Specialist Speech & Language Therapist

Job responsibilities

Key responsibilities

Clinical

To be responsible for triaging referrals to the Speech and Language Therapy Community Adult service alongside SLT colleagues.

To independently manage a caseload of community patients with highly complex speech, language, communication and swallowing (dysphagia) difficulties with reference to theory, published research and evidence, and agreed best practice.

To prioritise and respond to referrals, allocating to less experienced colleagues and exercising professional judgement based on extended clinical experience.

To identify, collect, analyse, and interpret highly complex case related information and data from medical notes, patients, carers and other relevant sources

To undertake a range of formal and informal assessments, including risk analysis of swallowing, understanding and use of voice, grammar, vocabulary, speech sounds, fluency, social use of language, patient/carer interaction and non-verbal communication, and make judgements from these concerning prioritisation and future management.

To be responsible for ensuring patients safety with regard to eating and drinking by assessing, monitoring and updating, and communicating details of safe practice to the patient, medical and ward staff, and carers, ensuring that recommendations are clearly documented.

To make judgements about when to refer patients for videofluoroscopy (X ray) examination taking into account the risks and benefits of the procedure. To participate in the examination with radiology colleagues and to jointly interpret results in order to plan appropriate SLT treatment.

To identify, collect, analyse, and interpret highly complex case related information and data from patients, carers and other relevant sources in order to reach an accurate diagnosis.

To reach differential diagnoses on the basis of assimilated evidence from formal and informal assessments including psychological and social factors (some of which may be conflicting) and with reference to normal and abnormal functioning and research evidence.

To prioritise and decide on appropriate highly specialised treatment programmes individual or group, matched to individual patient/family need and to adapt and modify management options based on extended and developing clinical expertise whilst ensuring patient/carers/multi-disciplinary team are fully involved in the decision making process.

To assess the need for alternative and augmentative means of communication and to create personalised low- tech communication systems such as communication booklets and charts, and train and support patients and carers in their effective use.

To identify where high -tech electronic communication systems are required to meet patient needs including assessment, and identification and selection of appropriate aid, sourcing and identifying funding. Training of patients, carers, other members of MDT in the effective use of the highly complex equipment.

To make referrals for specialist AAC assessment as appropriate.

To provide expert advice to enable professionals and carers to provide clear explanations when the patients levels of understanding and ability to communicate their wishes are severely affected e.g. supporting patients to give informed consent for complex procedures and life choices and power of attorney.

To contribute to clinical teams, both multi- and uni-disciplinary, by discussing and negotiating own and others input around patients needs, ensuring a well co-ordinated care plan and pathway. And ensure patients and families are aware of voluntary and support agencies.

To be responsible for updating notes within the patients care setting, departmental notes, and a range of report writing including for legal purposes, and dissemination of findings to appropriate professionals and relevant others.

To have autonomy for prioritisation, management and discharge of patients in relation to highly complex caseload.

To use highly developed communication and counselling skills such as reflective listening, open questioning, empathy, and reassurance when explaining highly complex and sensitive information to the full range of levels in understanding of patients and carers, where anxiety frequently acts as a barrier and co-operation is not guaranteed.

To demonstrate empathy and reassurance when providing patients and carers with unwelcome information that has long-term implications for lifestyle and employment e.g. when communication skills will not be recovered and/or oral feeding is no longer an option. To provide counselling and support before onward referral for more formal consultations if judged necessary.

To monitor, recognise, assess and evaluate subtle changes in patients conditions and adapt assessment and treatment programmes accordingly based on extended clinical experience, including in palliative care.

To assess the risk to, and vulnerability of, patients and families in relation to timing and manner of treatment and amount of information provided, i.e. where inappropriate intervention could have a negative effect e.g. inappropriate introduction of a communication aid, or introduction of fluids when this would put the patient at serious risk.

To implement the second opinions process as and when necessary, and refer on for further medical investigations.

To negotiate with carers/patients and professionals around individual case diagnosis and management where others have less specialist knowledge and/or experience in relation to SLCD and swallowing disorders (dysphagia), and differences of professional judgement can occur e.g. over or under estimation of patients understanding which would effect goals for treatment and life choices, and/or texture of foods which can be eaten safely.

To reflect on practice both individually and with peers/mentors and to identify personal strengths and development needs in order to raise clinical competence.

