Speech and language therapists help patients of all ages with varying levels of speech, language and communication problems, or difficulties in swallowing, drinking or eating

As a speech and language therapist (SLT), you'll provide treatment, care and support to babies, children, adults and elderly people with a range of conditions, including cleft palate, stammering, language delay and voice disorders. These can be caused by a range of issues, including:

  • developmental delays
  • injury
  • illness
  • learning disabilities
  • mental health conditions
  • physical disabilities.

You'll usually work as part of a multidisciplinary team alongside other health professionals, and will often liaise with family, carers or teachers when developing treatment plans. You can also work in private practice.

Responsibilities

Your tasks will vary depending on your client and the nature of the problem. However, you'll typically need to:

  • identify the speech and communication difficulty or disorder
  • assess the cause and nature of the problem, for example, congenital problems (such as cleft palate) or acquired disorders after a stroke or injury
  • devise and deliver a suitable treatment programme, working on a one-to-one basis or in groups, to enable each of your clients to improve as much as possible
  • review and revise the programme as appropriate
  • advise carers on implementing a treatment programme and train other professionals in therapy delivery
  • monitor and evaluate your clients' progress
  • write confidential client case notes and reports, as well as information for clients, carers and other professionals
  • manage a caseload while taking into account priority cases, waiting lists, successful outcomes, referral and discharge of service users
  • work within a team to improve the effectiveness of service delivery.

At a more senior level, you'll need to:

  • conduct personal development reviews with colleagues
  • support newly qualified SLTs and speech and language therapy assistants
  • plan and deliver training sessions
  • undertake clinical audit
  • participate in research projects.

Salary

  • Jobs in the NHS are usually covered by the Agenda for Change (AfC) pay rates consisting of nine pay bands. As a newly qualified SLT your starting salary is likely to be £24,907 (Band 5), rising up the pay scale to £30,615.
  • As a specialist SLT you can earn between £31,365 and £37,890 (Band 6).
  • Typical salaries for advanced or highly specialised SLTs range from £38,890 to £44,503 (Band 7). Some management roles (for example, head of children's therapies) can attract higher salaries at Band 8.

Salaries in the public and private sector are usually broadly equivalent to the NHS bands.

Fees in independent practice vary significantly depending on the scope and size of your practice, your experience and reputation, and your location.

Income figures are intended as a guide only.

Working hours

If you're working for the NHS, you will typically work 37.5-hours a week. In other settings you may need to work some evenings or weekends to suit client needs.

There are opportunities for flexible or part-time work and job-sharing.

What to expect

  • Jobs are available throughout the UK, although there are more opportunities in cities and towns.
  • You can work in a range of settings, for example hospitals, health centres, day-care centres, rehabilitation units, schools or pre-schools, a client's home, prisons or young offenders' institutions. It's possible to work in several different locations during the week.
  • Depending on where you work, you may need to travel between client visits.
  • With experience, you can take on freelance work or become self-employed.
  • Competition for entry-level posts is fierce and it's important to be geographically flexible if possible.

Qualifications

To practise as a SLT you must be registered with the Health & Care Professions Council (HCPC). In order to register you'll need to complete an HCPC-approved undergraduate or postgraduate degree in speech and language therapy.

Undergraduate degree courses typically last three or four years full time and combine both theory and clinical practice. Clinical practice takes place in NHS hospitals, schools, community health clinics and day centres under the supervision of qualified therapists.

For most undergraduate courses you'll need at least five GCSEs or equivalent (including maths and English language, and sometimes a science) and three A-levels or equivalent. Some providers may ask for specific subjects such as English, languages, psychology and sciences. Applications for undergraduate degrees are made through UCAS.

A speech and language therapist degree apprenticeship has also been approved for delivery, combining paid work with part-time study. Vacancies will be available via NHS Jobs or Find an apprenticeship.

If you already have a degree, you can take an accelerated two-year postgraduate course in order to qualify. Some course providers will ask for specific subjects relevant to speech and language therapy such as psychology, human biology, linguistics/languages, education, social science or medical sciences. Applications for postgraduate study are made directly to the relevant institution.

Entry requirements for both undergraduate and postgraduate courses vary so you should check with course providers for details of what they are looking for. A list of approved courses is available on the Royal College of Speech and Language Therapists (RCSLT) website.

All pre-registration undergraduate and postgraduate speech and language therapy students on an eligible course in England can receive non-repayable funding support of at least £5,000 per year towards their studies. For full details, see the NHS Learning Support Fund.

Details of financial support for students studying in Scotland, Wales and Northern Ireland are available from:

Entry without a degree is possible at speech and language therapy assistant practitioner level, working with qualified SLTs. You'll receive training on the job and may have the opportunity to take an S/NVQ or BTEC qualification or a healthcare apprenticeship.

