Speech and Language Therapy

  • Treating adults with speech, swallowing and language difficulties.

  • Address: Maidstone Hospital and Tunbridge Wells Hospital,

What we do

Speech and language therapy provides treatment, support and care for people who have difficulties with communication, or with eating, drinking and swallowing.

We work with adult inpatients and outpatients with a speech and swallowing issues, caused by different disorders including:

  • Stroke
  • Neurological disorders such as Parkinson’s Disease, multiple sclerosis
  • Head injuries
  • Cancer, including head and neck cancer
  • Voice disorders
  • Dementia
  • COPD and patients with recurring chest infections
  • Post-surgery complications and tracheostomy
  • Swallowing problems
  • Patients being tube fed
  • Learning disability.

We have a commitment to training speech and language therapy students who spend up to 10 weeks at a time with us.

 

Get in touch

Tunbridge Wells Hospital

The outpatient voice therapy clinic is on level 0, Clinical Zone 2, next to the Ear, Nose and Throat department.

The videofluoroscopy clinic is on Level 0, in the main X-ray department.

Contact number: 01892 635648

Maidstone Hospital

The outpatient voice therapy clinic is in the Therapy department, along the first corridor on the right as you come into the main entrance.

The oncology clinic is in the Kent Oncology Centre on the first floor.

The videofluoroscopy clinic is next to MRI, by the Kent Oncology Centre, on the first floor.

Contact number: 01622 224308

You can also email us at mtw-tr.speechandlanguagetherapy@nhs.net.

Inpatients

Caring for inpatients with speech and swallowing issues including:

  • Neurology inpatients with acquired neurological disorders, including stroke, Parkinson's disease, multiple sclerosis, motor neurone disease
  • Elderly care patients with dementia and Alzheimer’s disease
  • Cancer (oncology) patients, particularly those with head, neck and oesophageal cancers
  • Patients with organic (caused by physical changes such as nodules or paralysis) and functional (when the larynx is structurally normal but used effectively) voice disorders 
  • Respiratory patients, including those with recurrent chest infections or chronic obstructive pulmonary disease (COPD)
  • Gastroenterology patients including those needing to be tube fed
  • Helping diagnose the cause of swallowing problems using video x-rays (videofluoroscopy).

Outpatients

Caring for outpatients with speech and swallowing issues including:

  • Patients with acquired neurological disorders, including stroke, Parkinson's disease, multiple sclerosis, motor neurone disease
  • Cancer (oncology) patients, particularly those with head, neck and oesophageal cancers
  • ENT patients with organic (caused by physical changes such as nodules or paralysis) and functional (when the larynx is structurally normal but used effectively) voice disorders 
  • Respiratory patients including those with recurrent chest infections or chronic obstructive pulmonary disease (COPD) 
  • Gastroenterology patients, including those needing to be tube fed
  • Helping diagnose the cause of swallowing problems using videofluoroscopy

Children and elderly care outpatients are seen by Kent Community Health NHS Foundation Trust.

Before your appointment

You will usually be referred to us by your GP, and will need an ENT (ear, nose and throat) examination before starting therapy.

If voice therapy is recommended for you, your consultant will write a detailed report on the workings of the larynx (voice box) so the speech and language therapist can make the right treatment plan for you.

If you have completely lost your voice, referral by your GP to speech and language therapy means we can give early advice, although we can't start your treatment until the exact cause of your voice loss has been found by the ENT consultant.

We may assess you in a joint ENT/SaLT clinic.

Initial assessment

During the initial assessment we will:

  • Take a case history, including medical and social details, to try and establish the cause(s) of your voice problem
  • Assess your voice quality and how you use your breathing to support your voice. This may may include recording your voice.
  • Assess your face and neck muscles to make sure these are not being overused, as this can create muscle tension as you talk.

The results of your assessment will be sent to the consultant and your GP, as well as other teams if needed.

Ongoing therapy

We'll decide the best way to manage and treat your voice. This may include:

  • Showing you how to care for your voice
  • A period of direct therapy (on average four to six sessions).
  • Review appointments to check on your progress.

If we discharge you, we will discuss this with you and (and with your consultant if we need to). We will do this if:

  • Your voice disorder is better and we are happy with the improvement.
  • Your voice disorder has improved as much as it can
  • You have told us you don't want further treatment
  • You missed an appointment without giving us notice.

If we discharge you, we will tell your GP.

 

Cancer patients

Head and neck cancer may lead to difficulties with swallowing and communication. We aim to support you from diagnosis through treatment and follow up.

Before your appointment

All new patients with head and neck cancer are discussed at a weekly meeting in the Kent Oncology Centre to decide the best treatment for you. The team includes specialist head and neck surgeons, oncologists, radiographers, specialist nurses, dietitians and a speech and language therapist.

If your treatment involves having surgery, a speech and language therapist from Queen Victoria Hospital may see you with the surgeon after that meeting. 

They will make an appointment which will give you the chance to ask questions and for them to look at your swallowing and speech so they can offer advice and support.