Professional

To maintain registration with the Health and Care Professions Council and the Royal College of Speech & Language Therapists

To be professionally accountable for independent clinical judgements for prioritisation, assessment, diagnosis, treatment, onward referral and discharge criteria in line with HCPC and RCSLT standards.

To continue to develop deeper and more highly specialist professional expertise and clinical skills across a range of acquired and/or progressive neurological speech, language and communication difficulties (SLCD) by working with the Team Leader Therapist, attending Clinical Excellence Networks (RCSLT), specialist courses, self directed study and maintaining personal CPD portfolio.

To recognise own professional and clinical boundaries and competencies and seek advice, support and training when necessary with in an individual performance review framework.

With the Team Leader SLT, to maintain and develop professional and service standards and policies with adherence to local and national guidelines and clinical governance, including confidentiality.

To record and update personally generated clinical observations, assessment results, treatment and advice details in patient medical and departmental case notes.

To participate in Annual Appraisal Process and to act as an appraiser of junior staff.

To follow and implement local and national policies with elements of independent professional judgement and make recommendations for change for own specialism through the clinical governance process.

To be responsible for maintaining equipment records and the safe use and security of clinical equipment. To identify and request therapy equipment to meet caseload demands.

To provide clinical activity data, and routine recording of CPD, travel, and other related activity, observing data protection guidelines

To contribute to the formal clinical and professional training and assessment of less experienced SLTs, SLT students and other AHP students and graduates as required.

To supervise and provide advice, training and support to less experienced speech and language therapists, assistants and volunteers.

With the Team Leader SLT to take part in and initiate research and clinical audit, undertaking action research with the rehabilitation caseload and contribute to others research by providing data.

To be able to recognise breakdown/conflict when it occurs and seek to reach resolution with support from Team Leader SLT if required

Qualifications

Essential

• Degree or equivalent in speech and language therapy
• HCPC Registration
• RCSLT Registration
• Post-graduate qualification in dysphagia management
• Evidence of on-going education and professional development
• Recognised qualification in written and spoken English if this is not first language
• The post holder will need to travel and attend to service users based across Plymouth and other geographical areas. Full and valid driving licence and access to a car for work purposes is required. Reasonable adjustments under the Equality Act will be taken into account for the successful applicant.

Desirable

• Advanced Clinical Educator.
• Relevant post graduate education
• Membership of relevant Clinical Excellence Network
• MSc in related field

Experience

Essential

• Minimum 3 years post graduate experience in adult neurological rehabilitation
• Demonstrate an understanding of multi-disciplinary team working and individual roles
• Autonomous practitioner with experience of managing a caseload
• Experience of working in a multi-disciplinary team in a rehabilitation setting
• Experience in assessment and provision of high tech AAC
• Experience in facilitating group therapy
• Experience of working with dysphagia patients at post basic level
• Evidence of CPD to maintain and develop competencies and knowledge base e.g. working with more specialist staff, Clinical Excellence Networks, training courses, self- directed study
• Supervision/ Line management of SLT assistants and less experienced therapists

Desirable

• Experienced clinical educator of students
• Experience of audit projects
• Experience of teaching/ training
• Experience managing tracheotomised clients
• Evidence of participation in service improvement initiatives
• Additional experience in other fields of adult SLT
• Experience managing tracheotomised clients
• Experience of training Conversational Partners
• Evidence of participation in service improvement initiatives
• Experience of working with an adult neuro caseload in a community setting

Knowledge

Essential

• Specialist knowledge and evidence of communication assessment, diagnosis and management, to include; aphasia, apraxia and dysarthria
• Specialist knowledge and evidence of dysphagia assessment, diagnosis and management

Desirable

• Experience of the assessment, diagnosis and management of clients with cognitive-communication disorder
• Experience of the assessment and management of clients with progressive neurological conditions

Skills

Essential

• Highly developed communication and interpersonal skills, and ability to communicate highly complex information to meet a range of levels of in understanding of clients and carers
• Independent clinical management of complex caseload with access to support from senior staff
• Able to undertake and adapt wide range of formal and informal assessments to meet patient need based on extended clinical experience beyond graduate level
• Commitment to evidence based practice
• Able to recognise own clinical competencies, and the need for onward referral for more specialist advice
• Ability to reflect on practice to identify own strengths and development needs
• Able to demonstrate effective team working
• Highly developed IT skills to support use of high tech communication aids and clinical systems

Desirable

• Experience in applying research to practice
• Leadership qualities
• Knowledge and experience of clinical governance

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

UK Registration

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).