Prioritising a SALT Caseload

The Royal College of Speech and Language Therapists provides guidance on prioritisation in their book on best practice; Communicating Quality 3 (RCSLT 2006). Prioritisation is a highly relevant topic in the NHS environment at present due to the streamlining of services and the demand for efficacy.

CQ3 states that:

1    ‘a prioritisation policy should be formulated which defines a range of criteria upon which the decision to fulfil a duty of care will be made on a case by case basis’.

2    ‘ The key factor in relation to prioritising an individual for therapeutic care is the judgement about the level of clinical risk’.

Recommended Prioritisation Criteria:

1  Risk

·   Immediate health risks if the individual is not seen e.g. risk of penetration.

·   The risk of secondary complications if the individual is not seen e.g. aspiration pneumonia.

2Timing

·   Optimal time for intervention to achieve maximum potential, e.g. there is evidence for improved health outcomes for people with long term neurological conditions  when they are seen early on in their pathway by a specialist.

·   Medical urgency e.g. rapidly deteriorating condition.

3Wellbeing

·   Anxiety/distress/concern expressed by the individual, caregiver or family.

·   Effect of difficulties on the individuals communicative/ swallowing function in the current environment.

·   Effect of difficulties on participation in everyday activities/ quality of life.

4Predicted outcome in current context

·   Individual/carers ability to engage with therapy.

·   Availability of SLT resources/ skilled support to help the individual maintain gains.

·   The individuals potential for change.

·   Response to previous SLT.