If your treatment involves radiotherapy and/or chemotherapy and we think this may affect your speech or swallowing, we will contact you. If we need to, we'll make an appointment to see you before you start treatment. This may be a joint appointment with the dietitian.

At your appointment

You will have the chance to ask questions and we will look at how your tongue, lips, palate, jaw and voice are working and whether you have any difficulty talking or swallowing.

We may give you some exercises to help your tongue and jaw movement and explain how to look after your voice during treatment. If you find swallowing difficult we will do a full assessment, which may include a video x-ray called videofluoroscopy. 

The dietitian will give you advice on textures of foods you might find easier to eat, and how to supplement and enrich your diet. We will give you tips and techniques to help you swallow.

During treatment

If you need surgery as an inpatient at Queen Victoria Hospital you will be seen regularly by the speech therapist on the ward. After discharge you will be offered an appointment locally.

If you are having radiotherapy and/or chemotherapy you will be seen during your treatment at the Kent Oncology Centre in Maidstone Hospital.

Your appointments will usually be on a Thursday morning and will be arranged around when you come in for your treatment. Appointments usually last 15 to 20 minutes and most people are seen at the beginning, middle and end of their treatment depending on need. Joint appointments with the dietitian will be offered when needed.

At your appointment you can ask questions about your speech and swallowing and we will look at your progress, advise and support you.

We will help you practice exercises to maximise your recovery. This may include lip, tongue, palate, jaw and voice exercises, as well as ways to help you swallow and communicate more easily.

Some exercises help prevent future difficulties, by keeping the jaw and tongue moving freely and keep your voice working efficiently.

Your speech therapist will make an appointment to follow up after you have finished your treatment this may be a phone review or an appointment at Maidstone Hospital.

After your treatment

At your appointment we will review your speech and swallowing, and continue to support you in your recovery.

We will reassess how your tongue, lips, palate and jaw are moving and how your voice is working. We show you how best to swallow and communicate, working with other members of the team (particularly the dietitians).

Videofluoroscopy

Before your appointment

When we get your referral, we will send you an information sheet and a questionnaire to complete and bring with you.

What is videofluoroscopy?

Videofluoroscopy is a video x-ray of your swallow. It lets us see what happens when you swallow food and drink, so we can see how to manage any problems you are having.

It is not painful or uncomfortable, is not invasive and no tubes will be put down your throat. It only takes about 15 minutes

Do I have to lie down?

No. We will ask you to stand on a platform if you can, and stay as still as possible while we line you up with the camera. There are handles available if you need them. If you need to stay sitting in a wheelchair, this can be arranged.

What will happen?

So we can see which consistencies are easiest for you, you will be given a drink of barium (which shows up on an x-ray), some yoghurt, some mashed banana and a piece of bread and butter. 

If there are certain foods you know are difficult for you, please bring these with you. To get the best picture of how you manage these, you will need to follow some instructions:

Drink

  • Take a large sip and hold the fluid in your mouth until we tell you to swallow
  • The radiographer will count to three and will say “1,2,3, SWALLOW”
  • Please swallow the liquid in your usual manner, trying not to move your head any more than you need to
  • Please keep swallowing until you feel it has all gone.

Yoghurt

  • Hold the yoghurt in your mouth until we tell you to swallow
  • The radiographer will again say “1,2,3, SWALLOW”
  • Please swallow the yoghurt in your usual manner, trying not to move your head any more than you need to
  • Please keep swallowing until you feel it has all gone.

Mashed banana\bread and butter

  • Please chew the food for as long as you need to but do not swallow it
  • When you are ready to swallow, wave your hand at the radiographer
  • The radiographer will again say “1,2,3, SWALLOW”,
  • Please swallow the food in your usual manner
  • Please keep swallowing until you feel it has all gone.

After the videofluoroscopy

During the procedure you may hear us talking about the swallow as it happens. This is normal and you should not worry. After the clinic we will watch your x-ray again and write a detailed report. This is sent to the person who referred you who will normally see you for a follow up appointment. A copy of the report will also be sent to your GP and to you. This will include any recommendations or strategies that may help you.

Please ask us if you have any questions or concerns.

Frequently asked questions

Why have I been referred for speech and language therapy?

You may be referred to us if there is a new or recent difficulty with your eating, drinking, swallowing, talking, understanding, reading or writing.

How often will I be seen?

Patients are seen according to their needs, so some are seen weekly and others may need to be seen daily.

If you have severe problems swallowing, for example if you can't eat and drink at all – perhaps because food and drink goes the wrong way – you will be given greatest priority.

How will I be referred?

Any healthcare professional in the hospital may refer you but inpatients are usually referred by doctors, nurses or therapists.

Outpatients are usually referred by their GP.

Family involvement

It is very useful to have information and involvement from your family or carers and we encourage this at every stage.

If your family members are not able to visit during the day, they can call us on 01892 635271 and leave a message if we are not available.

Will there be anyone else with the speech and language therapist when I see them?

We have junior speech and language therapists, speech and language therapy students and speech and language therapy assistants, and they may also be at your appointment. If you have any questions about this, please ask us.