Pre-registration eating, drinking and swallowing competencies - about the project

What this means

This means that:

• Learners graduating from UK speech and language therapy pre-registration education and training courses in 2026 will receive practical experience and training in EDS in line with the new pre-registration EDS competencies (PDF)
• For NQP’s who work with people with EDS difficulties there will be additional elements within their NQP competency framework to reflect working more independently with this client group – see NQP expectations document
• We will work with EDS services to provide student placements/additional placements
• UK trained SLTs will have clinical parity with international colleagues/recognised by mutual recognition agreement (MRA) countries.

This does not mean that:

• All services need to provide EDS placements
• SLTs who have already graduated will be able to access dysphagia training through this project – the normal postgraduate training route will still apply for learners entering courses before academic year 2022–2023, and in some cases 2023-2024. For specific guidance based on course start time and length, please read the implementation timeline and end-point expectations for learners graduating with the pre-registration EDS competencies
• All SLTs will be expected to work with dysphagia patients
• NQPs will be able to see complex cases without supervision or further dysphagia specialisation
• The pre-registration EDS competencies directly align to Level C in the RCSLT Dysphagia Training and Competency framework (2014), although there is some overlap.  This competency framework is currently being updated and will be released in 2024.

Have questions or feedback about the pre-registration EDS competencies? Let us know.

Get involved

We are really interested in hearing your thoughts and plans about implementing these competencies and if you have any local practice educator meetings, or any other speech and language therapy group meetings, we would be delighted to come and join you. Please email Kathleen Graham at kathleen.graham@rcslt.org to coordinate this.

Good practice examples of EDS practice placements

We have already begun gathering case studies of best practice on EDS practice placements, which we encourage you to read.

If you would like to contribute a case study, please email  kathleen.graham@rcslt.org

Have questions or feedback about the pre-registration EDS competencies? Let us know.

FAQs

About the competencies

Find out more about the competencies, including how we developed them, why they are being implemented and how they fit in with other dysphagia competencies.

How were the competencies developed?

These competencies were developed collaboratively with RCSLT members . Read about the RCSLT’s guidance development process.

How do the pre-registration competencies fit in with other RCSLT EDS-related frameworks? Do they replace any aspects of previously published frameworks?

The eating, drinking and swallowing competency framework (EDSCF) is not intended for use by speech and language therapists. Speech and language therapists should instead use the profession-specific RCSLT dysphagia training and competency framework.

We will be reviewing the dysphagia training and competency framework (2014) to ensure consistency of career progression.  This will be available in 2024

Why should learners be required to spend time completing these competencies when they may not be interested in specialising in dysphagia?

HCPC and other bodies recognise that the scope of the speech and language therapy profession includes eating, drinking and swallowing and that it is the lead profession in dysphagia management.

To future-proof the workforce, and ensure that we are fulfilling our professional mission to create better lives for people with communication and swallowing needs, it is vital that all graduates are trained to understand eating, drinking and swallowing needs at a basic level.

Once learners have successfully achieved their EDS competencies, will they be able to practice in dysphagia after they qualify and start working, or will they still need to do the post-graduate training?

If they gain a role which requires them to work with people with dysphagia, they will need to have a supervisor who is dysphagia trained. They will discuss their portfolio with them and look at any areas they need support and supervision in. For some trusts, this may mean they need to be supervised, to complete in-house training, or to attend a post-graduate training course. It is down to the individual and supervisor to decide what is needed to become fully independent with dysphagia. There may be some learners who finish their competencies and have a good level of knowledge on dysphagia and require less support to become independent.  See NQP expectation document for further information

Who is responsible for the overall sign off of the completed 60 exposure hours?

HEIs will regularly review progress against these hours and be responsible for overall signoff however learners will be expected to keep a log of these hours.

The competencies and practice placements

Find out how the pre-registration competencies fit in with practice placements.
Interested in examples of competency implementation on placement? Read our case studies.

Looking for more information on the definition of a placement hour? Download our guide to what constitutes an hour of eating, drinking and swallowing (EDS) exposure (PDF).

How do the pre-registration EDS competencies fit within the broader move towards practice placement expansion and innovation?

