Key points

  • Access to an early, timely, responsive and appropriately-skilled speech and language therapy service is a requirement for all people with critical-care needs who have communication and/or swallowing difficulties
  • Speech and language therapists provide specialist knowledge and skills that are vital for optimising the care, experience, safety and outcomes of patients in critical care

What is critical care?

If you are a Speech & Language Therapist, please sign up or log in to access the full version of this content.

This page refers to people who are in hospital and who have critical care needs.

Critical care refers to the level of care given to a group of people who are deemed to be critically ill. Many people who are critically ill have requirements for support for their neurological, medical, respiratory and digestive systems, all of which can impact on their ability to communicate and swallow independently. 

Role of speech and language therapy in critical care

  • Through their detailed knowledge of communication and swallowing, speech and language therapists (SLTs) have a vital role in optimising the care, experience, safety and outcome of patients on critical care
  • Speech and language therapy services should provide equal access to intervention for both communication and swallowing difficulties dependent on clinical need
  • Commissioners should ensure that speech and language therapy services are incorporated in critical care service planning and development. Therefore, speech and language therapy services should be examined to ensure they are appropriately resourced and skilled to provide quality care for people with critical care needs throughout the patient’s pathway, including appropriate provision after discharge from ICU (NICE CG83 2009; Guidelines for the Provision of Intensive Care Services 2016, NCEPOD 2014) This would include funding for appropriate speech and language therapy staffing and equipment, e.g. communication aids
  • Organisations should develop critical care competency programmes for speech and language therapy staff and ensure staff are appropriately trained and competent (GPICS 2016, American Speech and Hearing Association (ASHA, 2009)
  • Speech and language therapy services need to engage in continuous appraisal of service provision and quality via clinical audit or research, e.g. auditing unmet need. Contributions should be made to multi-professional clinical governance and collaborative research
  • Speech and language therapy services for people with critical care needs should be provided within an integrated multidisciplinary context, to ensure the philosophy and goals of intervention are shared, consistent and most effective
  • Communication and swallowing are the responsibility of the whole team. The role of the speech and language therapist is to empower and educate others, as well as providing direct specialist input


RCSLT Position Paper speech and language therapy in adult critical care 2014 


For more videos visit the RCSLT YouTube channel

Related topics


Please contact us with any feedback on these pages.