Representing speech and language therapy in national guideline development

Speech and language therapists Nicholas Behn and Gerry Roxburgh share their experience of contributing to NICE guidelines, explaining the guideline development process, sharing their tips for getting involved and highlighting the vital role SLTs play in advocating for people with communication and swallowing needs in national guidelines.

NICE and the RCSLT

The National Institute for Health and Care Excellence (NICE) provides evidence-based clinical guidelines for health and social care services. RCSLT is a stakeholder for all NICE guidelines, and we rely on the support of expert members to respond to their formal consultations. RCSLT strives for people with communication and swallowing needs to be appropriately considered in national guidance and recommendations and encourages members to follow NICE guidelines where relevant. As such, RCSLT and its members have a role in the development of guidance, ensuring they are appropriate and fit for purpose.

A recent example of this involvement is the contribution of Nicholas and Gerry who represented the profession in the development of the Rehabilitation for chronic neurological disorders including acquired brain injury NICE guideline published in October 2025.

Tips for getting involved in NICE guidelines

If you are interested in being involved there are a number of steps to familiarise yourself with the process and to work out whether it is the right fit for you.

Be aware of upcoming projects. You can find these on the NICE website.

1. Look at the scope of the guideline. This is important as a guideline can ONLY cover what is within its scope. You will need the experience, knowledge and skills to write both speech and language therapy and wider multidisciplinary team (MDT) guidance within this scope (with support from the wider guideline team).
2. Ensure your employer supports your application to be involved. Some guidelines are relatively quick from scoping to publication (e.g., one year); others can take several years of monthly full day meetings. For a meeting to proceed it must be quorate so your attendance will generally be expected even if you believe the day’s topic has little relevance to speech and language therapy (remember you are writing with the MDT and communication should be embedded throughout any goals, where possible)
3. Fill in the application form, which will feel like applying for a job and you will need to evidence your skills and experience. The process of becoming a NICE committee member is challenging and you approach it as if applying for a SLT role.
4. Attend an interview, most likely with the guideline Chair and NICE advisor (you are writing guidelines that will potentially influence commissioning and the way services are run so be prepared)
5. There may be a lull between acceptance onto a committee and starting. Use this time to read everything you can on your subject matter, chat with RCSLT advisors and expert colleagues. Once you are involved in the committee you will be required to keep all discussions confidential so get your questions out early.
6. Keep in contact with RCSLT. They may be privy to information that may affect the guideline before you are.  Although you will not be able to discuss the contents of the guideline you can provide any new information to the committee itself.

The guideline development process

The speech and language therapy profession has a unique perspective within the NICE committee, channelling the voice of those who often do not have one, upholding the standards and values of our profession and providing expert opinion where the research evidence does not meet NICE standards for inclusion.

Once the scope of the NICE guidance has been agreed and the research questions identified then a full evidence review will be conducted. Given the breadth of evidence in some areas and the number of studies that will be screened, you will need to be specific in providing NICE with areas for research. These will be dependent on your guideline’s scope.  The NICE research team will screen thousands of articles for compatibility with the research terms you suggest. They will exclude evidence if it does not meet specific quality standards.

The remaining evidence will be ranked for quality and impact and presented to the committee within a meeting.  Once the evidence is presented the committee will start writing guidelines. Strong NICE recommendations can only be developed when there is strong evidence, despite what your experience tells you.  This can be frustrating at times!  Weaker recommendations can then be created using expert consensus opinion. This is your opportunity to advocate for speech and language therapy. Any recommendations must cover the entire population within scope and you will be supported to ensure that any economic effects of recommendations remain neutral.

Why get involved with NICE guideline development?

Writing NICE guidelines can seem daunting at first. In reality it is an opportunity to learn from a multidisciplinary team of experts in your chosen field, while shaping guidelines for the speech and language therapy profession, the people we serve and our wider colleagues. By being involved with NICE you will advance your own knowledge and gain valuable insight into how national guidelines are created. This chance to support meaningful change across services nationally is unique and for many of us, what we signed up for when becoming an SLT.  Believe in your expertise and knowledge and go for it.