Once you've successfully completed an approved undergraduate or postgraduate qualification, you're eligible to register with the HCPC and begin practising.

Skills

You'll need to have:

  • excellent communication and listening skills, to relate to people of all ages and backgrounds, motivate clients and gain trust. Clients may be uncooperative because they're frightened, frustrated or disorientated by their situation
  • patience, as progress may be slow - involving repetitive exercises to aid clients who have problems memorising, processing and retaining information
  • creativity and problem-solving skills, to design programmes appropriate for different learning styles and communication issues
  • the ability to work in a team, for interacting with other professionals
  • organisational skills and flexibility, to deal with a range of clients in varied settings
  • the ability to be at ease in a clinical environment
  • qualities such as empathy, assertiveness, tact, a sense of humour and physical and mental stamina.

You'll also need a driving licence, particularly if you're working as a community speech and language therapist, to travel between appointments.

Knowledge of Welsh, Gaelic or community languages may be a requirement or an advantage in some parts of the UK.

Work experience

Competition for places on training programmes is strong and you'll need to show that you have an understanding of what an SLT does when you apply. Try and arrange an observation session at your local speech and language therapy service.

Relevant work experience, including voluntary work, is also useful. This can include working with children and adults with a learning disability, the elderly or disabled people, particularly those recovering from a stroke or head injury. Try contacting local nursing homes, schools or stroke groups to ask for work experience.

It's also possible to gain experience by working as an SLT assistant/support worker or bilingual co-worker under the guidance of a qualified SLT.

Employers

There are around 17,000 SLTs in the UK working in a range of settings (RCSLT). The majority of SLTs are employed by NHS trusts and work in hospitals (on wards, in intensive care units and in outpatient departments), schools, clinics, community health centres and day care centres. Some mainstream work may be managed by local authorities.

You may also be employed directly by:

  • nurseries and schools (mainstream and special)
  • child development centres
  • voluntary and charitable organisations
  • GP practices and community clinics
  • education and social services departments
  • prisons, secure units and young offenders' institutions
  • residential homes for the elderly or people with learning difficulties
  • higher education institutions (lecturing and research).

With experience, you can move into self-employment and set up in private practice.

Look for job vacancies at:

Specialist recruitment agencies such as Maxxima also handle vacancies.

If you decide to work in independent practice, you can add your details to the Association of Speech and Language Therapists in Independent Practice's (ASLTIP) register of members, Find a speech therapist. This database allows you to showcase your skills to potential clients.

Professional development

Once qualified, your first year is spent under supervision as a newly qualified practitioner (NQP) working towards the RCSLT NQP Framework in order to become a full (Certified) member of the RCSLT. You will need to complete a set of NQP goals, which will support your learning and practice in your first year of practice.

You'll be responsible for your own professional development and must show that you're developing and keeping your professional knowledge up to date in order to remain on the HCPC register.

The RCSLT provides a range of courses and seminars in areas such as:

  • children with severe language difficulties
  • adult neurology
  • dysphagia (problems with swallowing)
  • clinical effectiveness.

Other continuing professional development (CPD) activities include observation of other therapists' practice, reflective practice, peer review of performance, case discussion and video analysis. You can also join a clinical specialist interest group and attend or take part in national conferences and clinical meetings. Full details of the range of activities and resources are available to RCSLT members.

If you're working as a freelance SLT you can join ASLTIP, which also runs events and conferences.

There are also opportunities to undertake a higher degree, such as a postgraduate certificate, diploma or Masters, or a PhD by research. Search for postgraduate courses in speech and language therapy.

Career prospects

First posts are often within the NHS and involve working from one of several locations, such as health centres, hospital clinics or special schools. In your first year of practice you'll have a general caseload and will normally work with both adults and children.

Many qualified SLTs choose to specialise in a particular disorder such as:

  • acquired conditions, for example stroke or brain injuries
  • cleft lip and palate
  • developmental language disorder
  • head, neck or throat cancer
  • hearing impairment
  • learning disabilities
  • mental health conditions
  • neurodegenerative disorders
  • stammering.

You can also specialise in a particular client group, although it's possible to move between groups.

Senior therapist positions exist in clinical specialisms, management, and research and teaching. A typical career path will often involve increased management responsibilities, which can include supervising students on placement and junior staff.

As the head of a local speech and therapy language service, you'll have responsibility for managing budgets, strategy and staff. There are a small number of opportunities to move into strategic management positions across different therapies.

Self-employment is another option for experienced SLTs and support for therapists working in independent practice is provided by ASLTIP.

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