Speech and language therapist job profile

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
eating disorders such as avoidant/restrictive food intake disorder (ARFID)
voice disorders
neurological impairments such as strokes and head injuries
degenerative conditions such as dementia and Parkinson's disease
dysphagia (eating, drinking and swallowing difficulties).

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 and supervise 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 £29,970 (Band 5), rising up the pay scale to £36,483.
With experience, you can earn between £37,338 and £44,962 (Band 6).
Typical salaries for senior or highly specialised SLTs range from £46,148 to £52,809 (Band 7). Some management roles (for example, head of children's therapies/service or professional lead) and consultant SLT roles can attract higher salaries at Band 8.

When looking for jobs, look beyond the job title to the job description to find out what the role involves.

Those working in London and the surrounding areas may receive a high-cost area supplement of between 5% and 20% of their basic salary. 

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.

AfC pay bands differ across the four countries of the UK. Pay negotiation happens annually at different times, so salaries will change when each country agrees their new pay award. Check your country's AfC scales for the most up-to-date NHS salary information. 

Income figures are intended as a guide only.

Working hours

In the NHS, you will typically work 37.5 hours a week, which may include weekend work and on-call rotas to meet the needs of the service.

In other settings you may have to work some evenings or weekends to suit client needs.

There may be opportunities for flexible or part-time work, compressed hours, home or remote working, or job-sharing.

What to expect

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 locations during the week.
You'll typically work in a multidisciplinary team with other professionals such as doctors and nurses, psychologists, teachers, mental health professionals and dietitians.
Jobs are available throughout the UK, although there are more opportunities in cities and towns. With experience, you can take on freelance work or set up in private practice.
Depending on where you work, you may need to travel between client visits.
Competition for entry-level posts is fierce and it's important to be geographically flexible if possible.

Qualifications

To practise as an 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 degrees 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 (at grade 4/C or above), including maths, English language and 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.

In England, it's also possible to do a speech and language therapist degree apprenticeship, combining paid work with part-time study. Currently there are three universities offering the degree apprenticeship - the University of Essex, Birmingham City University and The University of Sheffield. For more information, see the Royal College of Speech and Language Therapists (RCSLT).

If you already have a degree, you can take an accelerated two-year postgraduate speech and language therapy course to qualify. Some course providers will ask for specific subjects relevant to speech and language therapy such as psychology, human biology/biological sciences, language and linguistics, 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. Take a look at a list of courses approved by the HCPC and accredited by the RCSLT.

You also need to complete an enhanced criminal record check, as you will be working with children and young people, and have occupational health clearance.

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

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 as a speech and language therapy assistant/support worker, working with qualified SLTs. Although there are no set entry requirements for this role, you'll typically need good numeracy and literacy skills, such as GCSEs in maths and English, as well as an NVQ, BTEC or equivalent qualification in health and social care.

Skills

You'll need to have:

excellent interpersonal, communication and listening skills in order to gain the clients' trust, and to motivate and reassure people of all ages and backgrounds. Clients may be uncooperative because they're frightened, frustrated or disorientated by their situation
patience, as progress may be slow and involve 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 collaboratively as part of a multidisciplinary team in order to improve the effectiveness of service delivery, as well as independently on your own
organisation and time management skills, with the ability to plan and prioritise your own workload
a flexible approach to work in order to deal with a range of clients in varied settings
the ability to remain calm under pressure
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 a good understanding of what an SLT does when you apply. Try and arrange an observation/work shadowing 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, or the elderly or disabled people, particularly those recovering from a stroke or head injury. Try contacting local nursing or residential care homes, schools, nurseries 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.

Find out more about the different kinds of work experience and internships that are available.

Employers

There are over 18,300 practising 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
courtrooms, 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 work independently or set up in private practice.

Look for job vacancies at:

HealthJobsUK
LG Jobs - jobs in local authorities.
NHS Jobs - for vacancies in England and Wales.
NHSScotland Jobs
RCSLT Jobs - jobs board of the Royal College of Speech and Language Therapists.

Specialist recruitment agencies such as Maxxima and Your World Healthcare also handle vacancies.

If you decide to work in independent practice, you can become a member of the Association of Speech and Language Therapists in Independent Practice (ASLTIP) and have your details added to their register of members. 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. The RCSLT provides a range of support to newly graduated SLTs.

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.

If you're working as a freelance SLT you can also join ASLTIP, which runs events and conferences. Courses cover areas such as setting up an independent practice.

There are also opportunities to undertake a post-registration 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.

Speech and language therapist