2 November 2023

The Intercollegiate Stroke Working Party have responded to the RCSLT’s concerns on stroke guidelines 

In April this year, the national clinical guidelines for stroke for the UK were published.  In October, NICE published their guideline for stroke rehabilitation in adults

The RCSLT were very concerned that there was significant variation between these two major pieces of stroke guidance concerning the amount of speech and language therapy people could receive post stroke, issuing a statement about our concerns in October.  

The RCSLT’s CEO, Steve Jamieson, wrote to the chair of the Intercollegiate Stroke Working Party, who oversees the National Clinical Guideline for Stroke, calling for clarity for our members working in stroke across the UK. 


The RCSLT has received confirmation from the Intercollegiate Stroke Working Party that:  

  • Motor therapy is based on recovery of upper and lower limbs and gait only. It does not include communication or dysphagia which have their own separate areas in the Guideline with their own evidence base.
  • Speech and language therapy will continue to be provided for at least 45 minutes per day, for at least 5 days a week, per person. It is not included in the “motor” therapy 3-hour goal.
  • Measurement of the therapy inputs is under development. These have been tested by eight8 acute and 4four community teams. The new measurement separates therapy input into different person-centered goals. It is suggested that aphasia, dysphagia, apraxia and dysarthria will be grouped together into one section. The RCSLT and our expert representatives will work hard to ensure that all activity related to speech and language therapy needs is easy to record and provides meaningful outputs.
  • At present it is not proposed to score single therapy disciplines, however this is still being discussed.
  • Therapy teams will be encouraged to use the data derived from SSNAP along with the recommended therapy staffing levels to improve and invest in their speech and language therapy workforce.

RCSLT will continue to work closely with the Intercollegiate Stroke Working Party to advocate for and support members to understand, transition to, and implement the Guideline and national stroke audit over the coming months and year. 

We will continue to work with NICE to understand how the two stroke documents are aligned. 

Please contact us if you have any concerns.