Failure to provide timely speech and language therapy for swallowing risks
First to latest report 5 Mar 2014 — 1 Jul 2026
Reports that mention this concern
5
Times this concern has been raised
8
Stated actions linked to this concern
12
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.
What is 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.
Trends
Reports over time
Reports mentioning this concern, 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
Reports and published responses 5 reports
See individual reports that have raised this concern, and the actions taken in response
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
Linked responses
NHS Shropshire, Telford and Wrekin Integrated Care Board
NHS Staffordshire and Stoke-on-Trent Integrated Care Board
University Hospitals of Derby and Burton NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.9
University Hospitals of Derby and Burton NHS Foundation Trust
Continue providing remote community SALT advice to care homes and domiciliary settings by telephone and email.
University Hospitals of Derby and Burton NHS Foundation Trust
Deliver community SALT activity using a secured two-day-per-week Band 7 locum therapist.
University Hospitals of Derby and Burton NHS Foundation Trust
Explore appointing a temporary Band 6 practitioner using potentially remaining locum funding to increase community SALT capacity.
University Hospitals of Derby and Burton NHS Foundation Trust
Explore alternative community SALT service delivery options with Integrated Care Board support.
NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care Board
Provide care homes with specialist SALT advice through remote support, including email advice.
NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care Board
Maintain escalation routes for complex cases requiring specialist SALT input.
NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care Board
Review the effectiveness of interim pathways while workforce shortages are addressed.
NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care Board
Plan recommissioning of community SALT services, considering resilience, workforce sustainability, responsiveness and reduced-staffing arrangements.
NHS Shropshire, Telford and Wrekin Integrated Care Board and NHS Staffordshire and Stoke-on-Trent Integrated Care Board
Continue contractual performance management of UHDB regarding workforce recovery and SALT service capacity.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
University Hospitals of Derby and Burton NHS Foundation Trust
Face-to-face community SALT assessments cannot currently be provided because staffing and recruitment constraints limit team capacity.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
University Hospitals of Derby and Burton NHS Foundation Trust
Long-term community SALT delivery should transfer from the acute Trust to a community NHS provider, supported by the ICB.
Redirects 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.
Linked responses
Department of Health and Social Care
NHS England
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
NHS England
Publish guidance outlining recommended actions to reduce community health service waiting times.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
NHS England
Local services determine SALT referral criteria and make referral decisions according to individual patient need.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
NHS England
Integrated Care Boards are responsible for increasing community SALT capacity and managing waiting times under national planning requirements.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Department of Health and Social Care
NHS England is responsible for reporting separately on current Speech and Language Therapy waiting lists.
Redirects 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.
Linked responses
Hill Care Group
Northumbria Healthcare NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
Northumbria Healthcare NHS Foundation Trust
Implement revised electronic SALT referral form questions, mandatory detail fields, and mandatory Next of Kin or LPA information.
Northumbria Healthcare NHS Foundation Trust
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.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
Hill Care Group
The measures described are considered sufficient to satisfy the concerns, so no further safety work is proposed.
No action considered necessaryThe respondent said that no further action was needed.
Northumbria Healthcare NHS Foundation Trust
The referral information did not indicate or corroborate dysphagia, swallowing difficulty, coughing or choking requiring face-to-face assessment.
Disputes the concernThe respondent disagreed with part of the concern or the basis for it.
Northumbria Healthcare NHS Foundation Trust
Existing dysphagia guidance and referral thresholds were considered sufficient to determine that face-to-face assessment was not required.
Existing 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.
Linked response
Royal Free Hospital
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Royal Free Hospital
The Trust could not find evidence of a delay in referring the patient to the Speech and Language Team.
Disputes 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.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.