The RCSLT hopes that introducing these competencies will encourage more services to offer practice placements that allow learners to work towards completing the EDS competencies.

It is our vision that through practice placements, innovative opportunities for EDS exposure will be found within traditional communication practice placements as well.

Read more about practice-based learning.

Will practice placement opportunities all require EDS-specialised staff?

It is expected that the practical competencies will be fulfilled through a wide range of practice placement experiences, and therefore there are many practice placement opportunities that will not require specialist dysphagia staff.

As eating, drinking and swallowing issues affect most of our service user groups it is our hope that such issues will be embedded within practice placement experiences to promote holistic, patient-centred evaluation.

Clinicians working with service users who have eating, drinking and swallowing needs – even if this is not their main focus – can supervise learners and sign off on their practical competencies relative to their scope of practice. Some of the competencies can be achieved in all clinical areas, such as completing an oro-facial examination on clients without EDS difficulties.

What constitutes a paediatric practice placement?

Paediatric practice placements are those which occur within a paediatric service. All activities that include eating, drinking and swallowing issues are relevant. For example:

• Lunch time at a school with children who have physical or learning disabilities.
• Speaking to a parent about their child’s eating, drinking and swallowing needs.
• Working with a child with sensory and/or behaviour issues relating to food or drink.
• Discussing with other professionals what the issues are or how to best support the child.
• Evaluating the whole person, with EDS being one aspect.

To what skill level will learners be expected to function independently during practice placements and upon qualification?

Completing this framework won’t provide complete dysphagia training or lead to competency at a specialist level, i.e. this competency does not map directly onto Level C of RCSLT Dysphagia Training and Competency framework (2014). Rather, it aims to provide learners with exposure to EDS needs so that they are better prepared to enter the workforce.

Newly qualified practitioners (NQPs) who have completed the pre-registration competencies will be supervised to the same level that they would be in clinical areas related to communication.

As is current practice, individuals and organisations make judgement calls regarding capability and independence when it comes to recruitment, supervision and training in all roles. We have developed an end-point graduate criteria page to clarify the level of competence that is expected at graduation.

Further information is available on expectations of NQPs working within EDS.

However, not all NQP roles will require EDS skills. These NQP will not need to continue with their EDS development unless it is specified by their employer.

Will newly trained EDS therapists be required to take on learners?

Clinicians should only take on learners in areas where they feel confident in their own ability. Clinicians are expected to be competent in all areas included in their job description, and to be able to take on learners in listed areas, including eating, drinking and swallowing.

Newly qualified practitioners (NQPs) may support learners on their practice placements, but according to the practice-based learning guidance, NQPs cannot supervise learners or sign off competencies in any clinical area. This precedent will be maintained in EDS.

How can equity of experience for learners be ensured when it is not always possible to predict what they will be exposed to on a certain practice placement?

As in communication practice placements, there is always some need for flexibility, and this framework fits in with the continued work to expand practice placement capacity and encourage innovation in all practice placement areas. This ought to reduce pressures resulting from practice placement shortages.

Learn more about the practice-based learning guidance.

Additionally, as is likely already part of the learning and education process in other areas, HEIs will have regular check-ups with learners to review their progress against the given competencies throughout the duration of the course to ensure they are on target for full sign off by graduation.

How will learners’ EDS exposure be measured under the framework?

Learners will have to achieve 60 hours in total as part of the overall pre-registration EDS sign off: 10 hours direct with paediatric clients, 30 hours direct with adult clients and 20 indirect hours. Hours achieved through technology enhanced learning and simulation can count towards direct hours with client groups. The hours sign off is in conjunction with double sign off of 16 out of 20 competencies. HEI’s will have ultimate responsibility for overall sign off but practice educators are likely to sign multiple competencies.

Simulation/technology enhanced learning and the competencies

A small number of competencies will need to be signed off following face-to-face experience. However, many will be able to be signed off via simulation, eLearning or other teaching methods. Read which competencies require face-to-face exposure in the clinical setting (PDF).

HEIs are encouraged to be innovative in their use of simulation for practice placements and learning, and they will be supported by the RCSLT in this endeavour.