First reported 5 Mar 2014•Latest report 1 Jul 2026
Definition
What this concern includes
Includes failures in the speech and language therapy process for swallowing-related safety needs, including service capacity, referral thresholds, referral completion, waiting times, assessment, observation of eating, review of relevant information and recommendations for diet, fluid intake, supervision or monitoring.
Not included
Excludes speech and language therapy concerns unrelated to swallowing, choking, aspiration or associated eating and drinking safety.
Excludes generic healthcare staffing, funding, communication or referral deficiencies unless they directly impair speech and language therapy provision for swallowing-related risks.
Excludes failures in implementing speech and language therapy recommendations after timely and adequate assessment where the speech and language therapy access or assessment process itself was not deficient.
Excludes general nutrition, hydration or mealtime-supervision failures where no speech and language therapy or swallowing-risk connection is identified.
Reports
5
Distinct published reports
Individual concerns
8
A report can raise multiple concerns
Date range
2014–2026
First to latest report issue date
Stated actions
12
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Adelaide Medical Centre, London1
Department of Health and Social Care1
East Lancashire Hospitals NHS Trust1
Hill Care Group1
Lodge Care Home1
NHS England1
Northumbria Healthcare NHS Foundation Trust1
Royal Free London NHS Foundation Trust1
Staffordshire and Stoke-on-Trent Integrated Care Board1
University Hospitals of Derby and Burton NHS Foundation Trust1
NHS trust4
Care-home operator1
Executive non-departmental public body1
Healthcare site1
Ministerial department1
Nursing home1
Type not available1
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
Staffordshire and Stoke-on-Trent
Concerns raised2
Unavailability of alternative provision when Speech and Language Therapy assessment is absent
Unavailability of Speech and Language Therapy assessments for care home residents
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.9
Action
Continue providing remote community SALT advice to care homes and domiciliary settings by telephone and email.
Stated by University Hospitals of Derby and Burton NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 2 September 2026.
Action
Deliver community SALT activity using a secured two-day-per-week Band 7 locum therapist.
Stated by University Hospitals of Derby and Burton NHS Foundation TrustStated completedThe respondent said that this action was complete when they made their response on 2 September 2026.
Action
Explore appointing a temporary Band 6 practitioner using potentially remaining locum funding to increase community SALT capacity.
Stated by University Hospitals of Derby and Burton NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 2 September 2026.
Action
Explore alternative community SALT service delivery options with Integrated Care Board support.
Stated by University Hospitals of Derby and Burton NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 2 September 2026.
Action
Provide care homes with specialist SALT advice through remote support, including email advice.
Stated by NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 2 September 2026.
Action
Maintain escalation routes for complex cases requiring specialist SALT input.
Stated by NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care BoardStated completedThe respondent said that this action was complete when they made their response on 2 September 2026.
Action
Review the effectiveness of interim pathways while workforce shortages are addressed.
Stated by NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 2 September 2026.
Action
Plan recommissioning of community SALT services, considering resilience, workforce sustainability, responsiveness and reduced-staffing arrangements.
Stated by NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 2 September 2026.
Action
Continue contractual performance management of UHDB regarding workforce recovery and SALT service capacity.
Stated by NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care BoardStated in progressThe respondent said that this action was in progress when they made their response on 2 September 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
Position
Face-to-face community SALT assessments cannot currently be provided because staffing and recruitment constraints limit team capacity.
Stated by University Hospitals of Derby and Burton NHS Foundation TrustUnable to actThe respondent said that a constraint prevented them from taking the relevant action.
Position
Long-term community SALT delivery should transfer from the acute Trust to a community NHS provider, supported by the ICB.
Stated by University Hospitals of Derby and Burton NHS Foundation TrustRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Northamptonshire
Concerns raised2
Failure to refer people at risk of choking to Speech and Language Therapy for support and intervention
Delays in access to Speech and Language Therapy support
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
Action
Publish guidance outlining recommended actions to reduce community health service waiting times.
Stated by NHS EnglandStated completedThe respondent said that this action was complete when they made their response on 24 February 2026.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
Local services determine SALT referral criteria and make referral decisions according to individual patient need.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
Integrated Care Boards are responsible for increasing community SALT capacity and managing waiting times under national planning requirements.
Stated by NHS EnglandRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Position
NHS England is responsible for reporting separately on current Speech and Language Therapy waiting lists.
Stated by Department of Health and Social CareRedirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Northumberland
Concerns raised2
Failure to conduct speech and language therapy assessment using referral information, eating observation and care records
Failure to provide pertinent referral information to speech and language therapy
This report raised 6 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Action
Implement revised electronic SALT referral form questions, mandatory detail fields, and mandatory Next of Kin or LPA information.
Stated by Northumbria Healthcare NHS Foundation TrustStated plannedThe respondent said that this action was planned when they made their response on 30 July 2025.
Action
Complete and approve a SALT standard operating procedure requiring clarification documents, specified face-to-face assessment triggers, family liaison, and confirmation of recommended IDDSI levels.
Stated by Northumbria Healthcare NHS Foundation TrustStated in progressThe respondent said that this action was in progress when they made their response on 30 July 2025.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Position
The measures described are considered sufficient to satisfy the concerns, so no further safety work is proposed.
Stated by Hill Care GroupNo action considered necessaryThe respondent said that no further action was needed.
Position
The referral information did not indicate or corroborate dysphagia, swallowing difficulty, coughing or choking requiring face-to-face assessment.
Stated by Northumbria Healthcare NHS Foundation TrustDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Position
Existing dysphagia guidance and referral thresholds were considered sufficient to determine that face-to-face assessment was not required.
Stated by Northumbria Healthcare NHS Foundation TrustExisting arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Inner North London
Concerns raised1
Delays in referral to the speech and language team
This report raised 9 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Position
The Trust could not find evidence of a delay in referring the patient to the Speech and Language Team.
Stated by Royal Free HospitalDisputes the concernThe respondent disagreed with part of the concern or the basis for it.
Blackburn, Hyndburn and Ribble Valley
Concerns raised1
Failure to respond to swallow assessment referrals within two working days
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concerns
Each statement is shown once, even when linked to more than one concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
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Includes failures in the speech and language therapy process for swallowing-related safety needs, including service capacity, referral thresholds, referral completion, waiting times, assessment, observation of eating, review of relevant information and recommendations for diet, fluid intake, supervision or monitoring.
