2035
The Scottish Public Services Ombudsman
4 Melville Street, Edinburgh EH3 7NS
Tel:0870 011 5378
Fax:0870 011 5379
Michael Palin Adult Service (stammering)
Finsbury Health Centre, Pine Street, London EC1R 0LP
Tel: 020 7883 3842
The Northern Ireland Ombudsman
Freepost BEL 1478, Belfast BT1 6BR
Tel: 0800 34 34 24
